06 August 2021 — The Parliament of Sierra Leone has approved a bill to regulate the marketing of breastmilk substitutes (also called infant formula) to improve the nutrition of infants and young children. Sierra Leone joins 136 other countries with similar laws to protect and promote breastfeeding, a crucial step in its fight against malnutrition.
In Sierra Leone, 47% of the population is food insecure – 4.7 million people, while 30% of children are stunted. Breastfeeding is a crucial intervention to prevent child malnutrition yet in Sierra Leone only 54% of the babies are exclusively breastfed up to six months, while only 30% continue to be breastfed until two years.
Breastfeeding is one of the most effective ways to ensure child health and survival. If breastfeeding were scaled up to near universal levels, approximately 820,000 child lives would be saved every year. Yet often, mothers are insufficiently counselled and supported to initiate or continue breastfeeding. Through misleading and unethical marketing or commercial advice, many mothers are convinced to end breastfeeding and use breastmilk substitutes instead, with a potentially dramatic impact on their own health and that of their children.
Since 1981, the International Code of Marketing of Breastmilk Substitutes protects breastfeeding and ensures that dedicated rules govern marketing, advertisement and commercial practices related to products intended to feeding babies. This code needs to be transposed into national legislation to be enforceable at the national level. Not all countries do so, and even when they do, national-level regulations are not always as strict and comprehensive as the code.
The new bill in Sierra Leone, approved by parliament on 21 July 2021, is the product of long-lasting efforts, starting in 2012. Collaboration between the Ministry of Health and Ministry of Justice were needed, along with an unprecedented collaboration between the Ministry of Health, the Directorate of Food & Nutrition and parliamentarians, which was convened and supported by the Scaling Up Nutrition platform and FOCUS 1000 (a SUN Pooled Fund grantee) among others.
A three-day workshop with parliamentarians was organised in November 2020 to sensitise parliamentarians on the issue. A previous workshop held in 2017 had facilitated this collaboration, through the support of the SUN Movement Secretariat, Action Against Hunger, UNICEF and partners. Subsequently, nine parliamentarians formed a committee with the mandate to accelerate the pace towards a national code to regulate the sale of breastmilk substitutes across the nation.
Now that the bill has been passed, practices of distributors of infant formula and of health workers need to change to fully adhere to the legislation. This needs to be enforced – a step that many countries struggle with after passing even excellent legislation.
While this positive action in Sierra Leone is much to celebrate, more efforts are needed worldwide to improve breastfeeding protection and promotion and to support mothers on their breastfeeding journey.
 WFP. 2021. Sierra Leone – State of Food Security: Comprehensive Food Security and Vulnerability Analysis, May 2021
 WHO and UNICEF. 2021.