Understanding the “Code” in Practice
Quinn Goin, CLC
What Counts as Promotion?
When most people hear about the International Code of Marketing of Breast-Milk Substitutes, they imagine commercials or direct advertisements selling formula. But in reality, “promotion” takes many subtle forms, especially in healthcare spaces and on social media platforms. When healthcare providers or lactation professionals participate in these activities, even unintentionally, the consequences for families can be deeply harmful.
What Is Considered Promotion Under the Code?
The Code defines promotion broadly, covering any activity that directly or indirectly encourages the use of breast-milk substitutes, bottles, or teats. Some examples include:
Free samples: Providing families with “just in case” formula samples to take home.
Branded gifts: Handing out pens, diaper bags, or educational materials with a formula company’s logo.
Branded clothing or accessories: Wearing scrubs, lanyards, sweatshirts, or tote bags featuring formula or bottle company logos. This still communicates endorsement.
Sponsorships: Attending or promoting events, trainings, or conferences funded by formula companies.
Biased information: Recommending one formula brand over another without medical justification.
Educational materials: Using pamphlets, apps, or websites created by formula companies as “resources” for families.
Implied endorsement counts. If a healthcare provider or lactation professional speaks positively about a specific brand (“This company is setting the standard for formula” or “I really trust this brand”), it communicates to parents that this brand is superior.
Parents trust authority figures. Families often interpret a provider’s praise as a recommendation, even if it’s framed casually.
The Code emphasizes neutrality. The expectation is that providers give accurate, unbiased information about infant feeding, without steering parents toward a specific brand.
Instead, if families need formula, the Code supports giving evidence-based guidance on how to safely prepare and use any formula, and (when necessary) providing medical criteria for choosing a type (e.g., hydrolyzed, hypoallergenic, preterm formulas) without promoting a specific company’s product.
In short: Even casual “this company is great” comments create brand-specific promotion and can unintentionally undermine the Code.
The Unspoken Impacts of Promotion
When professionals don’t follow the Code, the message families receive is rarely neutral. Even subtle forms of promotion can:
Erode confidence in breastfeeding: A “just in case” sample implies that breastfeeding is likely to fail.
Create brand loyalty: A parent who trusts their provider may assume the recommended brand is safer or better.
Distort informed choice: Marketing materials often highlight benefits while downplaying risks, leaving families without a full picture.
Damage trust: Parents may later learn their guidance was influenced by industry ties rather than their best interests.
These impacts are rarely spoken aloud, but they shape how families feel about feeding, their own capabilities, and the professionals who guide them.
Why Upholding the Code Matters
The Code doesn’t exist to limit access to formula; it exists to protect breastfeeding from commercial pressures. Breastfeeding is uniquely sensitive to outside influence., Once confidence is shaken, it’s often difficult to rebuild.
As healthcare providers and lactation professionals, our role is to ensure families receive evidence-based, unbiased information. When we accept gifts, share branded resources, post branded content, or allow marketing to enter our practice, we compromise that trust. By upholding the Code, we make sure every parent’s decision is truly their own, grounded in support and accurate information, and not shaped by subtle advertising.
Final Thoughts
Promotion isn’t always flashy. It’s often quiet, unspoken, and woven into moments when families are most vulnerable. Recognizing what counts as promotion is the first step. Refusing to participate in it is the next. When we honor the Code, we protect breastfeeding, respect formula as a safe option when needed, and most importantly, uphold families’ right to unbiased, compassionate care.
