Punching Above Its Weight

BackgroundAlthough a small nation of slightly more than 4 million people, New Zealand's potential influence on infant feeding practices is far reaching.Although there is general support for breastfeeding within New Zealand, infant formula manufacturing and marketing to key overseas markets, particularly East Asia, have reached unprecedented levels.On the domestic front, there has been a recent rise in breastfeeding initiation rates; however, exclusivity and duration rates could be improved, particularly among "vulnerable" populations, including Maori and Pacific groups. 1 Organization for Economic Cooperation and Development data show that "around 2005," New Zealand occupied seventh place among mainly high-income member countries in terms of the proportion of exclusively breastfed infants at 3 months of age, yet exclusivity rates at 6 months were among the lowest.2 Recent New Zealand initiatives to support breastfeeding include the following: in 1997-1998, the New Zealand Breastfeeding Authority was established to oversee the implementation of the Baby-Friendly Hospital and Community Initiatives; in 2006, the (since disbanded) National Breastfeeding Advisory Committee initiated the National Strategic Plan of Action for Breastfeeding 2008-2012 3 ; and around 2009, a breastfeeding promotion campaign was conducted with an emphasis on Maori and Pacific populations.New Zealand is also a signatory to the International Code of Marketing of Breast-Milk Substitutes, with the Ministry of Health handling complaints under 2 voluntary codes: (1) the Code of Practice for Health Workers and (2) the Infant Nutrition Council Code of Practice for the Marketing of Infant Formula (a voluntary agreement between major infant formula manufacturers not to market formula for infants younger than 6 months of age in New Zealand).4 In 2006, the Infant Feeding Association of New Zealand (IFANZ) was established to monitor the implementation of the International Code of Marketing of Breast-Milk Substitutes in the Oceania region.5 There is also legal protection (albeit with restrictive eligibility criteria) for employed mothers through the Employment Relations (Breaks, Infant Feeding and Other Matters) Amendment Act 2008, which provides workplace nursing breaks, and the Paid Parental Leave Act 2010, which provides 14 weeks' paid leave around childbirth.