GINA is abiding by the scientific evidence on how to support infant’s nutrition, particularly where  lack of hygiene and malnutrition are subjecting the most vulnerable of children to increased risk of illness and death. 

The International Code of Marketing of Breastmilk Substitutes (the Code) is an international health policy framework to regulate the marketing of breastmilk substitutes in order to protect breastfeeding. It was published by the World Health Organization in 1981 and is an internationally agreed voluntary code of practice.

The Code was written in response to the marketing activities of the infant feeding industry which were promoting formula feeding over breastfeeding, in turn leading to dramatic increases in maternal and infant morbidity (illness) and mortality (death).

The underlying basis for the Code is the belief that the health of babies is so important that the usual rules governing market competition and advertising should not apply to products intended for feeding babies. Therefore, all Governments should legislate to prevent commercial interests from damaging breastfeeding rates and the health of their population.

During an emergency such as in Gaza, the Code still applies. Distributing or promoting anything other than human milk is forbidden unless deemed medically required and after assessment using agreed UNICEF tools. Breast milk substitutes - if indicated following professional assessment - should be offered using pre-made formulas and disposable teats. 

GINA does not engage in providing any breast milk substitute in Gaza, with the exception of medically indicated breastmilk supplements for premature infants in the NICU who are receiving them under strict medical supervision. 

GINA promotes direct breastfeeding from mothers. If the mother is unable to put the baby to her breast directly, our team supports the mother to express her milk into a clean cup by hand, and then demonstrates to her how to feed her baby safely using cups rather than bottles or teats. 

In exceptional circumstances, where hand expression is not yielding an adequate amount of breast milk to meet the demands of a premature infant in the NICU, GINA team can support the mother to pump her breasts while in the hospital using electric or manual pumps that are cleaned and sterilised thoroughly at the hospital. 

GINA acknowledges the controversy around using breast pumps and fortifiers being added to breast milk as the WHO Code does not support their use. However, where the scientific evidence from peer-reviewed articles suggests that premature and low weight infants require supplements our team will support those infants to receive what the neonatologists recommend while keeping a log of the practices that were deemed to violate the WHO Code and explain the context and scientific advice behind it. 

GINA is a volunteer-based non-profit alliance and operates within a small budget, to facilitate our work in Gaza we may accept donations from companies producing premature infants milk fortifiers or breast pumps, we will not promote their products and will seek to purchase those items when possible rather than accept donations as this is considered a violation of the Code.