KARACHI: Experts representing the Pakistan Paediatric Association (PPA) and the Pakistan Medical Association (PMA) have expressed grave concern over recent reports indicating a potential significant tax relief for the import and supply of breast milk substitutes in the upcoming federal budget.

In a letter to Federal Minister for National Food Security and Research Rana Tanveer Hussain, the PPA stated that the proposed tax relief threatened mother feeding and child health in Pakistan.

“Such a tax relief on breast milk substitutes risks setting a dangerous precedent that could significantly undermine breastfeeding, a critical pillar of child survival, and development.

“Pakistan is amongst the few countries of the world with a very high death rate of children — neonatal mortality and infant mortality rates are 42/1000, and 62/1000, respectively, while under five mortality rate stands at 74/1000.

If a mother does not breastfeed baby, she is at risk of breast cancer, experts warn

“About 1/3rd of our children are under weight (Punjab 23.5 per cent, Sindh 41.3pc, Khyber Pakhtunkhwa 23.1pc and Balochistan 31pc), while stunting, which is chronic malnutrition, is high (Punjab 36.4pc, Sindh 45.5pc, KP 40pc and Balochistan 46.6pc),” the letter says.

The experts argue that the best food for infants up to six months is exclusively mother’s milk. After that, up to two years is mother’s milk and adequate home food.

“This is also the Quranic advice. The practice of giving breast milk substitutes predispose the child to diarrhoea, pneumonia and malnutrition. Moreover, many children either die or become malnourished. In addition, if a mother does not breastfeed, she is also at risk of breast cancer,” the letter says.

The association also refers to the relevant legislation in place since 2001 — Promotion and Protection of Breast Feeding and Young Child Nutrition — which strictly prohibits promotion of breast milk substitutes.

Raising similar concerns, the PMA in a press statement has urged the government to reject any tax relief on breast milk substitutes and ensure they are not positioned as replacements for breast milk.

“Maintain or even increase the existing excise duty on breast milk substitutes (BMS) to actively discourage their use for non-medical reasons and reinforce public health gains.

“Prioritise the implementation and enforcement of the BMS Code and breastfeeding protection laws through a transparent, evidence-informed process aligned with global and national commitments, before finalising any such decisions.

“Strengthen the enforcement mechanisms for the BMS Code and breastfeeding protection laws to safeguard the rights and well-being of women and children across the nation,” the association stated.

Published in Dawn, May 21st, 2025