The Cambodian government translated the International Code of Marketing of Breastmilk Substitutes (the Code) into national legislation. The Sub-Decree on Marketing of Products for Infant and Young Child Feeding (Sub-Decree 133) was passed 2005.
Sub-Decree 133 is classified by WHO, UNICEF and IFBAN as “Moderately Aligned with the Code”, setting a foundation to protect infants and young children under two from the misleading and inappropriate promotion of infant formula and other BMS.
In this photo, four-month-old baby is fed with formula milk by her grandmother while her mom is away for work.
However, a study to assess the promotion and consumption of commercial products for infants and young children in Phnom Penh revealed that 86% of mothers reported observing commercial promotions for BMS, 19.0% reported observing infant and young child food product brands or logos on health facility equipment, and 18.4% reported receiving a recommendation from a health professional to use BMS.
These data are clear signs that companies are violating the Code and creating conflicts of interest in the health system. Actions like these risk babies’ health and undermine their parents’ right to accurate information about infant feeding.
A recent study by Alive & Thrive reveals the industry is now using the COVID-19 pandemic to capitalize on families’ fears and sell their products.
Acting on the complaints, the Cambodian Directorate-General of the Competition and Fraud Repression Department (Ministry of Commerce) conducted an investigation of these products and found that the formula contained only a fraction of the iron and zinc required by law - putting babies' health at serious risk with a grave Code violation.
In this photo, The General Department of Consumer Protection, Competition, and Fraud Repression (CCF) officials inspect supermarkets, pharmacies, and stores to confiscate Nutrilatt formula in Tbong Khmum province. Photo Credit: Phnom Penh Post.
The Ministry of Commerce ordered Nutrilatt to halt the sale of products in Cambodia. CCF, with the support of Helen Keller International (HKI), UNICEF and Alive & Thrive continued testing 60 other formula milk brands, revealing that many exaggerated the amounts of iron and zinc their products contained. Out of the 60 BMS brands tested, one in five brands had low levels of iron compared to what they advertised on their labels, while one in ten brands had exaggerated the levels of zinc on their labels. This photo shows brands going through a blind test with black ink, revealing their levels of iron and zinc.
The scope of the law was extended to regulate the marketing of products for children up to 36 months of age; closing loopholes that allow BMS companies to engage with health workers; monitoring and enforcing the Code on social media; and increasing penalties for violators.
Simultaneously, together with HKI, A&T is working to improve on-going monitoring of Sub-Decree 133 through capacity building for Point-of-Sale monitoring for CCF staff at provincial level.
These inspectors are trained to use checklists to identify Code violations by shop owners, which were then recorded for further enforcment.
More than 100 inspectors, from each of Cambodia’s 25 provinces, were trained to monitor Code violations. Training included visits to shops, where inspectors used checklists to identify violations of the Code.
Alive & Thrive’s work to support the enforcement of BMS regulations earned an official letter of appreciation from CCF and Cambodia's Ministry of Commerce.
Alive & Thrive and partners, including HKI, UNICEF, and WHO, are actively involving in efforts to ensure that the national code and supportive policies are fully implemented and enforced to support breastfeeding - protecting our most vulnerable lives.
Alive & Thrive