KARACHI: The provincial health department has formed a six-member ‘technical committee’ to weigh the law on breastfeeding and recommend amendments to it which have been sought by certain baby food manufacturers, it emerged on Sunday.

Though the law on breastfeeding had been passed by the Sindh Assembly a year and a half ago, it has not yet formally come into effect.

A notification recently issued by the health department named Dr D.S. Akram, a paediatrician, as the committee’s chairman and the chief drug inspector as its secretary to listen to the representatives of baby food manufacturers and marketing association and recommend their suggestions (for amendment to the law) to the health secretary.

It asked the representatives of the baby food manufacturers and marketing association to appear in person before the committee.

Sources in the health department said there were certain clauses in the Sindh Protection of Breastfeeding and Child Nutrition Act 2013, which worried the baby food manufacturers and they wanted them to be amended.

Officials said the health department had constituted the Infant Feeding Board with chairman standing committee on health, Dr Sohrab Sarki, as its chairperson. Two members of the provincial assembly nominated by the speaker, Nasir Hussain Shah and Mehtab Akbar Rashidi; two paediatricians, Dr Ghaffar Billo and Dr Ayesha Minhas, two obstetricians, Dr Shireen Bhutta and Dr Nighat Shah, and Uzair Saboor of the Baby Food Manufacturer and Marketing Association and Dr D.S. Akram from civil society nominated by the health department will be on the committee.

Secretary of health is the board’s secretary while programme manager of the Nutrition Support Programme of the health department has also been nominated as a member. The board has not yet held a formal meeting despite its constitution two months ago.

The breastfeeding act puts certain explicit restrictions on the baby food manufacturers and it envisages penalties as strict as two years of sentence and Rs500,000 fine for the violators.

It says: “No person shall, in any form whatsoever, promote any designated products except as provided for under this act. Similarly, no person shall in any manner assert that any designated product is a substitute for mother’s milk, or that it is equivalent to or comparable with or superior to mother’s milk.”

It restricts all manufacturers and distributors from offering or making gift or contributions of any kind, or pays to any extent for any reason whatsoever, or give any kind of benefit, to a health worker or one’s family, or any personnel employed, directly or indirectly, in a healthcare facility or any member of the board or the employees thereof.

The act also binds the manufacturers and distributors that they cannot donate any designated product and equipment or services related to a designated product free of charge or at low cost to a healthcare facility or offer or give any benefit to a professional association of medical practitioners for this purpose.

No person other than a health worker who is not engaged by a manufacturer or distributor can instruct any user on the need and proper preparation and use of any designated product, provided that a manufacturer or distributor may instruct any user on the need and proper preparation and use of any designated product.

Similarly, no distributor or manufacturer shall for the purposes of one’s business have contact, directly or indirectly, with general public within a healthcare facility.

Neither of them nor any person engaged by them shall produce, nor distribute any educational or informational material relating to infant and young child feeding.

The act also makes it clear that the label of a designated product should not be designed so as not to discourage breastfeeding and should provide necessary information in Urdu about the appropriate use of such product and the age before which a designated product should not be used.

Every container shall have a clear, conspicuous and easily understood message printed on it, or on a label that cannot become separated from it, which should be written in Sindhi and Urdu, and if so desired by the manufacturers, in English as well.

The label should not contain anything that may discourage breastfeeding; contain a conspicuous notice in bold characters in the prescribed height stating “Mother’s milk is best for your baby and helps in preventing diarrhoea and other illnesses”.

Expressions like “maternalised” or “humanised” or equivalent making comparison with mother’s milk are also prohibited.

Besides, the manufacturers or distributors should not show photographs, drawings or graphics, except those to illustrate the correct method of preparation; except for bottles, teats, pacifiers and nipple shields, contain appropriate instructions in Sindhi and Urdu for the correct preparation in words and easily understood graphics, and indicate the ingredients, composition and analysis of a designated product, required storage conditions, batch number and expiry date, and contain any warning as might be prescribed for the implementation of the act in characters of the prescribed height in Sindhi and Urdu.

Published in Dawn, July 28th, 2014