Sunday 20 May 2012

The WHO Code and KASAD20: Icing

The first part of this post is devoted to discussing the World Health Organisation's International Code of Marketing Breastmilk Substitutes. It aims to contribute to the provision of safe and adequate nutrition for infants, by the protection and promotion of breastfeeding, and by ensuring the proper use of breastmilk substitutes, when these are necessary, on the basis of adequate information and through appropriate marketing and distribution. It was adopted in 1981.

It is important to note that the WHO Code is not 'anti-formula' but is about ensuring that companies should not use unethical marketing practises to sell more formula or other products and in so doing jeopardising infant health.

I would like to take this opportunity to point out to my readers that this is not an 'anti- formula' post, not am I trying to make a judgement on any parent's feeding choices. Indeed, I think that freedom of choice is very important for parents - please don't think that I am saying anything about if you should or shouldn't use formula or dummies or how feeding choice determines if you are a 'good mother' - whatever that means. What this post is about it about exposing the dodgy marketing practises which are used to increase profits - both for formula companies and for chemists.

Many of the advertising techniques which are used by formula companies are unethical, deceptive and endanger health to increase profits. If this was a blog post about the dodgy marketing strategies of tobacco companies, then people would be calling for action to prevent this. Please keep this in mind while following this story - it is about holding large companies responsible for their dishonest methods, not about feeding choice. Breastmilk substitute marketing is even more complex that tobacco advertising, because it deals with a legitimate, needed and life saving (in some cases) product, which enable the companies to get away with much more, to the detriment of our children's health.

The WHO Code covers formula, but also bottles, dummies and solid food (when replacing breastmilk). it is quite comprehensive but, in my opinion, it tells manufactures and retailers to 'play nice' when it comes to advertising. Formula should not be claimed or implied as to be superior or equivalent to breastmilk and there should not be formula advertising to the general public - including toddler formula. Health facilities and health professionals should not promote or recommend a particular formula brand and free samples of formula or items that promote breastmilk substitutes (eg a freebie toy, blankie, pen or changemat with a formula logo should not be provided to pregnant women, new mothers, or health facilities. Pictures or text that idealise the use of breastmilk substitutes should not be used - this includes using a 'shield' logo which implies protection, or made up non-words like 'immunocare' and 'prebiotics'.

I note that many of these measures also apply to medication and cigarettes. There are many rules about the advertising of prescription medication - for example in Australia it cannot be advertised to the general public. This does not mean that the medication is bad, or that it shouldn't be used, or that you are a bad person if you take the medication, but that direct advertising may convince people to take it who don't need to which may place them at risk.

I must admit, I once felt sceptical about these advertising rules. If the product isn't bad, then why is
advertising it bad? It was once explained to me using this analogy.

The marketing regulation is in response to a real problem ie babies dying because of the advertising of infant formula and feeding bottles, it is in response to the UNNECESSARY and INAPPROPRIATE use of these products. If advertising and marketing of infant formula did not result in the unnecessary and inappropriate use of infant formula and feeding bottles then there would be no need for marketing to be regulated. I'll try to develop an example (and this will not be perfect so please forgive- it is an extreme example)...another product that can be useful and necessary in some situations is a urinary catheter. It is used when people have surgery, when they have various medical conditions and in the past even by astronauts (I think!) but there could be a wider market....they could be sold to long haul truck drivers or to people who find it difficult to drag themselves away from the TV or game console for toilet breaks, others who just find it more convenient. Most I would think would say that such usage is inappropriate and potentially dangerous. I think however, that should there be a situation where urinary catheters were marketed for such purposes and the marketing worked (ie people were using them) that it would be reasonable for such marketing to be banned because it was harming people. This not because there is anything wrong with the product itself but because the climate that was created by the marketing had made any marketing harmful. That's what happens with bottles....and bottles are so ingrained all over the world that they are a universally accepted symbol for babies.

The WHO Code is not in itself legally enforceable, and this is the problem. Some of it has been prohibited under legislation in Australia, particularly the MAIF agreement. For more information see here. However, this is not sufficient and the government's failure to enforce the entirety of The WHO Code.

In my next post I will give details of a breach of The WHO Code at my local pharmacy, why I'm concerned about it and what I am doing to change it.



KASAD20: Icing

Materials
- 8 ply yarn in three colours.
- 6 mm knitting needles
- yarn needle to weave in ends, scissors to cut yarn.

Skills and difficulty
Beginner knitter
- cast on
- cast off
- knit stitch
- changing colour at the end of row

Colours
In this example, C1 is pale yellow, C2 is pink and C3 is purple.
Procedure
1. Using C1, cast on 32 stitches.
2. Knit 8 rows (4 ridges) End C1.
3. Knit 8 rows (4 ridge) of C2. End C2.
4. Knit 8 rows (4 ridge) of C3. End C3. 
5. Repeat steps 2, 3 and 4.
6. Repeat step 2.
7. Cast off and leave a 50cm tail.
8. Weave in beginning end and butterfly the tail.


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