Ching Constance, Nguyen Tuan T, Pereira-Kotze Catherine, Zambrano Paul, Baker Phillip, Mathisen Roger
Alive & Thrive, FHI 360 Global Nutrition, Hanoi, Vietnam.
College of Health Sciences, VinUniversity, Hanoi, Vietnam.
Front Pediatr. 2025 Jul 9;13:1553599. doi: 10.3389/fped.2025.1553599. eCollection 2025.
The rise of commercial milk formulas (CMF) consumption by infants and young children raises concerns about their health, development, and survival. Implementing the International Code of Marketing of Breast-milk Substitutes (the Code) and maternity protection policies are two of seven critical policy actions to protect breastfeeding. This study explores the implementation of the Code, maternity protection policies, and CMF consumption in 11 countries in the East Asia Pacific (EAP) region and determines whether there are any correlations.
Data on CMF consumption (from 2006 to 2019 with the projection to 2024 at the global, regional, and national levels), Code implementation scores and the age range covered by national measures, and maternity protection policies were used. Simple linear regressions were conducted to explore correlations between CMF consumption and Code implementation as well as maternity protection.
In 2019, EAP contributed to 63% of global CMF consumption, toddler formula was the highest category, a product that is unnecessary and unsuitable for consumption by young children. Sales volumes and per capita consumption of most CMF types have increased in the region between 2006 and 2024. Currently, nine out of the 11 countries have adopted Code legal measures. Japan and Malaysia have none and are relying on voluntary measures. Australia, New Zealand, and Singapore now have some Code provisions as legal measures (none in 2020). CMF marketing in Australia and New Zealand remain largely voluntary. Only the Philippines and Thailand are covering CMF up to 36 months. Seven of the 11 countries provide the minimum maternity protection entitlements based on International Labour Organization (ILO) standards. As total scores on Code implementation increased, per capita CMF consumption decreased. Most countries with high overall CMF consumption had no Code legal measures. Philippines, with the highest Code implementation score, showed the lowest per capita CMF consumption. Though no correlation found between CMF consumption and paid maternity leave duration, other forms of maternity protection were not included in the regression.
Adopt legal measures to give full effect to the Code as opposed to relying on voluntary measures. Prioritise strengthening comprehensive maternity protection, cultivate intersectoral policy environments.
婴幼儿商业配方奶粉（CMF）消费量的上升引发了人们对其健康、发育和生存的担忧。实施《国际母乳代用品销售守则》（《守则》）和产假保护政策是保护母乳喂养的七项关键政策行动中的两项。本研究探讨了《守则》、产假保护政策在东亚及太平洋地区（EAP）11个国家的实施情况以及CMF的消费情况，并确定它们之间是否存在关联。
使用了关于CMF消费的数据（2006年至2019年，并预测至2024年，涵盖全球、区域和国家层面）、《守则》实施得分以及国家措施所覆盖的年龄范围，还有产假保护政策。进行简单线性回归以探讨CMF消费与《守则》实施以及产假保护之间的关联。
2019年，东亚及太平洋地区的CMF消费量占全球的63%，幼儿配方奶粉是占比最高的类别，这类产品对幼儿来说既不必要也不适合食用。2006年至2024年期间，该地区大多数CMF类型的销量和人均消费量都有所增加。目前，11个国家中有9个国家采取了《守则》法律措施。日本和马来西亚没有采取，而是依靠自愿措施。澳大利亚、新西兰和新加坡目前有一些《守则》条款作为法律措施（2020年时没有）。澳大利亚和新西兰的CMF营销在很大程度上仍属于自愿性质。只有菲律宾和泰国将CMF的适用年龄范围覆盖到36个月。11个国家中有7个国家根据国际劳工组织（ILO）的标准提供了最低限度的产假保护福利。随着《守则》实施的总得分增加，人均CMF消费量下降。大多数CMF总体消费量较高的国家没有《守则》法律措施。《守则》实施得分最高的菲律宾，其人均CMF消费量最低。虽然未发现CMF消费与带薪产假时长之间存在关联，但回归分析中未纳入其他形式的产假保护。
采取法律措施以全面实施《守则》，而非依赖自愿措施。优先加强全面的产假保护，营造跨部门政策环境。
