ISLAMABAD: Pakistan remains among countries facing challenges in effectively restricting aggressive marketing of formula milk and breast milk substitutes, as weak enforcement, loopholes in regulations and growing digital promotion by infant formula companies continue to undermine breastfeeding practices, says a new report by the World Health Organisation (WHO) and Unicef.
The report, titled ‘Marketing of Breast-milk Substitutes: National Implementation of the International Code, Status Report 2026’, warned that although many countries have introduced laws to regulate formula milk marketing, substantial gaps remain globally in banning advertisements, health claims, sponsorships and industry influence over healthcare systems.
While Pakistan was not specifically discussed in the report’s executive findings, public health experts and child health advocates in the country have repeatedly expressed concern over widespread promotion of formula milk through hospitals, pharmacies, healthcare providers and retail outlets, and increasingly through social media and digital platforms.
The WHO and Unicef report revealed that only 37 countries are substantially aligned with the International Code of Marketing of Breast-milk Substitutes, while 46 countries still have no legal measures at all to control unethical marketing of infant formula and related products.
According to the report, countries with stronger laws protecting breastfeeding report significantly higher exclusive breastfeeding rates. Exclusive breastfeeding rates reach 54 per cent in countries substantially aligned with the Code compared to just 24 per cent in countries with no legal measures. Continued breastfeeding at one year also remains much higher in countries with stronger legislation.
Health experts in Pakistan say that the findings are highly relevant for the country, where exclusive breastfeeding rates remain below global targets and formula milk companies continue to market their products through indirect advertising, sponsorships and nutritional claims.
The report stated that as of March 2026, 148 of the 194 WHO member states had adopted at least some legal measures related to the Code, but only 37 countries had laws substantially aligned with international recommendations.
WHO and Unicef identified major weaknesses in national legislation worldwide. Only 34 countries legally define the full scope of the Code by covering products marketed for children up to three years of age, complementary foods improperly marketed for infants, and feeding bottles and teats.
The agencies also highlighted weak protections against conflicts of interest within healthcare systems. Only 35 countries prohibit gifts to health workers from formula milk companies, 24 ban sponsorship of professional meetings and scientific events, while only 56 prohibit free or low-cost supplies of formula milk within healthcare facilities.
Public health specialists in Pakistan have long argued that healthcare facilities and professionals should remain free from commercial influence of formula milk manufacturers, warning that sponsorships, free samples and promotional activities can discourage breastfeeding among mothers.
The report noted that although 91 countries prohibit formula milk advertisements and 119 ban promotional devices at points of sale, only 77 prohibit nutrition and health claims on product labels, while only 32 prohibit informational and educational materials produced by the industry itself.
WHO and Unicef also expressed concern over the rapidly expanding digital marketing of breast milk substitutes. The report said that the World Health Assembly in 2025 had urged countries to strengthen regulation of online and social media marketing of formula milk products, as companies increasingly target parents through digital advertisements, influencers and social media campaigns.
The findings are particularly important for Pakistan, where internet and smartphone penetration has increased rapidly, exposing young parents to online marketing of infant formula and baby feeding products.
The report further noted that breastfeeding remains one of the most effective interventions for protecting maternal and child health, and reducing infections, malnutrition and long term health complications among children.
WHO and Unicef stressed that full implementation of the International Code should be treated as a major public health priority and a human rights obligation for governments worldwide.
