Violations of the International Code of Marketing of Breast-milk Substitutes: Indonesia context.
To measure compliance with the International Code of Marketing of Breast-milk Substitutes ('the Code') in Indonesia.



The study was a cross-sectional survey using the Interagency Group on Breastfeeding Monitoring protocol.



Public and private health facilities in six provinces on Java island in Indonesia.



A total of 874 women (382 pregnant women and 492 breast-feeding mothers of infants below 6 months) and seventy-seven health workers were recruited from eighteen participating health facilities. The study also analysed a total of forty-four labels of breast-milk substitute products, twenty-seven television commercials for growing-up milk (for children >12 months) of nine brands and thirty-four print advertisements of fourteen brands.



The study found that 20 % of the women had received advice and information on the use of breast-milk substitutes and 72 % had seen promotional materials for breast-milk substitutes. About 15 % reported receiving free samples and 16 % received gifts. Nearly a quarter of the health workers confirmed receiving visits from representatives of breast-milk substitute companies. Two health workers reported having received gifts from the companies. The most common labelling violations found were statements or visuals that discouraged breast-feeding and the absence of mention about the consideration of local climate in the expiration date.



Violations of the Code by health workers, breast-milk substitute companies and their representatives were found in all provinces studied. A regular monitoring system should be in place to ensure improved compliance with and enforcement of the Code.
1Independent Public Health Consultant,Jakarta,Indonesia.
Irma
I
Hidayana
2South East Asian Ministers of Education Organization (SEAMEO),Regional Centre for Food and Nutrition (RECFON),Universitas Indonesia,SEAMEO RECFON Building,Campus of UI Salemba,Salemba Raya no. 6,Jakarta 10430,Indonesia.
Judhiastuty
0000-0003-0304-5952
J
Februhartanty
3Department of Communication, Faculty of Social and Political Sciences,Universitas Indonesia,Campus of UI Depok,West Java,Indonesia.
Vida A
VA
Parady
D000329:Advertising / Q000331:legislation & jurisprudence* / Q000592:standards; D000818:Animals; D001942:Breast Feeding; D003430:Cross-Sectional Studies; D005260:Female; D019649:Food Industry / Q000331:legislation & jurisprudence / Q000592:standards; D006268:Health Facilities; D006282:Health Personnel; D006801:Humans; D007214:Indonesia; D007223:Infant; D040541:Marketing / Q000331:legislation & jurisprudence* / Q000592:standards; D008892:Milk; D041941:Milk Substitutes / Q000592:standards*; D011247:Pregnancy
Breast-milk substitutes; Indonesia; The Code; Violations