Sale of Infant Foods Ethics Committee Singapore (SIFECS) Code of Ethics

Background

Nutrition in early life has been shown to impact later health outcomes and hence, it is imperative that infants are provided with the best start in life through ensuring optimal feeding practices. Singapore supports World Health Organisation’s (WHO) recommendation on exclusive breastfeeding for the first six months of life as it provides all the energy and nutrients needed for optimal growth and development, and protection against infectious and chronic diseases. To meet their evolving nutritional requirements, infants should also receive nutritionally adequate and safe complementary foods no later than six months (or 26 weeks) but not before four months (or 17 weeks).

Breastfeeding provides many established health benefits for infants, mothers, families and society and is widely recognised as an effective measure to decrease infant morbidity and mortality in both developing and industrialised countries. Except in very few specific medical situations, breastfeeding should be universally encouraged and well supported for all mothers and infants. However, if breastfeeding is not possible, infant formula can be a viable alternative, although its sale and distribution should be carried out in such a way as to avoid competing with breast milk and undermining efforts to improve breastfeeding.

In 1979, the Ministry of Health (MOH) thus established the Sale of Infant Foods Ethics Committee, Singapore (SIFECS), to guide the practices of the Infant Food Industry as well as protect and promote the practice of breastfeeding. This was done through the formulation and implementation of the 'Code of Ethics on the Sale of Infant Foods in Singapore', in alignment with the WHO International Code of Marketing of Breast Milk Substitutes. In 2001, the administration of the SIFECS was transferred from MOH to the Health Promotion Board (HPB).

What is the SIFECS Code

The aim of the SIFECS Code is to ensure optimal nutrition for infants, through the protection and promotion of breastfeeding and by ensuring the proper and safe use of breastmilk substitutes when necessary, on the basis of adequate information and through appropriate promotion and distribution practices in Singapore. The Code applies to the promotion and distribution practices of the Infant Food Industry, distributors and retailers, to the public, healthcare personnel and healthcare institutions.

All stakeholders are obligated to adhere to the Code. While there are no regulatory measures to enforce compliance to the Code, there is an ethical obligation for industry players to adhere to the Code. SIFECS is appointed by HPB and consists of representatives from the infant food industry, maternity hospitals, government organisations (Singapore Food Agency (SFA), HPB), health professionals, and relevant NGOs (Association of Breastfeeding Advocates Singapore and the Breastfeeding Mother’s Support Group).

In consultation with the relevant stakeholders and professionals, the SIFECS Code is regularly reviewed and updated by a panel of experts to ensure that it takes into consideration local needs and context, whilst adhering to the spirit of the 69th World Health Assembly Resolution released in 2016. Since 1981, this Code has undergone four revisions to keep up with the changing landscape of the Infant Food Industry and consumer needs. It has served as a useful guide for all who are involved in the promotion of childhood nutrition and distribution of breast milk substitutes in Singapore, by providing parameters on its appropriate marketing and distribution.

The 5^th edition of the SIFECS Code is effective since 1^st January 2019, with a one-year grace period for compliance till 1^st January 2020.

Monitoring & compliance of the SIFECS Code

The successful implementation and monitoring of the SIFECS Code calls for cooperation of all stakeholders, who are responsible for monitoring their activities to ensure adherence to the principles and aims of the Code. Stakeholders who violate any of the articles within the Code will result in any one or combination of actions (Appendix 3) imposed by the Ministry of Health and Health Promotion Board.

HPB and SIFECS will carry out regular monitoring and compliance checks to ensure compliance. This will be accompanied by the issuance of notification letters and warning letters to violators, and the publication of violators and their violations on the HPB website.

Documents

SIFECS Code & related Documents

• Refer to the latest version (updated 5th Revision) of the SIFECS Code of Ethics here - WEF 1 January 2019 (updated 1 December 2020)

• 5th ed. SIFECS Code (2019)

• FAQs for online sales of infant formula

• Previous SIFECS Code (2007)

• Previous SIFECS Code (2002)

• Singapore Food Agency’s Food Regulations

• Singapore Code of Advertising Practice

Monitoring & Compliance

HPB and SIFECS carry out regular monitoring and compliance checks. Violators who fail to complete the required rectifications after receiving notification and warning letters will be published, along with their violations, on the HPB website.