Joint statement advocating for stronger regulation of breast-milk substitutes in Myanmar

October 15, 2020 - Last update: February 10, 2023

The Scaling Up Nutrition (SUN) United Nations Network (UNN) in Myanmar, which brings together UNICEF, FAO, UNFPA, UNOPS, UN Women, WFP and WHO, welcomed with great appreciation the recent announcement by the Myanmar Food and Drug Administration (FDA) that prohibits the consumption of unqualified batches of Nutrilatt brand breastmilk substitute (BMS) infant formula product produced by MS Nutrition Pte Ltd. from Singapore, which were found to be lacking in key nutrients for child growth and development including iron and zinc.

This measure was taken in response to reports that the use of unqualified BMS products has led to the hospitalization of Cambodian children due to severe iron deficiency (anemia), posing a risk of serious illness. Independent testing of the Nutrilatt Infant Formula commissioned by the Royal Government of Cambodia found that levels of iron and zinc, key nutrients for child survival and development, were nearly non-existent in these products, with the product containing less than 5 per cent of the quantity of iron and half the quantity of zinc advertised on the product label, and required by Codex Alimentarius standards. The Royal Government of Cambodia subsequently issued an order to immediately end the import and distribution of Nutrilatt BMS products produced by MS Nutrition Pte Ltd. until further notice and recalled all relevant BMS products with certain batch numbers.

Breastmilk gives children the best start in life and is the ideal food for infants. It is safe, clean and contains antibodies that provide protective immunity against many common childhood illnesses. Breastfeeding significantly improves the health, specifically physical, mental and social development and survival of infants and children. It also contributes to improved health and wellbeing of mothers, both in the short and long term. Breastfed children perform better on intelligence tests, are less likely to be overweight or obese and are less prone to diabetes later in life. In short, breastfeeding is natural, low-cost and the optimal way to feed babies and young children. According to WHO recommendations, which are based on rigorous research, babies should consume breastmilk exclusively until six months of age, without addition of water or any supplementary foods. Only under special circumstances should breastmilk substitutes be considered. At six months of age, a child should be introduced to complementary foods that are healthy, diverse, clean and safe, and prepared appropriately for infant consumption. Where necessary and based on advice from a health professional, appropriate supplementation and use of fortified foods may also be appropriate.

The Government of Myanmar adopted the “Order of Marketing of Formulated Food for Infants and Young Children” (OMFFIYC) in 2014, aiming to support optimal infant and young child feeding practices and to protect infants, young children and mothers from unethical marketing and promotion from Breastmilk Substitute (BMS) companies. The Order also requires designated food products and accessory feeding utensils to comply with relevant Myanmar Standards, Guidelines and International Standards and Guidelines including the Codex Code of Hygiene Practice for Foods for Infants and Children and Codex Alimentarius Commission Standards and Guidelines.

World Health Assembly (WHA) Resolution 69.9 recommends that countries define breastmilk substitutes as any kind of milk (or product that could be used to replace milk, such as fortified soy milk), in either liquid or powdered form, that are specifically marketed for feeding infants and young children up to the age of 36 months (including follow-up formula and growing-up milk).

The SUN UN Network urges companies to refrain from engaging in unhealthy marketing and unethically engaging health care professionals, celebrities and social influencers to promote follow-on or growing-up milk formula products which are not covered by the Order on Marketing of Formulated Food for Infants and Young Children in Myanmar.

Pervasive and unhealthy-promotion of follow-on and growing-up milk has negative impacts on parents’ and family members’ decisions, with misleading information selling infant formula as ‘the same as mother’s milk’ or ‘second best’.

Therefore, member agencies of the SUN UNN, as longstanding partners to the Government of the Republic of the Union of Myanmar, would like to take this opportunity to recommend the following actions to ensure proper child nutrition and protect the lives of children:

To continue tracing batch numbers of the formula milk product referenced above and instruct distributors to mandatorily withdraw these batches from the market with immediate effect under the authority of the Order on Marketing of Formulated Food for Infants and Young Children in Myanmar
To conduct a rapid review of the status of compliance with the Order on Marketing of Formulated Food for Infants and Young Children
To expedite actions towards the enforcement of the Order on Marketing of Formulated Food for Infants and Young Children in Myanmar
To adopt WHA 69.9 into the existing Order

We also reiterate our commitment and support to the Government, particularly around strengthening and implementation of legal and regulatory frameworks pertaining to food and products that are marketed and made available to children in Myanmar, including BMS products, fortified infant cereal and snacks, so as to ensure that children and families can make appropriate, informed choices and have access to safer and affordable nutritious foods.