Table 1 Human rights instruments protecting breastfeeding

1919 (adopted by the International Labour Organisation)

Maternity Convention No. 3 (binding)

Article 3(d)- Two half-hour breaks to breastfeed during working hours.

Articles 3(a), 3(b) and 3(c) provide for the payment of ‘benefits sufficient for the full and healthy maintenance of herself and her child’ for a maternity leave that covers six weeks before and six weeks after birth, as well as medical entitlements.

Article 4- Unlawful to dismiss women during this maternity leave.

1948 (adopted by the UN General Assembly)

Universal Declaration of Human Rights (non-binding)

Article 25- ‘Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family…Motherhood and childhood are entitled to special care and assistance.’

1952 (revised by the ILO)

Maternity Protection Convention No. 103 (binding)

Article 3- Maternity leave of at least 12 weeks, with extensions in the case of medical illness.

Article 4- Compulsory social insurance to ensure cash benefits during maternity leave, and wider medical benefits.

Article 6- Maternity leave dismissal unlawful.

Article 5- Nursing breaks to be part of paid working hours.

1961

European Social Charter (binding)

Article 8- Maternity protections for employed women that include adequate social security benefits for a paid maternity leave of at least 12 weeks, unlawful dismissal during maternity leave, and ‘sufficient time off for’ mothers to nurse their infants.

1966 (adopted by the UN General Assembly)

International Covenant on Economic, Social and Cultural Rights (binding)

Article 10(2)- Special protection should be accorded to mothers during a reasonable period before and after childbirth. During such period working mothers should be accorded paid leave or leave with adequate social security benefits.

Article 11(1)-  The right of everyone to an adequate standard of living for himself and his family, including adequate food.

Article 12(1)- 'The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.'

Article 12(2)(a)- The provision for the reduction of the stillbirth-rate and of infant mortality and for the healthy development of the child.

1979 (adopted by the UN General Assembly)

Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) (binding)

Article 10(h)- Access to specific educational information to help to ensure the health and well-being of families, including information and advice on family planning.

Article 11(1)(f)- ‘The right to protection of health and to safety in working conditions, including the safeguarding of the function of reproduction.’

Article 11(2)(a) and (b)- ‘prohibit, subject to the imposition of sanctions, dismissal on the grounds of pregnancy or of maternity leave and discrimination in dismissals on the basis of marital status’; and require ‘maternity leave with pay or with comparable social benefits without loss of former employment, seniority or social allowances’.

Article 12.2- States Parties shall ensure to women appropriate services in connection with pregnancy, confinement and the post-natal period, granting free services where necessary, as well as adequate nutrition during pregnancy and lactation.

1981 (adopted by the World Health Assembly)

International Code of Marketing of Breast-Milk Substitutes (non-binding) (‘The Code’)

Regulates and restricts infant formula marketing and other breastmilk substitutes to prevent interferences with and discouragement of breastfeeding.

1989 (adopted by the UN General Assembly)

1990 (Date in Force)

Convention on the Rights of the Child (binding)

Article 24(2)(e)- ‘To ensure that all segments of society, in particular parents and children, are informed, have access to education and are supported in the use of basic knowledge of child health and nutrition, the advantages of breastfeeding, hygiene and environmental sanitation and the prevention of accidents’.

Article 24(2)(d)- To ensure appropriate pre-natal and post-natal health care for mothers.

Article 18(2)- States Parties shall render appropriate assistance to parents and legal guardians in the performance of their child-rearing responsibilities and shall ensure the development of institutions, facilities and services for the care of children.

1990 (Organisation of African Unity)

African Charter on the Rights and Welfare of the Child (binding)

Article 2(h)- Repeats article 24(2)(e) of the CRC as above.

Article 2(e)- To ensure appropriate health care for expectant and nursing mothers.

1990 (World Health Organisation and UNICEF)

Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding. Breastfeeding in the 1990s: A Global Initiative (non-binding)

Stated that all women should be enabled to practise exclusive breastfeeding and all infants should be fed exclusively breastmilk up to 4-6 months of age, with continued breastfeeding following this.

Call to action for implementation of initiatives to protect, promote and support breastfeeding, and to remove obstacles to breastfeeding.

1991 (World Health Organisation and UNICEF)

Baby-Friendly Hospital Initiative (BFHI) (non-binding)

Sets out ten steps for the protection, promotion and support of breastfeeding hospitals.

1995 (from the 4^th World Conference on Women)

Beijing Declaration and Platform for Action (non-binding)

Initiatives to protect, promote and support breastfeeding.

1999 (CEDAW Committee)

Interpretation (adopted as General Recommendation No. 24) of CEDAW requirements relating to Women and Health (Article 12)

No interpretative comments relating to breastfeeding.

2000 (revised by the ILO)

2002 (Date in force)

Maternity Protection Convention No. 183 (& Recommendation No. 191) (binding)

Article 4- Maternity Leave entitlements of not less than 14 weeks.

Article 6- Cash benefits for maternity leave to be such that a woman can maintain herself and her child in proper conditions of health and with a suitable standard of living. Medical benefits to include postnatal care and hospitalisation care when necessary

Article 8- Women cannot have their employment terminated on the basis of nursing. Women are guaranteed the right to return to the same position or an equivalent position paid at the same rate at the end of her maternity leave.

Article 9- Maternity cannot be a source of discrimination in employment, including access to employment.

Article 10- (1) A woman shall be provided with the right to one or more daily breaks or a daily reduction of hours of work to breastfeed her child. (2) The period during which nursing breaks or the reduction of daily hours of work are allowed, their number, the duration of nursing breaks and the procedures for the reduction of daily hours of work shall be determined by national law and practice. These breaks or the reduction of daily hours of work shall be counted as working time and remunerated accordingly.

Recommendations No 191- 'frequency and length of nursing breaks should be adapted to particular needs’ on ‘production of medical certificates.’

‘Where practicable and with the agreement of the employer and the woman concerned, it should be possible to combine the time allotted for daily nursing breaks to allow a reduction of hours of work at the beginning or at the end of the working day.’

‘Where practicable, provision should be made for the establishment of facilities for nursing under adequate hygienic conditions at or near the workplace.’

2002 (endorsed by World Health Assembly)

WHO/UNICEF Global Strategy for Infant and Young Child Feeding (non-binding)

Sets out goals and initiatives for the protection, promotion and support of breastfeeding. Recommends exclusive breastfeeding for 6 months, and then up to two years or beyond with the ‘timely introduction of adequate and safe complementary foods’.

2003 (Assembly of the Union)

The Protocol to the African Charter on Human and People’s Rights on the Rights of Women in Africa (‘African Women’s Protocol’) (binding)

Article 14(2)(b)- State duties to establish and strengthen existing prenatal, delivery, and postnatal health and nutritional services for women during pregnancy and while they are breastfeeding.

Article 24- Special Protection of Women in Distress- ensure the right of pregnant or nursing women or women in detention by providing them with an environment which is suitable to their condition and the right to be treated with dignity.

2005 (World Health Organisation and UNICEF)

Innocenti Declaration 2005 (non-binding)

Assessed progress since 1990, and called upon duty-holders to increase efforts to implement the targets in the 1990 Innocenti Declaration and the 2002 Global Strategy.

2013 (CRC Committee)

General Comment No. 15 on the right of the child to enjoy highest attainable standard of health

Noted the significant number of infant deaths caused by ‘suboptimal breastfeeding practices’, and called for ‘particular attention to ensuring full protection and promotion of breastfeeding practices’ in accordance with the WHO recommendations.

Required states to implement and enforce the Code.

Encouraged states to adopt the Baby-Friendly Hospital Initiative.

Stated that private companies should comply with the Code.

2013 (CRC Committee)

General Comment No. 16 on State obligations regarding impact of business sector on children’s rights

Required the enforcement and implementation of the Code by states and relevant World Health Assembly resolutions.

Requires states to create employment conditions within businesses that ‘support and facilitate breastfeeding’.

2016

Joint statement by the UN Special Rapporteurs on the Right to Food, Right to Health, the Working Group on Discrimination against Women in law and in practice, and the Committee on the Rights of the Child in support of increased efforts to promote, support and protect breast-feeding (non-binding)

Recognition of breastfeeding as a human right of the mother and the child, and calls for the end of inappropriate marketing of breast-milk substitutes. Calls for comprehensive and enforceable measures to promote, support and protect breastfeeding.