Legislation and Policies Examples

Example: Malta developed a National Breastfeeding Policy for 2015 - 2020 that includes an Action Plan to implement the policy. The policy was developed through an extensive national process of consultation. The policy “recognizes the biological, health, social, cultural, environmental and economic importance of breastfeeding. It also provides direction for priorities and action for the Maltese government at all levels working in partnership with mothers and society to promote, protect, support and maintain breastfeeding.”

Score: Major Progress
Domain- Existence: Yes
Domain- Effective: National policy on breastfeeding is written and as it is a government document, it is officially adopted/approved by the government.

Example: The Philippine IYCF Strategic Plan of Action 2011-2106 is an example of an action plan with measurable, time-bound objectives and detail on the actions, interventions, collaborations and internal structural arrangements necessary to achieve the strategic breastfeeding objectives within the national health strategy.

Score: Partial Progress
Domain- Existence: Yes
Domain- Quality: National breastfeeding plan of action contains measurable and time bound objectives/targets and, according to the WBTi report, some strategies have been implemented.

Example: On May 22, 2014, the Brazilian Ministry of Health put forth a decree (#1,153) that acknowledges the Baby Friendly Hospital Initiative (BFHI). In Brazil, BFHI is a strategy to promote, protect and support breastfeeding as well as the health of children and women within the Unified Health System. This Decree includes the BFHI as a Health Program in the context of other Health Policies and Programs as the Program for Humanization of Prenatal and birth, Health Care Network, Stork Network, Primary Care for the Family Health Strategy and the Program of Community Health Agents. It is consistent with the BFHI WHO/UNICEF global criteria.

Score: Major Progress
Domain- Existence: Yes
Domain- Effective: Adopted and part of the unified health system strategies
Domain- Quality: Consistent with BFHI WHO/UNICEF global criteria

Example: In the case of Mexico, the adopted Code only covers formulas for children 0-6 months, even though WHO Code states that it should cover all formulas and products for children <24 months. In the most recent Health Assembly, WHO modified the Code to cover children <36 months. Mexico’s regulatory framework includes some provisions related to labelling, promotion and distribution of breastmilk substitutes. However, there are important provisions not included, such as regulatory measures at points of sale and advertising in the media. Also, there are not effective mechanisms for monitoring, reporting and sanctioning against non-compliance. When applied, the sanctions are so insignificant in monetary terms and in the image of companies producing breastmilk substitutes that they are not sufficient to discourage behaviors that violate the Code.

Score: Minimal Progress
Domain- Existence: Yes
Domain- Effective: Includes some provisions of the Code but not but not all of them
Domain- Quality: No provisions for a monitoring system, penalties for violations, and reporting of violators.

Example: In Brazil, the penalties for non-compliance the Code regulation are applied in a progressive manner, according to the severity and frequency of the infraction. The infractions will be punished, alternatively or cumulatively, with: 1) Warning, 2) Fine, 3) Product disuse, 4) Interdiction, 5) Suspension of product sale, 6) Cancellation of product registration, 7) Prohibition of advertising, 8) Imposition of rectifying message, and 9) Suspension of advertising and publicity. The fine is applied in accordance with infraction classification in (a) mild, (b) serious, and (c) extremely serious. In the case of recidivism, the fines will be applied twice. In each sphere of Government (Federal, State, Municipal and District), National Agency of Sanitary Surveillance (Anvisa) has a competent body for the judgment of Administrative Proceedings instituted by its Sanitary Authorities in accordance with the provisions of the Law.

Monitoring of compliance with the legislation to protect breastfeeding has been done in the country every year since 2006. For example, in 2014, IBFAN Brazil in partnership with IDEC (Brazilian Institute of Consumer Protection) conducted a monitoring survey and found 114 infractions to NBCAL (Brazilian Standard for Commercialization of Foods for Infants and Toddlers, Teats Pacifiers and Bottles). In total, 35 companies (located in 10 cities of 5 Brazilian states) were notified of irregularities in products for children under two years that discourage breastfeeding. The results of the monitoring survey were sent to Ministry of Health and National Agency of Sanitary Surveillance (Anvisa) responsible for applying the penalties. Every year Anvisa provide a report about infractions and penalties related with NBCAL.

Score: Major Progress
Domain- Coverage: Clear evidence of enforcement undertaken throughout the whole country.

Examples: Brazil has signed the first two ILO Conventions, but not the third one. However, the Maternity Protection Law in Brazil covers and, in some cases, surpasses the latest ILO convention recommendations. The law provides for full paid maternal leave (120 to 180 days), full paid paternal leave (5-20 days), environmental protection against risk during pregnancy and breastfeeding, breastfeeding breaks, and job protection (a woman cannot be fired 4 months after delivery).

Score: Major Progress
Domain- Existence: Yes
Domain- Quality: Maternity protection laws all meet or exceed the provisions of the Maternity Protection Convention, 2000 (No 183).

In Mexico, the ILO Conventions no.103 and no.183 have not been ratified but national legislation does provide for 12 weeks of paid leave at 100% of previous earnings.

Score: Minimal Progress
Domain- Existence: No, Convention has not been ratified.
Domain- Quality: A few maternity protection laws meet the provisions of the Maternity Protection Convention, 2000 (No 183).

Example: In Sweden, pregnant woman’s benefits can be paid as early as 60 days (two months) into the pregnancy and continue up to 11 days before the due date. The amount received is roughly 80 per cent of the mother’s daily pay and is paid by the Swedish Social Insurance Agency. Parents are entitled to 480 days of paid parental leave when a child is born or adopted. For 390 of the days, parents are entitled to nearly 80% of their normal pay. The remaining 90 days are paid at a flat rate.

Score: Major Progress
Domain- Existence: Yes
Domain- Quality: Maternity leave is more than 14 weeks and paid in excess of 2/3 of previous earnings.

Examples: In New Zealand, under the law, employers are obligated to provide appropriate facilities within the workplace for breastfeeding employees. Employers are also required to provide additional paid breaks for employees that wish to breastfeeding during working hours.

Score: Major Progress
Domain- Existence: Yes
Domain- Coverage: National legislation protects and supports breastfeeding/ expressing breaks at work.

In Canada, only the provinces of Ontario and British Columbia have laws protecting breastfeeding breaks at work.

Score: Partial Progress
Domain- Existence: Yes
Domain- Coverage: Local legislation only.

Example: Uruguayan law states that any worker, during pregnancy or breastfeeding, is entitled to a temporary change of job if the health of the mother or child may be affected. This temporary change of job can not affect the woman’s salary and she may not be suspended, fired, or adversely affected in her labor rights or delayed in her career.

Score: Major Progress
Domain- Existence: Yes
Domain- Coverage: National legislation supports worksite accommodations, including providing alternate work at the same wage until the mother is no longer breastfeeding.

Example: In Mexico, the BBF Committee reviewed the relevant legislation and carried out in-depth interviews with the Secretary of Labor and Social Welfare, the Director of the National Institute of Women, and the President of the National Council for Preventing Discrimination. The national legislation includes all the provisions of protection against the discrimination specified by this benchmark.

However, there is evidence to suggest that the legislation is ineffective and that violations do occur: according to the National Survey on the Dynamics of Relationships in Households 2011, 3.1% of the workers were dismissed or their salary was reduced due to their pregnancy. Data from the Council to Prevent and Eliminate Discrimination in Mexico City indicate that from 2013 to 2015 there were 423 complaints, of which 163 (38.5%) were related to the dismissal upon returning from maternity leave or during the lactation period.

The BBF Committee recommended the following to address the violations:

• Implement monitoring, supervision and reporting measures to ensure that all maternity protection and non-discrimination rights that are stipulated in the national legal framework are met.
• Periodically publish statistical information on employers' compliance with these obligations.
• Provide information to working women to enable them to enforce their rights.

Score: Major Progress
Domain- Existence: Yes
Domain- Quality: National legislation prohibits employment discrimination against pregnant and breastfeeding women including against termination, same position and payment upon return from maternity leave, and no pregnancy test upon hiring.