Challenges in implementing the Infant Feeding Act: Rising use of powdered milk instead of mothers’ breastmilk

Birgunj – At Narayani Hospital’s neonatal ward, some newborns are reportedly relying on powdered milk instead of breastmilk.

Although the message “Initiate breastfeeding within the first two hours is best” is displayed in the hospital, it seems that this advice has little practical impact, raising serious concerns about infant health.

The reasons why doctors recommend powdered milk remain unclear. Health workers are reluctant to speak publicly, but inside sources report that sometimes doctors write the brand name directly for mothers.

There are allegations that active foreign companies influence doctors via foreign trips, seminars, or equipment assistance. However, no concrete evidence has emerged to confirm these claims.

Law exists, but implementation is lacking

Nepal enacted the Breast Milk Substitute (Control of Sales and Distribution) Act in 1992. Under this law, promotion of baby food is prohibited, and doctors or health institutions must not be influenced by formula companies. Yet enforcement appears limited to paper only.

A health worker noted that at Narayani Hospital, infant feeding law inspections have never been conducted, and no teams from local health authorities or the ministry have visited the hospital for supervision.

Hospital development committee chairman Dhiraj Gupta stated, “We allow doctors to work according to their discretion. Unless links with companies are proven, we cannot take action.” This ambiguity and lack of accountability stand out as major issues. As one pediatrician put it, “There is a policy, but no one is held accountable in implementation.”

A mother complained:

“No one explains well to us. When the doctor writes the name of powdered milk, why shouldn’t we feed it?”

Some infants fed powdered milk reportedly develop digestive problems, bloating, diarrhea, or allergies. No institutional data is being collected, which hampers policy-making.

This situation calls for urgent government attention to ensure infant health protection and effective enforcement of the law.