Harnessing private sector expertise to improve complementary feeding within a regulatory framework: Where is the evidence?

Global recognition that the complex and multicausal problems of malnutrition require all players to collaborate and to invest towards the same objective has led to increased private sector engagement as exemplified through the Scaling Up Nutrition Business Network and mechanisms for blended financing and matched funding, such as the Global Nutrition for Growth Compact. The careful steps made over the past 5 to 10 years have however not taken away or reduced the hesitation and scepticism of the public sector actors towards commercial or even social businesses. Evidence of impact or even a positive contribution of a private sector approach to intermediate nutrition outcomes is still lacking. This commentary aims to discuss the multiple ways in which private sector can leverage its expertise to improve nutrition in general, and complementary feeding in particular. It draws on specific lessons learned in Bangladesh, Côte d'Ivoire, India, Indonesia, and Madagascar on how private sector expertise has contributed, within the boundaries of a regulatory framework, to improve availability, accessibility, affordability, and adequate use of nutritious foods. It concludes that a solid evidence base regarding the contribution of private sector to complementary feeding is still lacking and that the development of a systematic learning agenda is essential to make progress in the area of private sector engagement in nutrition.

Infant Formula: The Addition of Minimum and Maximum Levels of Selenium to Infant Formula and Related Labeling Requirements. Final rule.

The Food and Drug Administration (FDA or we) is amending the regulations on nutrient specifications and labeling for infant formula to add the mineral selenium to the list of required nutrients and to establish minimum and maximum levels of selenium in infant formula.

Change strategies to protect, promote, and support infant and young child feeding.

BACKGROUND: Despite the existence of a strong evidence base for investing in infant and young child feeding (IYCF), sufficiently supported IYCF policies and programs are rare. OBJECTIVE: To develop evidence-based advocacy strategies in Bangladesh, Ethiopia, and Vietnam to enable policy change and to increase investments in and ensure scale-up and sustainability of IYCF programs. METHODS: Situational analysis, formative and opinion leader research, and stakeholder consultations were used to develop three contextualized advocacy strategies. RESULTS: Data were used to determine how IYCF was perceived and prioritized, identify opinion leaders and partners, identify barriers to and opportunities for strengthening commitment, and select messages, materials, and communication channels. Opinion leader research showed that malnutrition was a concern but not a priority for policy action. Where food security was an issue, poverty reduction strategies rather than IYCF programs were viewed as the solution. Few opinion leaders were aware of the importance of the first 1000 days of life. In addition to policy gaps, awareness and implementation of existing policies were limited. This was often complicated by intragovernment conflicts and perspectives. Advocacy messages needed to be evidence based and delivered by credible champions. Engaging medical associations and the media presented an opportunity rarely leveraged in IYCF advocacy. CONCLUSIONS. Although sociopolitical contexts may vary, awareness of the importance of IYCF is an overarching advocacy challenge. Consequently, investments in IYCF programs and policies lag. Evidence-based advocacy design has a potential for impact on national policies, investments, and commitment to implementation and should be used more widely to inform program design.

Three decades of the WHO code and marketing of infant formulas.

PURPOSE OF REVIEW: The International Code of Marketing of Breast Milk Substitutes states that governments, non-governmental organizations, experts, consumers and industry need to cooperate in activities aimed at improving infant nutrition. However, the evidence from the last three decades is that of a series of disputes, legal proceedings and boycotts. The purpose of this review is to assess the overall progress in the implementation of the Code and to examine the problematic areas of monitoring, compliance and governance. RECENT FINDINGS: There are continuing issues of implementation, monitoring and compliance which predominantly reflect weak governance. Many Member States have yet to fully implement the Code recommendations and most States do not have adequate monitoring and reporting mechanisms. Application of the Code in developed countries may be undermined by a lack of consensus on the WHO recommendation of 6 months exclusive breastfeeding. There is evidence of continuing conflict and acrimony, especially between non-government organizations and industry. SUMMARY: Measures need to be taken to encourage the Member States to implement the Code and to establish the governance systems that will not only ensure effective implementation and monitoring of the Code, but also deliver the Code within a spirit of participation, collaboration and trust.

Can a change in policy of complementary infant feeding reduce the risk for type 1 diabetes and celiac disease?

According to recent epidemiologic evidence, introducing solids while infants are still breastfed, and in any case not before the fourth month of life, could have positive impact on immune-related chronic disorders such as Type 1 Diabetes and coeliac disease.

Special Supplemental Nutrition Program for Women, Infants and Children (WIC): miscellaneous vendor-related provisions. Final rule.

This final rule amends the regulations governing the WIC Program to clarify issues that have arisen subsequent to the publication of the WIC Food Delivery Systems Final Rule on December 29, 2000, and to strengthen further the requirements for State vendor management and infant formula cost-containment systems. This rule contains provisions that would prohibit a State agency from requiring an infant formula manufacturer to provide free infant formula or other items in its infant formula rebate bid solicitation and contract; require that a State agency provide an abbreviated administrative review when a vendor receives a WIC civil money penalty (CMP) as a result of a Food Stamp Program (FSP) disqualification; and expand the types of vendor information that a State agency may release for general program purposes. Technical changes were also made to 7 CFR 246.16a due to revisions made to the WIC Food Packages, published in the Federal Register December 6, 2007. This rule updates regulatory citations contained in 7 CFR 246.16a that refer to 7 CFR 246.10.