Introduction: The topic rarely questioned
If you’re a mother, expecting parent, or healthcare professional, you’ve likely heard:
“Just switch to formula — it’s easier.”
Unfortunately, in Bosnia and Herzegovina, such advice is given far too often, even when there is no medical indication for stopping breastfeeding. Behind these seemingly simple suggestions often lie much deeper influences: how the formula industry and commercial interests shape both medical practice and parental decisions — often without people realizing it.
What is the WHO Code?
In 1981, the World Health Organization (WHO) and UNICEF adopted the International Code of Marketing of Breast-Milk Substitutes.
Its purpose is simple: to protect mothers and babies from aggressive marketing practices by formula, bottle, nipple, and breast pump manufacturers.
The Code:
- prohibits direct or indirect advertising of formula to parents and pregnant women;
- prohibits giving formula samples or promotional gifts to healthcare workers and parents;
- prohibits sponsorships of education, conferences, or gifts for healthcare professionals from formula companies.
The Code does not ban medically indicated formula use — it bans unethical marketing.
The statistics that should worry us
According to UNICEF and WHO:
– In Bosnia and Herzegovina, only 15% of infants are exclusively breastfed for, per WHO standards:
- only breastmilk,
- no water, teas, juices, or formula,
- breastfeeding at the breast, continuing up to 2 years and beyond.
In comparison:
– In Norway, exclusive breastfeeding rates reach 80-90% in early infancy.
Are Bosnian mothers less capable of breastfeeding than Norwegian mothers?
Of course not. The difference is not biological — it’s systemic.
Aggressive marketing disguised as “help”
The formula industry generates over $70 billion annually.
Their tactics include:
- Sponsoring healthcare education and conferences;
- Giving free samples and gifts to new mothers;
- Using “expert recommendations” by healthcare workers who often lack proper lactation training.
In Bosnia:
- Pediatricians,
- Visiting nurses (home health),
- Midwives,
…often quickly recommend formula, nipple shields, or bottles at the first sign of breastfeeding difficulties — without sufficient attempt to support or educate the mother.
Even more concerning is the potential conflict of interest:
- some healthcare workers receive financial or non-financial incentives from companies (sponsored trips, gifts, trainings);
- private consultants profit additionally from selling nipple shields, pumps, or feeding equipment.
Why is this dangerous?
Breastfeeding is not just a “choice” — it’s critical for mother and baby health:
- boosts immunity,
- reduces infections, allergies, obesity, diabetes,
- protects maternal health (lower risk of breast and ovarian cancer, type 2 diabetes).
– Unnecessary formula use directly undermines public health.
– When health advice is financially influenced, mothers cannot make fully informed decisions.
We must be clear:
Many excellent, ethical, and dedicated healthcare workers in Bosnia offer outstanding breastfeeding support.
We thank them.
But:
There are also those who — knowingly or not — normalize non-medically indicated formula use, often influenced by commercial interests.
Why Immuno Centar is speaking up
Immuno Center has chosen to fully comply with the WHO Code.
No commissions.
No partnerships with formula companies.
No samples, gifts, or sponsorships.
Only evidence-based counseling, always in the interest of mother and baby.
Knowledge — not marketing.
Profession — not commission.
Counseling — not sales.
References
-
International Confederation of Midwives. Midwives Must Uphold the Ethics of the International Code of Marketing of Breast Milk Substitutes.
Available at: https://internationalmidwives.org/midwives-must-uphold-the-ethics-of-the-international-code-of-marketing-of-breast-milk-substitutes/ -
KellyMom. What Do I Need to Know About the WHO Code?
Available at: https://kellymom.com/bf/advocacy/what-do-i-need-to-know-about-the-who-code/ -
Nestlé. WHO Code.
Available at: https://www.nestle.com/ask-nestle/health-nutrition/answers/who-code -
UNICEF UK Baby Friendly Initiative. The International Code of Marketing of Breastmilk Substitutes — Resources.
Available at: https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/international-code-marketing-breastmilk-substitutes-resources/the-code/ -
World Health Organization (WHO). Guidance on Ending Inappropriate Promotion of Foods for Infants and Young Children. WHO/NMH/NHD/17.1. Geneva: World Health Organization; 2017.
Available at: https://iris.who.int/bitstream/handle/10665/254911/WHO-NMH-NHD-17.1-eng.pdf
Prepared by Immuno Centar – Maternal and Infant Health Sector