The government still could not prepare the necessary rules to enforce the 'Breast Milk Substitutes, Infant Foods, Complementary Infant Foods Manufactured Commercially and the Accessories Related thereto (Regulation of Marketing) Act 2013' even after seven months of its passage.
Experts say the rules could not be formulated for a long period due to 'mysterious' reasons and that the slow pace of enforcement process of the law allows the milk companies to market and promote breast milk substitutes (BMS) from door to door violating every part of the law. Infant formula is increasingly becoming a threat to the healthy growth of the future generation as it lacks sufficient nutritional element like breast milk and contains germs.
The parliament passed the law on September 17, 2013 and the government published gazette on September 22 the same year enforcing it with immediate effect, scrapping the earlier 1984 ordinance.
The law is considered as the world's one of the best laws in favour of children to check aggressive marketing of breast milk substitutes, experts say.
Infant formula is a manufactured food designed and marketed for feeding babies and infants under 12 months of age, usually prepared for bottle-feeding or cup-feeding from powder (mixed with water) or liquid (with or without additional water).
According to the new law, no milk company or baby food manufacturer can advertise for selling its products, commercially produced complementary baby foods and accessories.
It also says the baby food-producing or importing companies cannot use healthcare centres or drug stores for its promotion and advertising and exposure, arrange any kind of competition or other programme for children, sponsor any seminar, symposium, conference, workshop, training, scientific seminar, study tour or higher education or research for the healthcare service providers or provide any kind of economic or other benefit to the health workers.
A nine-member national advisory committee, headed by the health secretary as its chairman has been formed to ensure implementation of the law. Institute of Public Health and Nutrition (IPHN) is the key implementing agency.
Experts say the law needs to be enforced to protect the achievement of 64 per cent of exclusive breastfeeding. Bangladesh needs to achieve 90 per cent to meet the global standard in exclusive breastfeeding rate.
Activists had long been demanding revision of the 1984 ordinance as they attributed aggressive marketing of the baby food companies to the low breastfeeding rate.
Bangladesh is home to the world's one of the most malnourished children with nearly half of its under-5 children underweight and too short for their age.
As per the law children under-five cannot be the target of baby food companies' marketing strategy unlike the BMS Code which usually aims at children under-two. The age limit has been extended in the new law. Also the punishment for violation has been heightened.
If any baby falls sick or dies after consuming baby food, the punishment will be 10 years of imprisonment or a fine of Tk 5.0 million or both.
The punishment for violation is three years of imprisonment or Tk 0.5 million fine or both.
When asked, IPHN director Hedayetul Islam told the FE that the rules were in the law ministry for vetting which will specify who will deal with the cases, it can be IPHN or any individual.
He said the old law was still in place where it is mentioned that IPHN is the implementing agency.
"I am hopeful of completing the process of finalising rules very soon. By this time we have issued letter to the pediatrician association president about the new law," said Mr Islam. “We are going to issue letters to the media mentioning the various clauses of the new law in publishing or broadcasting the advertisement of BMS which goes against the law, he added.
In 2003 World Health Organisation (WHO) and UNICEF published their Global Strategy for Infant and Young Child Feeding, which warned that "lack of breastfeeding-and especially lack of exclusive breastfeeding during the first half-year of life-are important risk factors for infant and childhood morbidity and mortality".
In particular, the use of infant formula in less economically developed countries is linked to poorer health outcomes because of the prevalence of unsanitary preparation conditions, including lack of clean water and sanitizing equipment.
UNICEF estimates that a formula-fed child living in unhygienic conditions is between 6 and 25 times more likely to die of diarrhoea and four times more likely to die of pneumonia than a breastfed child.
