Introduction

It is recognised that breastfeeding is the optimum method of infant feeding from birth and should be encouraged wherever possible. It is also recognised that women have the fundamental right to choose how they wish to feed their infants and every effort should be made to ensure that all the facts are made available to them.

The NZ Infant Formula Marketers' Association (NZIFMA) accepts that some mothers, for a variety of reasons, will choose to provide formula feeding. We recommend that proprietary infant formula should be the alternative to breast-milk for feeding infants up to at least the age of six months, and that the use of proprietary formulas throughout the first year of life is preferable if the infant is not breastfed.

It is agreed also that proper and suitable educational facilities be given to those mothers who do not breastfeed their infants. These educational facilities must be provided by the health care system with the co-operation, where appropriate, of the marketers of infant formula. It is essential that adequate instruction on the use of infant formula is given to mothers, both within the health care system, and in the educational literature and labelling provided by marketers. It is agreed that instructions provided should be simple and easy to comprehend.

This is a self-regulatory Industry Code of Practice which applies to all the companies represented on the Association.

Article 1

Aim of Industry Code

The aim of the Industry 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 infant formula, when this is necessary, on the basis of adequate information and through appropriate marketing.

Article 2

Scope of Industry Code

This Industry Code applies to the marketing in New Zealand of infant formula as suitable to provide the sole source of nourishment for an infant, or to replace part of a breastfeed. It also applies to quality and availability and to information concerning its use.

The WHO Code applies to the marketing of infant formula products. The International Code does not cover infant (complementary) weaning foods as they are not considered to be substitutes for breast-milk. Follow-on formula which is designed for infants over six months of age is not covered by the WHO Code interpretation in New Zealand. Refer to Ministry of Health publication Infant Feeding: Guidelines for New Zealand Health Workers (ISBN 0-478-09487-6).

Article 3

Definitions

For the purposes of the Industry Code the following definitions apply:

Formula Feeding Providing infants with proprietary infant formula, either exclusively or as a supplement to breastfeeding.

Complementary Foods Any food, whether manufactured or locally prepared, suitable as a complement to breast-milk or to infant formula when either becomes insufficient to satisfy the nutritional requirements of the infant. Such food is also commonly called "weaning food" or "breast-milk supplement".

Advertising The communication to the general public of a advertising promotional message through mass media, including television, national or local newspapers, magazines and radio or at point of purchase. Price information at point of sale is excluded for this definition.

Health Care System Governmental, non governmental, or private institutions or organisations engaged, directly or
indirectly, in health care for mothers, infants and pregnant women, and nurseries or child-care institutions. It also includes health workers in private practice. For the purpose of this Code of Practice, the health care system does not include pharmacists or other established sales outlets.

Health Worker A person working in a component of such a health care system, whether professional or non-professional, including voluntary unpaid workers. Infant Formula A food in liquid or powdered form intended for use as a substitute for human milk as the sole source of nutrition for an infant (the Food Regulations 1984).

Labelling Words, particulars, trade marks, brand names, pictorial matter or symbols relating to, and appearing on the packaging of, products that are offered for retail sale, as defined in the Food Regulations 1984.

Marketer A person, corporation or any other entity engaged in the business of distributing and marketing infant formula to wholesale or retail level, whether directly or through an agent.

Marketing Personnel Any persons whose functions involve the marketing of a product or products coming within the scope of this Code.

Marketing Product promotion, distribution, selling, advertising, product public relations and information services.

Sample A single package or small quantity of infant formula provided without cost to the recipient.

Supplies Quantities of a product provided for use over an extended period, free or at a low price, for social purposes, including those provided to families in need.

Article 4

Information and education

4.1

Any information or educational equipment or material provided by marketers should be in conformity with the overall policies promoted by the health care system.

4.2

Informational and educational materials provided by the marketers of infant formula, whether written, audio or visual, dealing with the feeding of infants with infant formula, should include clear information on all of the following points:
" the benefits and superiority of breastfeeding;
" maternal nutrition, and the preparation for and maintenance of breastfeeding;
" the negative effect on breastfeeding of introducing partial bottle-feeding;
" the difficulty of reversing the decision not to breastfeed;
" where needed, the proper use of proprietary infant formula.

4.3

When information and educational materials contain information about the use of infant formula, they should include the social and financial implications of its use, the health hazards of inappropriate foods or feeding methods and, in particular, the health hazards of unnecessary or improper use of infant formula. Such materials should not use any pictures or text which may idealise the use of infant formula.

4.4

Explicit instructions must be given to guide mothers on the appropriate and correct use of infant formula. Members of the health professions, and those members of the public who request it, must be provided with accurate and relevant information about infant formula, which should accurately reflect current knowledge and responsible opinion.

Article 5

Marketing to the general public

5.1

The general advertising of infant formula by NZIFMA companies through mass media, including television, national or local newspapers, magazines and radio or at point of purchase should be avoided.

5.2

NZIFMA will inform retailers of the provisions of the Industry Code and encourage their adherence to it.

5.3

Marketers should not distribute samples of infant formula to pregnant women, mothers of infants or their families.

5.4

Gifts of utensils or other articles that may discourage a mother from breastfeeding her infant should not be distributed to pregnant women or mothers of infants.

5.5

Marketing personnel, in their business capacity, should not seek direct or indirect contact with pregnant women or with parents of infants and young children. This does not prevent appropriately qualified personnel from responding to complaints or unsolicited requests for information. For these requests parents should be referred to a health care professional whenever health advice is required.

Article 6

Contact with the health care system

6.1

Marketers of infant formula should not use any facility of the health care system for the purpose of promoting infant formula. This does not, however, preclude the dissemination of information to health care professionals as provided in Clause 6.2.

6.2

Scientific, factual and relevant information regarding infant formula may be supplied to the health care system, provided that only appropriately trained personnel are used for this purpose.

6.3

The distribution or display of infant formula information and educational materials which meet the requirements of Article 4 of the Industry Code may be allowed in the facilities of the health care system, but this will be at the discretion of the health care system authorities concerned, whose agreement must be obtained.

6.4

The demonstration of the correct preparation and use of infant formula to all mothers who need this should be the responsibility of the health care system. Any assistance for this purpose may be given by marketing personnel, if requested by and used under the supervision of the health care system authorities.

6.5

Quantities of infant formula can be purchased by health care organisations at wholesale prices. However, the distribution of bulk quantities of free product to the health care system should be avoided, other than in circumstances of emergency relief or poverty.

The donated supplies may be given but only under the following conditions:
" for infants who are medically required to be fed, or are already being fed infant formula;
" the supply is continued for as long as the infants concerned need it;
" the supply is not used as a sales inducement.

6.6

The donation to the health care system of equipment and materials, should be made only in accordance with the normal policies of the health care system. Such equipment or materials may only bear the donating company's name or logo, but should not refer to a proprietary product that is within the scope of this Code, and should be distributed only through the health care system.

6.7

The use by the health care system of "professional service representatives", "mothercraft nurses" or similar personnel, provided or paid for by manufacturers or distributors, shall not be permitted.

Article 7

Contact with health workers

7.1

Information provided by marketers to health workers regarding infant formula should be restricted to scientific and factual matters and such information should not imply or create a belief that formula feeding is equivalent or superior to breastfeeding. Such information should include that specified in Articles 4.2 and 4.3 of this Code.

7.2

No financial or material inducement to promote infant formula should be offered to health workers or members of their families. However, articles of general utility may be distributed to members of the health care system, provided they are inexpensive and relevant to the practice of medicine and general health care.

7.3

Samples of infant formula, or of equipment or utensils for the preparation or use of infant formula, should be provided only for the purposes of professional evaluation and research, or for the education of mothers.

Article 8

Persons engaged in marketing

8.1

Marketers should inform all marketing personnel of the provisions of the Industry Code and of their responsibilities under it.

8.2

Marketing personnel should not perform educational functions about infant formula to pregnant women or mothers of infants, unless requested to do so by and under the supervision of the health worker.

Article 9

Labelling

9.1

Labelling of infant formula should comply with the requirements of the Food Regulations 1984 or the Australian Food Standards Code.

9.2

Labelling of infant formula should be designed to provide the necessary information about the appropriate use of the product and to conform to the provisions of Article 4.4 of the Industry Code.

9.3

Each container of infant formula offered for retail sale should comply with the appropriate food regulations and carry a clear and conspicuous message:
" stating the superiority of breast-feeding;
" recommending that personnel of the health care system should be consulted about infant feeding;
" giving clear and precise instructions on the use of infant formula;
" warning against the hazards of inappropriate preparation.

9.4

The provision of a contact point and telephone number on the product label is permissible.

9.5

Specialised infant formula for metabolic disorders are exempt from the provisions under Article 9.2 of the Industry Code.

Article 10

Compositional quality

10.1

Infant formula must comply with the general provisions of the Food Regulations 1984 or the Australian Food Standards Code.

Article 11

Implementation

11.1

The NZIFMA shall be responsible for monitoring the provisions of the Code.

11.2

All persons concerned in any way with the marketing of infant formula should co-operate with the NZIFMA in order to ensure that the provisions of the Industry Code are applied as effectively as possible.

Article 12

Complaints Process

12.1

Any complaints about possible contraventions of the Industry Code should be made in writing and sent to the Food and Nutrition Section, Public Health Group, Ministry of Health, PO Box 5013, Wellington. The complaint will be forwarded to the executive director of the NZIFMA if it relates to a possible breach of the Industry Code by an infant NZIFMA company.

12.2

NZIFMA companies are required to respond within twenty days to any complaint received. If the issue is not resolved to the complainant's satisfaction, it will be submitted to the compliance panel comprising:

• an independent chairperson;
• a representative from the health sector;
• a representative from the infant formula industry.

A Ministry of Health observer attends the meetings.

12.3

The panel is convened up to four times a year if necessary to consider the complaints./P>

12.4

Either party is able to appeal a decision of the compliance panel if new information is submitted. A representative from the health sector acting as an adjudicator will be appointed to carry out this function. The adjudicator's decision is final and binding.

12.5

All parties connected with any complaint will be notified immediately of the outcome of the compliance panel's decision and, if necessary, the appeal adjudicator's decision.

12.6

In accordance with the Letter of Understanding, the NZIFMA will report twice yearly to the Ministry on the outcome of the complaints received by the Ministry or NZIFMA and considered by the panel or the adjudicator.

12.7

All compliance decisions will be reviewed by the Food and Nutrition Advisory Committee (FNAC). This committee will also consider any recommendations made by the compliance panel or the adjudicator.

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