On 21 May 2021, the World celebrates the 40th Anniversary of the adoption of the International Code of Marketing of Breast-milk Substitutes (otherwise known as the Code) by the 34th World Health Assembly on 21 May 1981. The Code aims to contribute to the provision of safe and adequate nutrition for infants by the protection and promotion of breast-feeding, and by ensuring the proper use of breast-milk substitutes by restricting promotions that target the general public, mothers and health workers.

In collaboration with UNICEF, the WHO, and partners, the Global Breastfeeding Collective will host a virtual meeting via Zoom to celebrate this  milestone. This event aims to engage and equip delegates to strengthen country-level implementation of the Code, including its subsequent resolutions. As one in a series of major global events in the Year of Action on Nutrition, midway through the United Nations (UN) Decade of Action on Nutrition, the Code at 40 Celebration will focus on protecting babies’ health by calling on governments to make specific, measurable, time-bound (SMART) policy commitments to implement and enforce the Code, including subsequent resolutions. This event marks the beginning of a year of outputs and events focusing on strengthening implementation of the Code undertaken by the Global Breastfeeding Collective partners and its partner organisations.

Chad has launched "Stronger With Breastmilk Only," the regional exclusive breastfeeding initiative, becoming the eighth country to do so in the West and Central Africa.

Timing, as they say, is everything. UNICEF Niger approached MDM Crew, on behalf of the Stronger With Breastmilk Only initiative’s national committee, to contribute a song to the initiative when one of the group’s rappers was about to welcome the birth of his daughter. “That helped me to learn a lot about the recommended breastfeeding practices, the benefits of breastmilk and importance of exclusive breastfeeding for the baby and the mother and society in general,” said Majesty Sool, one of the two brothers that make up the popular group from Niger. “So, our song was a form of self-awareness raising on breastfeeding and it really helped me.”

These Frequently Asked Questions (FAQs) have been developed jointly by the IFE Core Group, UNICEF, and the COVID-19 Infant Feeding Working Group based on the most recent World Health Organisation (WHO) Strategic Advisory Group of Experts on Immunization (SAGE) Interim recommendations for use of the Pfizer–BioNTech COVID-19 vaccine, BNT162b2, under Emergency Use Listing, the Interim recommendations for use of the Moderna mRNA-1273 vaccine against COVID-19, and the Interim recommendations for use of the AZD1222 (ChAdOx1-S [recombinant]) vaccine against COVID-19 developed by Oxford University and AstraZeneca.

“The benefits of breastfeeding not just to nutrition but also to survival and long-term outcomes are so overwhelming... You want to double triple duty nutrition interventions and if there is one nutrition intervention that is a guarantee to impacting long-term optimal growth and prevention of obesity and overweight, that is breastfeeding. So, I think breastfeeding needs to be supported a hundred percent, particularly exclusive breastfeeding early with the interventions that are important to help mothers undertake.” Said Dr. Zulfiqar A. Bhutta as part of the launch event of The Lancet 2021 Series on Maternal & Child Undernutrition Progress. Check out the event recording here.

New evidence laid out by Emily Keats and colleagues1 shows that promotion of exclusive and continued breastfeeding, combined with other direct nutrition interventions remains essential to overcome maternal and child malnutrition.

The ‘Stronger With Breastmilk Only’ initiative calls for support at all levels from government leaders and policy makers, programme managers, businesses, health workers, communities and families to support breastfeeding – one of the smartest investments a country can make.

1 Emily C Keats, Jai K Das, Rehana A Salam, Zohra S Lassi, Aamer Imdad, Robert E Black, et al. Effective interventions to address maternal and child malnutrition: un update of the evidence. Lancet 2021; published online March 7. https://doi.org/10.1016/S2352-4642(20)30274-1.

The ‘’Stronger With Breastmilk Only’’ initiative remains a priority for the French Muskoka Fund.  Breastfeeding is not just a woman's business. Let's work together to ensure that babies under six months of age receive only breastmilk.

UPDATE from Johns Hopkins Center for Humanitarian Health, 10 March 2021

All publications provide emerging evidence related to COVID-19 and

• Breastfeeding and breast milk (including viral transmission and vaccination issues)
• Infant feeding recommendations
• Feeding difficulties in newborns

While there were several recent reviews of international literature, this update also adds emerging evidence from the United States, China, the United Kingdom, Saudi Arabia, Indonesia, Sweden, Italy, Israel, Morocco, India, and Vietnam.

Several articles discuss contradictory information that mothers receive regarding the safety of COVID-19 vaccination while breastfeeding. Some express concern that many breastfeeding women may either be excluded from COVID-19 vaccination, choose to stop breastfeeding, or choose not to disclose their breastfeeding status, thus missing the opportunity to have their progress recorded.

Four studies published in the last two weeks detected the transfer of anti-SARS-CoV-2 antibodies in breast milk after mothers received an mRNA-based COVID-19 vaccine. Researchers examined types of antibodies present, neutralizing activity, and timing of their presence after the first and second vaccine doses. Some researchers concluded that the immune response seen in breast milk samples post-vaccination was more robust than the immune response after natural SARS-CoV-2 infection.

Other publications discuss the consequences of separating newborns from their mothers. A case series of 70 neonates born to women with SARS-CoV-2 infection across 16 US hospitals examined how many neonates were separated from their mothers, the reasons for separation, and how the infants were fed during separation. The authors note that many hospital practices and policies were inconsistent with infant feeding recommendations by the American Academy of Pediatricians and the US Centers for Disease Control and Prevention.

The next update for this specific repository will be on Wednesday 7 April 2021. To subscribe to receive updates on this repository (updated every two weeks) or our general repository on COVID-19, Maternal and Child Health, Nutrition (updated weekly), please contact Mija Ververs at mververs@jhu.edu or mververs@cdc.gov.

Manufacturers of breastmilk substitutes (BMS) are capitalizing on COVID-19 fears by using health claims and misinformation about breastfeeding to deceive millions of breastfeeding mothers into using breastmilk substitutes, a new review of their promotional materials and activities in major world regions shows.

The webinar held in early December gathered more than 200 stakeholders from across the region who learned how the ‘Stronger With Breastmilk Only’ initiative is supporting health officials to increase rates of exclusive breastfeeding.