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Background <p>Inadequate breastfeeding practices increase the risk of mortality and morbidity among infants and young children. Recent global estimates suggest that inadequate breastfeeding is responsible for approximately 16% of child deaths worldwide each year, highlighting the ongoing need to strengthen support systems to improve infant and young child feeding practice in Bangladesh, 55% of infants under six months of age are exclusively breastfed. To improve breastfeeding rates and reduce infant mortality, the Government of Bangladesh enacted the Breast-milk Substitute (BMS) Act, 2013, and its Rules in 2017 to regulate the marketing of breast-milk substitutes.</p> Objectives <p>The study aimed to assess violations of the BMS Act, 2013, and Rules, 2017, focusing on the types, actors, and settings of such violations, while also raising awareness of the Act among key stakeholders and the public.</p> Method <p>We carried out a cross-sectional survey among 818 retail outlets and pharmacies; 969 baby-friendly hospitals; 969 doctors, nurses, and other health professionals; and 315 mothers with children aged 0–24 months across eight divisions of Bangladesh from August 2016 to December 2019. Data were collected through structured interviews, direct observations, and document reviews using a modified International Baby Food Action Network–International Code Documentation Centre (IBFAN–ICDC) protocol and the BFHI Hospital External Assessment Tool.</p> Results <p>All retail outlets surveyed (<i>n</i> = 818) sold unregistered BMS products, and all displayed promotional materials. These retail outlets also sold BMS products labeled with health and nutrition claims. In hospitals, 25.5% of doctors (<i>n</i> = 247) and 21.3% of nurses and other health professionals (<i>n</i> = 206) promoted BMS without medical indication. Additionally, 32.0% of health facilities (<i>n</i> = 300) reported providing financial incentives to health professionals to participate in events sponsored by BMS manufacturers. Furthermore, BMS manufacturers violated the BMS Act, 2013 by establishing breastfeeding corners in 164 hospitals (17.5%).</p> Conclusion <p>This study identified extensive violations of the BMS Act 2013 and its Rules 2017 in Bangladesh, revealing unethical promotion and distribution of BMS. Health professionals in BFHI-trained hospitals played a significant role in these breaches, contributing to the erosion of breastfeeding practices. Urgent monitoring and enforcement are needed to protect infant health and uphold national regulations.</p>

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Violations of the breast milk substitutes act-2013 and its rules − 2017 in Bangladesh

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月20日

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  • S. K. Roy,
  • Khurshid Jahan,
  • Saria Tasnim,
  • Soofia Khatoon,
  • Nurul Alam,
  • Tofail Md. Alamgir Azad,
  • Shahidul Islam,
  • Khadijatul Cubra

摘要

Background

Inadequate breastfeeding practices increase the risk of mortality and morbidity among infants and young children. Recent global estimates suggest that inadequate breastfeeding is responsible for approximately 16% of child deaths worldwide each year, highlighting the ongoing need to strengthen support systems to improve infant and young child feeding practice in Bangladesh, 55% of infants under six months of age are exclusively breastfed. To improve breastfeeding rates and reduce infant mortality, the Government of Bangladesh enacted the Breast-milk Substitute (BMS) Act, 2013, and its Rules in 2017 to regulate the marketing of breast-milk substitutes.

Objectives

The study aimed to assess violations of the BMS Act, 2013, and Rules, 2017, focusing on the types, actors, and settings of such violations, while also raising awareness of the Act among key stakeholders and the public.

Method

We carried out a cross-sectional survey among 818 retail outlets and pharmacies; 969 baby-friendly hospitals; 969 doctors, nurses, and other health professionals; and 315 mothers with children aged 0–24 months across eight divisions of Bangladesh from August 2016 to December 2019. Data were collected through structured interviews, direct observations, and document reviews using a modified International Baby Food Action Network–International Code Documentation Centre (IBFAN–ICDC) protocol and the BFHI Hospital External Assessment Tool.

Results

All retail outlets surveyed (n = 818) sold unregistered BMS products, and all displayed promotional materials. These retail outlets also sold BMS products labeled with health and nutrition claims. In hospitals, 25.5% of doctors (n = 247) and 21.3% of nurses and other health professionals (n = 206) promoted BMS without medical indication. Additionally, 32.0% of health facilities (n = 300) reported providing financial incentives to health professionals to participate in events sponsored by BMS manufacturers. Furthermore, BMS manufacturers violated the BMS Act, 2013 by establishing breastfeeding corners in 164 hospitals (17.5%).

Conclusion

This study identified extensive violations of the BMS Act 2013 and its Rules 2017 in Bangladesh, revealing unethical promotion and distribution of BMS. Health professionals in BFHI-trained hospitals played a significant role in these breaches, contributing to the erosion of breastfeeding practices. Urgent monitoring and enforcement are needed to protect infant health and uphold national regulations.