Abstract
Although processed complementary foods (PCFs) can contribute to meeting dietary needs of infants and young children, it has been associated with unethical marketing practices, which undermine practice of exclusive breastfeeding for 6 months. The current study assessed PCF labeling compliance to the International Code of Marketing of Breast Milk Substitutes (CMBMS) and the National Breastfeeding Promotion Regulation (NBPR) in Ghana. A variety of PCF were purchased from child welfare clinics, fuel station shops, supermarkets, "mother/baby" care shops, and pharmacies in the La and Osu Klottey sub-metropolitan areas in Accra. The labels were evaluated against the best practice indicators proposed by the Maternal, Infant, and Young Child Nutrition Working Group based on the international CMBMS, and also indicators based on the NBPR. An overall compliance estimate was determined based on intensity of compliance to the indicators. The PCF purchased included cereal-based products, fruit juices, fruit and vegetable purees, milk-based products, and combination meals; 75% of PCF were imported. One hundred of the 108 products identified were labeled in English and thus included in analysis. None of the products complied with all labeling requirements of CMBMS or NBPR; 84 and 17% of product labels complied with at least 50% of NBPR and 50% of CMBMS indicators, respectively. Only 5% of labels had content indicating importance of exclusive breastfeeding for 6 months. Additionally, only 5% of labels warned against the hazard of introducing PCF earlier than 6 months as required by the NBPR. Labeling of most PCF sold by selected retailers in Accra did not comply with NBPR and CMBMS labeling requirements. Enforcement of local law on labeling of PCF is urgently needed.
Highlights
The World Health Organization (WHO) recommends exclusive breastfeeding of infants for the first 6 months of life [1, 2]
Compliance was judged against indicators proposed by the Maternal, Infant, and Young Child Nutrition Working Group (MIYCN-WG) of the “10-Year Strategy to Reduce Vitamin and Mineral Deficiencies,” as well as indicators identified from the National Breastfeeding Promotion Regulation (NBPR), which is based on the international Code of Marketing of Breast Milk Substitutes (CMBMS) on Marketing of Breast milk substitutes in Accra, Ghana [24]
Labeling practices of particular concern were those on images of children as well as messages that support and protect breastfeeding
Summary
The World Health Organization (WHO) recommends exclusive breastfeeding of infants for the first 6 months of life [1, 2]. This is because breast milk provides adequate amounts of the essential nutrients needed by infants up to the first 6 months of life [3,4,5,6]. Processed complementary foods (PCFs) can contribute to meeting dietary needs of infants and young children, it has been associated with unethical marketing practices, which undermine practice of exclusive breastfeeding for 6 months. The current study assessed PCF labeling compliance to the International Code of Marketing of Breast Milk Substitutes (CMBMS) and the National Breastfeeding Promotion Regulation (NBPR) in Ghana
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