WRITTEN QUESTION E-1256/01

by Bart Staes (Verts/ALE) to the Commission

(26 April 2001)

Subject: European Union attitude to the promotion of breast-feeding

Directive 91/321/EEC(1) of 14 May 1991 on the approximation of the laws of the Member States relating to infant formulae and follow-on formulae constitutes a version of the International Code of Marketing of Breast-Milk Substitutes drawn up by the World Health Organisation and Unicef and adopted by the World Health Assembly in 1981.

In its Resolution 49.15, adopted in 1996, the WHO urges the adoption of accompanying measures to prohibit the promotion of breast-milk substitutes for children under the age of six months so that mothers are encouraged to continue breastfeeding. Under normal circumstances, a new resolution would have been adopted last year, but the debate about the maintenance or scrapping of the six-month limit was held over to next May's Assembly.

Will the Commission argue at the forthcoming World Health Assembly for accompanying measures to prohibit the promotion of breast-milk substitutes for children under the age of six months, as called for in Resolution 49.15? If not, why will it not implement Resolution 49.15 of the World Health Organisation, given the significance of breast-feeding for health?

(1) OJ L 175, 4.7.1991, p. 35.

Answer given by Mr Byrne on behalf of the Commission

(5 July 2001)

The aim of the International Code of Marketing of Breast-milk Substitutes World Health Organisation (WHO) Code) is to contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breast-feeding, and by ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution.

According to advice of our Scientific Committee for Food(1) and to the established WHO policy on infant feeding(2), breast-milk alone is usually adequate to sustain the normal infant's nutritional requirements during the first four to six months of life. Current Community legislation is in accordance with the above scientific advice and the relevant aims of the WHO Code.

The new Resolution discussed and adopted in the 54th World Health Assembly (WHA), held in May 2001, concerned the protection, promotion and support of exclusive breastfeeding for a certain period. The debate on this point took very much into account the outcome of an Expert Consultation on the optimal duration of exclusive breastfeeding, convened by the WHO on 28-30 March 2001. The adopted Resolution refers to its recommendations and conclusions.

The Expert Consultation noted that available good scientific evidence on the subject is limited (out of 3000 references considered, the review was based on two small controlled trials and 17 observational studies that varied in both quality and geographic provenance).

In summary it concluded that:

- Exclusive breastfeeding to six months confers several benefits on the infant and the mother. The most important potential advantage is the protective effect against diarrhoea, particularly in developing-country settings.

- Exclusive breastfeeding to six months can lead to iron deficiency in susceptible infants and depending on maternal iron status (this can be a problem both in developing and developed countries).

- The available data are insufficient to exclude several other potential risks with exclusive breastfeeding for six months, including growth faltering and other micronutrient deficiencies.

Based on the above conclusions the Expert Consultation recommends exclusive breastfeeding for six months, with the introduction of complementary foods and continued breastfeeding thereafter, noting however that this recommendation applies to populations rather than individual infants. The Expert Consultation also recognises that some mothers will be unable to, or choose not to, follow this recommendation and recommends that these mothers should be supported to optimise their infant's nutrition.

In view of the above the Commission will be arguing in the future for measures giving effect to the conclusions and recommendations of the Expert Consultation that take into account the specific individual needs of infants and mothers.

(1) Reports of the Scientific Committee for Food, 14th series, opinion expressed on 27.4.1983 and 24th series, opinion on essential requirements for weaning foods, expressed on 27.10.1989 and 30.3.1990.

(2) See paragraph 7 of WHO Report on Global strategy for infant and young child feeding (doc. A54/7, 9.4.2001).