Compliance with the Code and subsequent relevant resolutions is a key requirement of the revitalized BFHI and the Ten Steps to Successful Breastfeeding, though the implementation of the Code has always been a key part of the “promote, protect and support” approach to improving infant feeding practices.
While national legislation implementing the Code varies from non-existent to minimal to effective, for facilities seeking to fully apply the 10 Steps to Successful Breastfeeding, the key obligations need to be made operational in several areas that don’t necessarily normally involve themselves in the protection of breastfeeding.
The Code and the BFHI documents are especially useful as guidance for writing policy and procedures within an organization that may not have previously had strong protections in place to reduce commercial influence on care.
In a world where many professionals find themselves with only enough time to catch the headline or (at best) the abstract of a new finding, the Code is often said to be too complicated, legalistic or simply too hard to understand. It is true that the legal and ethical concepts that it lays are not necessarily the stuff of everyday clinical practice for many of us. Assessing conflicts of interest takes some focussed time to gather all the relevant information and think through the impact of a decision to participate or not in a particular scenario - time we are rarely afforded.
Whether the Code applies to a situation or not does not change the obligation as a professional (or organization) to prevent conflicts of interest and their impact on the families served. The Code, when it is relevant, makes the process easier and more robust.
Michelle Pensa Branco MPH IBCLC
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Last Updated: September 2018