WRITTEN QUESTION E-1256/01 by Bart Staes (Verts/ALE) to the Commission. European Union attitude to the promotion of breast-feeding.
Date: 2001-04-26
Institutions: European Parliament, Provisional data
Subjects: World Health Organisation, baby food, code of conduct, foodstuffs legislation, health policy, mother's milk

C 350 E/102

Official Journal of the European Communities

EN

11.12.2001

(2001/C 350 E/111)

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(cid:146)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 (cid:145)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(cid:146).

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(cid:146)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:

(cid:129) 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.

(cid:129) 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).

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(cid:129) 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
infants. The Expert
however that this recommendation applies to populations rather than individual
Consultation also recognises that some mothers will be unable to, or choose not
follow this
recommendation and recommends that these mothers should be supported to optimise their infant(cid:146)s
nutrition.

to,

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).

(2001/C 350 E/112)

WRITTEN QUESTION E-1257/01

by Bart Staes (Verts/ALE) to the Commission

(26 April 2001)

Subject: Distortions of competition in the Belgian Federation caused by failure to comply with Directive

91/321/EEC

In the Belgian Federation, Directive 91/321/EEC (1) of 14 May 1991 is implemented by the Royal Decree
of 27 December 1993 relating to advertisements for infant formulae and the distribution of free samples.
The Directive constitutes an incomplete version of the International Code of Marketing of Breast-Milk
Substitutes drawn up by the World Health Organisation and Unicef and adopted in 1981 by the World
Health Assembly.

In answer to a question about interpretation tabled by Senator Sabine de Bethune, the Federal Minister for
Consumer Affairs, Public Health and the Environment, Mrs Magda Aelvoet, stated on 22 March that
promotional campaigns undertaken by manufacturers of infant formulae were in breach of that Decree.
The practice of distributing free samples (cid:129) which equates to an advertisement for infant formulae (cid:129) seems
to be still very common in Belgian maternity wards. That approach is not only illegal,
is also
incompatible with the EC Treaty (as regards distortion of competition) and thwarts the core objective of
the WHO Code, i.e. the promotion of breast-feeding on health grounds.

it

1.
Does the Commission acknowledge that the approach taken by manufacturers and distributors of
infant formulae in the Belgian Federation is in breach of Directive 91/321/EEC of 14 May 1991? If not,
what are the grounds on which the Commission deems the distribution of free samples of infant formulae
by manufacturers and distributors in Belgian maternity wards to be legal and in accordance with Directive
91/321/EEC of 14 May 1991? If so, will it ensure that, henceforth, Directive 91/321/EEC of 14 May 1991
is fully and properly applied in the Belgian Federation?

2. Will the Commission take action so that the entire WHO Code may be incorporated into Directive
91/321/EEC? If not, why will it take no action so that the entire WHO Code may be incorporated into
Directive 91/321/EEC?

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