Bottle-feeding legislation in Papua New Guinea.

Healthworkers in Papua New Guinea were alerted to the serious risks of bottlefeeding and a follow-up study of 15 low birthweight bottlefed infants revealed that 14 were dead after 1 year. Following a 1975 survey by Lambert and Basford which revealed that 35% of those children in Post Moresby under age 2 were bottlefed the Health Department attempted to reduce the extent of artificial feeding. Breastfeeding was promoted by health personnel and efforts were made to ensure that lactation was well underway when infants and mothers were discharged from the hospital. Also infant formula manufacturers were prohibited from distributing their products at hospitals. Numerous other opportunities to encourage breastfeeding were also utilized. Legislation was ultimately introduced which restricted the sale of feeding bottles and teats and made them available only by prescription. This Baby Feed Supplies Control Act passed in February 1977 made it necessary to obtain a prescription from a registered healthworker who must insure that: 1) it is the babys best interest; 2) the guardian knows how to clean the bottle properly; 3) the guardian knows how to mix formula of correct strength and appropriate facilities to do so; and 4) the formula not used be refrigerated. Health inspectors help to enforce the act and pharmacists must maintain a record for all bottles and teats issued which were prescribed. Follow-up to examine the impact of this legislation shows that there was a highly significant (P < 0.001) decline in artificial feeding between 1975 and 1979 and a significant decline (P < 0.05) in the proportion of artificially-fed infants below 80% weight in this same time period (69% to 35%). Thus legislation has succeeded in reversing the trend towards more artificially-fed infants.