BMJ No 7138 Volume 316
Press Releases Saturday 11 April 1998
BABY MILK MANUFACTURERS ARE BREAKING THE RULES
(Violation of the international code of marketing of breast milk
In a paper published in this week's BMJ Anna Taylor, on behalf of the
The code was introduced to encourage mothers to breast feed their babies,
Taylor concludes that unless there is a commitment to enforce and monitor
Contact:
(Protecting breast feeding from breast milk substitutes)
In an accompanying editorial in this week's BMJ, Dr Anthony Costello,
from
Firstly, Costello advocates that governments should incorporate the
Finally, Costello accepts that, as with antismoking campaigns, legislation
Contact:
HORMONE RELEASING INTRAUTERINE DEVICE MAY BE AN ALTERATIVE TO HYSTERECTOMY
(Open randomised study of use of levonorgestrel releasing intrauterine
Most hysterectomies are carried out to treat excessive menstrual bleeding
As this result persisted beyond twelve months, Lahteenmaki et al conclude
Contact:
(The BMJ's website scales up. Now it provides free access to full
text)
This week, for the very first time, the BMJ will appear in its full
text
The authors go on to admit that they are unsure as to the format the
Contact:
NEED FOR HIV GUIDELINES FOR HEALTH WORKERS IN DEVELOPING COUNTRIES
(Reducing the risk of nosocomial HIV infection in British health workers
In an Education and Debate paper in this week's BMJ Dr Charles Gilks,
The authors note that the prevalence of HIV infection among patients
is
With such effective post-exposure prophylaxis available, if an in-country
Contact:
HORMONE RELEASING INTRAUTERINE DEVICE MAY BE AN ALTERATIVE TO HYSTERECTOMY
FULL TEXT OF THE BMJ NOW AVAILABLE ON THE WORLD WIDE WEB
NEED FOR HIV GUIDELINES FOR HEALTH WORKERS IN DEVELOPING COUNTRIES
BABY MILK MANUFACTURERS ARE BREAKING THE RULES
substitutes: prevalence in four countries)
Interagency Group on Breastfeeding Monitoring, reveals that baby milk
manufacturers are breaking the international code of marketing breast
milk
substitutes, which was adopted by the World Health Assembly in 1981.
in an attempt to prevent 1.5 million needless infant deaths each year
and
to protect mothers from pressure to use substitute breast milk.
Taylor's
study is the first of its kind and covered cities in Bangladesh, Poland,
South Africa and Thailand. The author found that baby milk manufacturers
violate the code by continuing to send free gifts to mothers or indirectly
apply marketing pressure through free gifts or samples to health workers.
the World Health Assembly code nationally, breast feeding will not
be
protected from the commercial pressures from substitute manufacturers.
Professor Andrew Tomkins, Centre for International Child Health, Institute
of Child Health, 30 Guilford Street, London
atomkins{at}ich.ucl.ac.uk
the Institute of Child Health, says that like the tobacco companies,
the
promotional activities of the baby milk manufacturers will only be
brought
into line when they face substantial claims for damages from consumers.
He
suggests that in the meantime countries and monitoring agencies can
take
four steps to prevent commercial pressures being placed on mothers.
articles of the code of marketing substitutes for breast milk into
national
legislation. Secondly, he suggests that monitoring for overt
violations
should be more systematic in an attempt to deter such promotional
activities. The author believes that doctors should also be warned
that
the baby milk manufacturers try to gain endorsement by association
by
allying themselves with prestigious national bodies, such as by sponsoring
a paediatric conference.
and monitoring are only part of the broader strategy to protect mothers
and
that positive public opinion towards breast feeding may be even more
crucial. He says that training midwives and doctors in lactation
counselling (including guidance for HIV positive mothers); breast feeding
advertisements; an extension of the baby friendly hospital initiative
and
financial support for advocacy groups could all go some way to counteract
the manufacturers propaganda.
Dr Anthony Costello, Reader in International Child Health, Institute
of
Child Health, University College, London
a.costello@ich.ucl.ac.uk (best means of contact)
or
Professor Harshpal Sachdev, Division of Clinical Epidemiology. Department
of Paediatrics, Maulana Azad medical College, New Delhi, India
system as alternative to hysterectomy)
(menorrhagia), say Lahteenmaki et al, in this week's BMJ. During
a six
month study in Finland, women scheduled for a hysterectomy to treat
menorrhagia were offered the alternative of a hormone releasing
(levonorgestrel) intrauterine device to control their bleeding and
pain.
At the end of the six month period the authors found that two thirds
(64
per cent) of the women opted to cancel their operation and continue
with
the intrauterine treatment.
that the hormone releasing intrauterine system (which also acts as
a
contraceptive) is an effective and acceptable alternative to hysterectomy
in the treatment of menorrhagia, particularly for sufferers who wish
to
maintain their fertility.
Dr P Lahteenmaki, Leiras Oy, Pansiontie 47, PO Box 415, FIN-20101,
Turku,
Finland
pekka.laehteenmaeki{at}leiras.fi
FULL TEXT OF THE BMJ NOW AVAILABLE ON THE WORLD WIDE WEB
version on the world wide web (www.bmj.com ) with free unrestricted
access
for all. In an editorial, Dr Tony Delamothe and Dr Richard Smith
of the
BMJ discuss the uniqueness of the site and the advantages that it will
bring to surfers. The full text of all BMJ articles will be
available
worldwide at 00.01 London time on Friday mornings. Extra material
will be
posted on the website, including letters for which there is currently
not
space in the paper version. There will be a fully searchable
archive of
the journal back to the beginning of 1997 and eventually to 1994.
Visitors will be able to access around 150 collections of material
on
subjects ranging from asthma through aging to end of life decisions.
They
can also register to be emailed the full contents list of the journal
or
material published on selected topics. All jobs advertised in
the BMJ -
about 700 a week - will also be listed.
website will take in the future; as is usually the case with a new
medium, it is handled like old media until its unique properties
are
recognised and exploited. However, they feel strongly that even
though
two per cent of the world's population are now estimated to be online,
75
per cent of the globe do not even have access to their own telephone.
Delamothe and Smith conclude that if the Internet is to be a means
of
closing the information gap between the developed and developing world
then
organisations such as the BMJ have an obligation to ensure that the
world
wide web lives up to its name.
Dr Richard Smith, Editor, BMJ, BMA House, Tavistock Square, London
100336.3120{at}compuserve.com
working overseas: role of post-exposure prophylaxis)
Liverpool School of Tropical Medicine, and David Wilkinson from the
Medical
Research Council in South Africa examine the issue of the risk of
occupational HIV infection from patient to health worker in the developing
world.
very high in some poorer countries and that such regions tend to lack
the
resources to implement adequate precautions to prevent transmission,
as
well as equipment and facilities. They also observe that health
professionals working in these areas are often relatively inexperienced
(for example medical students undertaking their elective) and therefore
they are more likely to inadvertently expose themselves to blood and
other
body fluids.
employer is not able to afford the cost and storage of such drugs then
should health workers be given a personal supply before travel
Gilks and
Wilkinson conclude that there is a need for realistic, usable guidelines
for both for those working overseas in medical environments and for
their
employers.
Dr Charles Gilks, Senior Lecturer, Division of Tropical Medicine, Liverpool
School of Tropical Medicine, Liverpool
gilks{at}liverpool.ac.uk
For accredited journalists
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