The WHO Code and its effect on breast-feeding promotion in hospitals.

This review outlines the development of the Code on the Marketing of Breast Milk Substitutes, and the impact of the Code and factors that led to its development on breast-feeding promotion in hospitals. Breast-feeding prevalence and duration in Canada, and influencing factors, are discussed. Hospital routines that may discourage breast-feeding are described, along with changes or official statements regarding the routines, where these are available. Areas in which further efforts are needed include routine use of supplements, routine before- and after-feed weighing of the baby, attitudes of health professionals, nursing staffing approaches, disruption of breast-feeding due to minor problems in the mother or baby, and written materials given to parents. Groups of mothers requiring special attention include Indian and Inuit mothers, mothers of preterm infants, and adolescent or young teenage mothers.