Regarding the Bill Proposed to Amend the “Act Relating to the Control of Sale and Distribution of Objects that Substitute Mother’s Milk, 2049”

Ensuring Every Infant’s Right to Safe Nutrition While Protecting Breastfeeding

We have taken positive note of the Bill proposed by the Ministry of Health and Population to amend the “Act Relating to the Control of Sale and Distribution of Objects that Substitute Mother’s Milk, 2049”, with the objective of making the existing legal provisions in the health sector more timely, scientific, and effective. The Government’s initiative to update the existing legal framework in line with changing health needs, scientific knowledge, and international practices is welcome.

Breastfeeding is a vital foundation for optimal nutrition and health protection during the early stages of an infant’s life. Therefore, protecting and promoting breastfeeding, while effectively regulating inappropriate commercial advertising and marketing, is an important responsibility of the State. Nepal also needs to continue strengthening its legal framework in this regard.

However, protecting breastfeeding and ensuring the nutritional rights of infants who are unable to receive breast milk are not contradictory objectives. Where an infant cannot receive breast milk due to medical conditions, the mother’s health, absence of the mother, special health conditions of the newborn, emergencies, or other genuine circumstances, the infant should not be deprived of safe, quality-assured, and scientifically validated alternative nutrition.

The World Health Organization’s International Code of Marketing of Breast-milk Substitutes also gives priority to the protection and promotion of breastfeeding while recognizing that breast-milk substitutes should be available when necessary to ensure safe and adequate nutrition and that their appropriate use should be ensured. It also clearly emphasizes that the availability and use of such products should be protected from inappropriate commercial promotion.

Therefore, the proposed legal amendment should clearly establish the principle of “responsible, regulated, and transparent availability” rather than relying solely on a concept of “prohibition of sale.” Products approved for infant nutrition and meeting prescribed registration and quality standards should not become instruments of uncontrolled marketing, digital promotion, or commercial inducement. Instead, they should be made available within a regulated framework that ensures quality, safety, and accountability.

In this context, pharmacies can be established not as channels for commercial promotion, but as important mechanisms for controlled and responsible distribution. The sale and distribution of such products through pharmacies that meet the prescribed standards can help ensure product legitimacy, batch number, expiry date, storage conditions, source of procurement, and sales records. This can further strengthen transparency, quality assurance, and traceability throughout the supply chain.

Accordingly, even where such products are distributed through pharmacies, the law may clearly prohibit advertising, discounts, gifts, incentives, promotional displays, or any other commercial activities that discourage breastfeeding. At the same time, approved products should remain safely and conveniently available to infants with genuine nutritional needs. Such an approach would help maintain the balance emphasized by the WHO and international practice: protecting breastfeeding without compromising necessary access to appropriate alternatives when required.

At a time when access to, supply of, and distribution systems for infant and child nutrition products are expanding rapidly in global markets, Nepal should avoid choosing between blanket prohibition and uncontrolled commercialization. Instead, it is necessary to adopt a system based on scientific regulation, quality assurance, transparent supply chains, and child-centred distribution. The WHO’s global review in 2026 has likewise highlighted the importance of strengthening legal measures relating to advertising, labelling, health systems, monitoring, and enforcement across countries.

Therefore, we urge the concerned authorities to give particular consideration to the following:

1. The fundamental policy of protecting and promoting breastfeeding as the optimal form of infant nutrition should not be compromised.

2. No situation should be created in which infants who are unable to receive breast milk are deprived of necessary alternative nutrition.

3. Rather than imposing an absolute prohibition on the availability of approved infant nutrition products that meet prescribed quality standards, a regulated and responsible distribution system should be developed.

4. Qualified pharmacies meeting the required standards should be incorporated as organized channels for the controlled sale and distribution of such products.

5. Even when products are sold through pharmacies, clear provisions should prohibit any form of inappropriate advertising, commercial incentives, discounts, gifts, or promotional activities that may undermine or discourage breastfeeding.

6. A robust traceability system should be developed by systematically maintaining records relating to product registration, quality, labelling, batch numbers, expiry dates, storage conditions, sources of supply, and sales.

7. The availability of products required for infants with special nutritional needs should be addressed with particular sensitivity from the perspective of public health and child nutrition.

Our clear position is that the purpose of the law should not be to allow market products to replace breast milk. At the same time, it should also ensure that no infant is deprived of safe and necessary nutrition when breast milk cannot be provided.

Therefore, the proposed amendment should be advanced through a comprehensive approach encompassing “protection of breastfeeding, the nutritional rights of infants, product safety, regulated distribution, and responsible marketing.”

The best interests of the infant should remain at the centre of the law-making process. Breastfeeding must be protected, while the nutritional rights of infants in special circumstances must not be compromised.

We expect that, through meaningful dialogue and cooperation among the Government, regulatory authorities, health professionals, nutrition experts, pharmacy professionals, manufacturers, and other relevant stakeholders, Nepal will establish a scientific, practical, and child-centred legal framework on this important matter.