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Is the WHO Creating Unnecessary Confusion Over Breast Milk Substitutes?

Forsyth, Stewart

Journal of Pediatric Gastroenterology and Nutrition: December 2018 - Volume 67 - Issue 6 - p 760–762
doi: 10.1097/MPG.0000000000002098
Short Communication: Nutrition

ABSTRACT A recent statement by WHO that “breast milk substitutes should be understood to include any milks …that are specifically marketed for feeding infants and young children up to the age of 3 years” differs significantly from the definition in the International Code which states “a breast milk substitute is any food being marketed or otherwise presented as a partial or total replacement for breast milk, whether or not suitable for that purpose.” The new interpretation, which lacks consultation and endorsement, is also ambiguous, with the boundaries between breast milk substitutes and complementary foods being blurred during the first 3 years of life. The logical definitions of breast milk substitutes and complementary foods contained within the Code should be maintained and inappropriate promotion of foods and fluids for infants and young children should be addressed through effective regulation of composition and labelling standards.

University of Dundee, Scotland, UK.

Address correspondence and reprint requests to Stewart Forsyth, MD, 1 Ellieslea Road, West Ferry, Dundee DD5 1JG, UK (e-mail:

Received 24 April, 2018

Accepted 19 June, 2018

S.F. has received research grants from government, charitable organisations, and industry; and consultancy fees and honoraria from government and industry, including companies that produce infant formula. He currently receives consultancy fees from DSM Nutritional Products, an international ingredient supplier.

© 2018 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology,