FAQs

EO 51 is the National Code of Marketing of Breastmilk Substitutes, Breastmilk Supplements, and Other Related Products. EO 51 is popularly known as the Philippine Milk Code of 1986. EO 51 regulates the marketing of infant milk formula, other milk products, foods and beverages, as well as feeding bottles and teats. The entities covered are milk companies that own and operate the product, including their manufacturers, distributors, marketing firms as well as their representatives.
The aim of the Code is to contribute to the provision of safe and adequate nutrition for infants by the protection and promotion of breastfeeding and by ensuring the proper use of breastmilk substitutes and breastmilk supplements when these are necessary, on the basis of adequate information and through appropriate marketing and distribution (Section 2, EO 51).
To regulate milk industries in aggressively marketing and advertising milk formulas in the Philippines specifically marketing efforts targeted to mothers.
It means product promotion, distribution, selling, advertising, product public relations, and information services.
EO 51 regulates the marketing, and practices related to the use of breastmilk substitutes, including infant formula; other milk products, foods and beverages, including bottle-fed complementary foods, for use as a partial or total replacement of breastmilk; and feeding bottles and teats. It also applies to their quality and availability, and to information concerning their use.
  1. Specific products and other products when marketed as partial or total replacement of breastmilk:
    • Breastmilk substitutes including infant formula
    • Feeding bottles and teats
      When marketed or otherwise represented to be suitable, with or without modification for use as a partial or total replacement of breastmilk:
    • Other milk products
    • Foods and beverages
    • Bottle-fed complementary foods
  2. The quality and availability, and information concerning the use of these covered products:

    The law mandates companies to provide the necessary information about the appropriate use of their products.

    However, the following vital information on the use of infant formula is rarely provided on product labelling thereof:
    • Infant formula is not a sterile product and is associated with contamination of harmful bacteria like Enterobacter sakazakii. This bacterium is associated with threatening risks of meningitis and sepsis, mostly to infants aged 28 days and below.
    • Among other precautions, the World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations (FAO) emphasizes that water no cooler than 70°C should be used to prepare infant feeds from powdered formula. This temperature will kill harmful bacteria that may be present in powdered formula.
EO 51 and its Revised Implementing Rules and Regulations (RIRR) defines entities covered as:
  1. Distributors (Section 4d EO 51, Section 5g RIRR);
  2. Manufacturers (Section 4j EO 51, Section 5r RIRR);
  3. Marketing personnel (Section 41 EO 51, Section 5 RIRR);
  4. Marketing firms (Section 5s RIRR); and
  5. Milk companies, which can be manufacturers or distributors (RIRR Section 5w).
The IAC is composed of representatives from the Department of Health (DOH), the Department of Trade and Industry (DTI), the Department of Justice (DOJ) and the Department of Social Welfare and Development (DSWD). Under the DOH, the Food and Drug Administration (FDA), formerly the Bureau of Food and Drugs (BFAD), is the designated secretariat of the IAC. This Committee is integral to the proper implementation of EO 51.
  1. Health and nutritional claims, content of materials
  2. Gifts of any sort
  3. Marketing in the health care system
  4. Marketing to health workers
  5. Classes, seminars and other activities
  6. Point-of-sale advertising
  7. Donations
Products should not create belief that bottle feeding is equivalent or superior to breastfeeding. As such, labels should indicate that breastmilk is best and there is no substitute for it. Statements like "with DHA and ARA" or "fortified with lutein" are not allowed.

Statements like "improves intelligence", "for better eyesight" and "for better nutrition" are no longer allowed. Images of babies and their caregivers on the labels are also prohibited.
It means any form of financial, personal or commercial reward, inducement, incentives and other favours provided directly or indirectly, with or without company name or logo or product or brand name. (Section 5j, RIRR; Section 20, RIRR)

  • Who are prohibited from giving "gifts of any sort"?
    Milk companies/manufacturers, distributors, and representatives of products covered by EO 51 are prohibited from giving any sort of gift (Section 5j and 21, RIRR). This provision in the Milk Code itself and the RIRR considerably expands the coverage of the prohibition beyond the actual formula milk product violating the Code, to the parent company manufacturing them.

  • Who are prohibited from receiving "gifts of any sort"?
    Covered entities cannot give gifts of any sort to any member of the general public, hospitals, and other health facilities, including their personnel and members of their families (Section 21, RIRR). It can be seen that other violations flow logically from these premises. It must be emphasized that the Code does not prohibit the actual sale of covered products, but the marketing and misleading advertising thereof.
Milk companies or their representatives are prohibited from using the health workers and the health care system in the dissemination, distribution and promotion of covered products (Section 20, RIRR).

This means there can be no display of marketing materials (e.g. placards, posters, toys, record books) or actual display of products covered by the Code in any healthcare facility. "Professional service" representatives, "mothercraft nurses" or similar personnel, provided or paid for by manufacturers or distributors is prohibited (Section 7d, EO 51).
"No financial or material inducements or gifts of any sort to promote products within the scope of this code shall be offered or given by milk companies nor accepted by health workers and/ or members of their families" (Section 18, RIRR). "No assistance, support, logistics or training from milk companies may be permitted" (Section 32, RIRR).
To avoid the use of these venues to market their brands or company names and to protect women and pregnant mothers, companies of covered products are prohibited from conducting or being involved in any breastfeeding promotion or education, production of information materials on breastfeeding, or holding/ participating in classes or seminars for women and children and other similar activities whether with the intention to promote covered products or not (Section 22, 34, RIRR).

This prohibition covers activities related to other products used as partial breastmilk substitutes (such as follow-up milk formula and complementary foods). The Code also covers feeding bottles and teats. Thus, manufacturers and distributors of feeding bottles and teats also cannot hold classes for women and children, whether related to infant feeding or not.
There shall be no point of sale advertising, giving of samples or any promotion devices to induce sales directly to the consumers at the retail level, such as special displays, discount coupons, premiums, rebates, special sales, bonus and tie-in sales, loss-leaders, prices or gifts for the products within the scope of this Code (Section 23, RIRR).
Donations of products, materials, defined and covered under EO 51 and its IRR are strictly prohibited (Section 51, RIRR).

Donations of products and equipment not falling within the scope ofEO 51 given by regulated entities, whether in kind or in cash, may only be coursed through the IAC which shall determine if the donation will be accepted or not (Section 52, RIRR).

RA 10028 mandates workplace compliance with EO 51, prohibiting companies with products under the scope of the law from making any donations for lactation stations and activities related to breastfeeding promotion in the workplace.

Donations are also prohibited in times of disasters and calamities.13 Indiscriminate distribution of these products put infants at greater risk of illness and death.14.15 Provision for the needs of bottle-feeding infants in disaster areas will be met in accordance with guidelines set by the DOH, UNICEF and WHO.
A Milk Code monitor:
  • Monitors compliance and problems encountered in the implementation of theMilk Code.
  • Submits reports on the status of the Milk Code implementation to the FDA
  • Verifies reports of Milk Code violations.
  • Monitors the labels and marketing practices of products within the scope of the Code at various distribution centres.
  • Carries out monitoring activities at any time, or based on specific reports/suggestions from the FDA in their respective jurisdictions.
  • Anyone who is committed to protecting and promoting breastfeeding can report a Milk Code violation.
To report violations, the following information must be collected using the monitoring form:
  1. Date and place where violation was found/seen.
  2. Specific location (health facility, store, TV ad, radio/TV channel).
  3. For printed matters, get sample or a picture of the violation.
  4. For radio/TV ad or programmes, clearly specify airing time, TV channel or radio frequency.
  5. For website based violations, provide web link or screenshoots.
  6. For violative products, e.g. mislabeled or misbranded product, a sample shall be purchased and receipt should be obtained and submitted as part of the evidence.


Submissions should be made to:
  • The Director
  • Food and Drug Administration
  • Civic Drive, Fi/invest Corporate City
  • Alabang, Muntinlupa City
  • Philippines 17 81
  • Trunkline: (+63) 2 857-1900
  • Fax: (+63) 2 807-0751 I
  • (+63) 2 807-8511
  • E-mail: report@fda.gov.ph

Violations can also be reported online through SMS, this website: (to follow), and mobile application (to follow).
The liability provided by law for those individuals or entities who engage in the prohibited acts displays how important breastmilk promotion and awareness is to the representatives of the Philippine people. The following sanctions will be imposed upon conviction for any violation of the Code:

Penalties per Entity:
  1. Individual
    • Imprisonment of two months to one year and/or
    • Fine of Php 1,000 to Php 30,000
  2. Corporation/Partnership
    • Impose the penalty for individuals on the chairman of the board of directors, president, general manager or partners and/or persons directly responsible
    • Suspension/ revocation of license, permit or authority for pursuit of business
  3. Health Worker
    • Revocation of license, permit or authority for the practice of profession/occupation

Section 46 of the RIRR provides for administrative sanctions not imposed by EO 51 which can include:
  1. Fine of Php 1,000,000.00, recall of the offending product, cancellation of the Certificate of Product Registration, revocation of the License to Operate of concerned company, blacklisting of the company to be furnished the Department of Budget and Management and the Department of Trade and Industry for repeated violations; and
  2. Penalty of Php 2,500 per day for each day of violation the violation continues after being notified by the appropriate body.

References:

  • Drudy, D., Mullane, N. R., Quinn, T., Wall, P. G., & Fanning S. (2006). Enterobacter sakazakii: An emerging pathogen in powdered infant formula, 42(7): 996-1002. doi: 10.1086/501019.
  • International Labor Organization. (2015). Healthy Beginnings for a Better Society: Breastfeeding in the Workplace is Possible- A Toolkit. Makati City: ILO Country Office for the Philippines.
  • Milk Code Monitoring Kit. (2012). (Phil.)

Republic Act No. 10028 is also known as the “Expanded Breastfeeding Promotion Act 0f 2009” or "An act providing incentives to all government and private health institutions with rooming-in and breastfeeding practices and for other purposes”, amending Republic Act 7600 or the “Rooming-In and Breastfeeding Act of 1992”.
RA 10028 encourages, protects, and supports the practice of breastfeeding by adopting rooming-in as a national policy. This creates an environment where basic physical, emotional, and psychological needs of mothers and infants are fulfilled through the practice of rooming-in and breastfeeding.
This law mandated health institutions to provide equipment, facilities and supplies for breastmilk collection, storage, and utilization in accordance with the standards set by the Department of Health. Also, they are encouraged to set up milk banks for storage of breastmilk donated by mothers and which have undergone pasteurization. The stored breastmilk will primarily be given to children in the neonatal intensive care unit whose own mothers are seriously ill.

Further, it requires all health and non-health facilities, establishments or institutions (including public places) to establish lactation stations in the work place or public places and to provide lactation breaks to its nursing employees.
It pertains to work premises, whether private enterprises or government agencies, including their subdivisions, instrumentalities and government-owned and -controlled corporations.
A nursing/lactating employee is any female worker, regardless of employment status, who is lactating or breastfeeding her infant and/or young child.
RA 10028 mandates all establishments, whether public or private, whether operating for profit or not, to support breastfeeding in the workplace by:

  • coming up with workplace policy on breastfeeding;
  • setting up lactation stations;
  • allowing lactation periods;
  • providing breastfeeding information to its employees; and
  • complying with Executive Order (EO) 51(National Code of Marketing of Breastmilk Substitutes, Breastmilk Supplement and Other Related Products or the “Milk Code”)
A workplace policy is a set of guidelines that protects, promotes, and supports the breastfeeding program. This should be developed in consultation with the workers, and shall be properly disseminated to all concerned. It should be part of the company’s general policy or manual of operation, and the policy should operationalize the provision of the implementing rules and regulations (IRR) of RA 10028.
It must include the use and duration of lactation periods, use of the lactation station, provision of breastfeeding information among workers, and provisions for compliance with EO 51.
In the Philippines, women represent 49.8 percent of the workforce (PCW, 2014). Working mothers spend most of these 1,000 Days in the workplace. Young children who are undernourished during first 1,000 Days of life have weaker immune systems, making them vulnerable to common illnesses and diseases. By creating breastfeeding-friendly workplaces, optimal infant feeding practices are promoted.
There should be a clean private area where a breastfeeding worker can breastfeed or express breastmilk. A workplace must also allot "lactation break" for a nursing mother. There should be a written policy in the workplace and all workers, women and men, married or unmarried, receive the information that this benefit is being offered, as well as why it is important to have.
It is also known as breastfeeding room/area/station. It refers to a private, clean, sanitary, and well-ventilated rooms or areas in the workplace or public places where nursing mothers can wash up, breastfeed or express their milk comfortably and store this afterward.
A lactation station should be:
  • accessible to the breastfeeding women
  • clean, well ventilated, comfortable and free from contaminants and hazardous substances
  • private for women to express their milk and/or in appropriate cases, breastfeed their child
  • not located in the toilet
  • compliant with the EO 51 or Philippine Milk Code of 1986

A lactation station should have:
  • a small table, comfortable seat
  • refrigeration or appropriate cooling facilities for milk storage
  • water source/lavatory for hand-washing (unless there is an easily-accessible lavatory nearby)
  • lactation logbook
For a detailed explanation of the models, please see Annex A of the Department of Labor and Employment (DOLE) Department Order No. 143 series of 2015.
Yes. Any of the four prototype models can be adopted. The usage of this common facility shall be clearly stated in their individual company breastfeeding policy.
The DOLE Department Order provides an Equivalency Guide for these kinds of establishments. The equivalency guide provides four (4) options for these establishments which they can adopt.
This is a guide for establishments which are prevented by certain circumstances to set up any of the prototype lactation stations. Adapting any one of the suggested equivalency guide, would qualify the establishment as compliant with the law.
  • maybe small in physical size;
  • may have very few workers (e.g. only two workers who are watching over the store or stall); and
  • may be far from the communal lactation facility.
Yes, they can but only those which adhere to the DOH Guidelines for the “Mother-Baby Friendly Workplace Certification” as provided under the DOH Department Circular No. 2011-0365 may be eligible for certification.
No, the employer has the say on how and what lactation station to adopt or set up, depending on their need, convenience, and financial capacity.
A prototype is a model or sample which establishments may adopt or modify according to their financial capacity and physical set up.
Lactation break should not be less than a total of 40 minutes for every 8-hour working period and shall be counted as compensable hours worked. This is in addition to the regular time-off for meals.
Breastfeeding information should be made available to all workers for them to appreciate the value of breastfeeding to society.

The general public may get information through breastfeeding classes and easily accessible educational materials (e.g. posters, pamphlets, videos and other resources). Specify who from…at the National level, city/municipal level and community level…

Pregnant and breastfeeding workers may obtain information through counselling by trained individuals or peer educators within the workplace, or resource persons within the community.
Information can be delivered by:
  • including the workplace lactation policy in the orientation of new workers, both men and women, unmarried or married;
  • discussing with a pregnant worker prior to her maternity leave;
  • making materials on breastfeeding information/policies in the workplace (e.g. posters, pamphlets, handouts) accessible to all workers; and
  • organizing and/or supporting breastfeeding classes for all workers.
The following can provide direct help to breastfeeding mothers:
  • company health care provider, fellow breastfeeding mothers or peer educators in the workplace;
  • trained professionals;
  • local health and nutrition workers;
  • breastfeeding support group members within the community;
  • their own medical providers; and
  • resources in the community through mother support groups, the local health office, or hospitals.
It prohibits any direct or indirect promotion, marketing or sales of infant formula and/or breastmilk substitutes or products within the scope of the law inside lactation stations or in any event involving women and children whether related to breastfeeding promotion or not.
It is an enclosed or confined areas such as schools, public transportation terminals, shopping malls, and the like.
Public places owned and operated by the City/Municipal Government office should allocate at least 5 per cent of the total budget for gender and development (GAD) initiatives. This is to promote breastfeeding among passengers, shop keepers and workers within the area
It is the placing of the newborn in the same room as the mother right after delivery up to discharge to facilitate mother-infant bonding and to initiate breastfeeding. The infant may either share the mother's bed or be placed in a crib beside the mother. RA 7600 or the Rooming-in and Breastfeeding Act mandates all private and public health facilities to room-in babies with their mothers. RA 7600 was expanded into RA 10028.
These are hospitals, health infirmaries, health centers, lying-in centers, or puericulture centers with obstetrical and pediatric services.
Rooming-in gives a mother and her baby the opportunity to get to know each other. It allows skin-to-skin contact and for the mother to breastfeed more often and conveniently and minimizes the baby's exposure to atypical germs present in the nursery or newborn intensive care unit (NICU).
The World Health Organization and the Department of Health recommend health facilities to practice First Embrace or Unang Yakap.
  • Immediate and Thorough Drying
    • Once delivered, baby is wet from the womb. To keep babies warm, babies should be thoroughly dried for at least 30 seconds on the mother’s abdomen or between thighs when born either normally or via Caesarean section (CS), respectively.
  • Early Skin-to-Skin Contact
    • Babies should be placed naked lying on his tummy upon the mother’s bare chest to initiate skin-to-skin contact. The wet linen used from drying should be removed and the baby should be covered with a dry blanket and a bonnet.
  • Properly-timed Cord Clamping
    • Umbilical cord clamping is done only after pulsations have stopped (within 1-3 minutes after birth) when warm, iron- and oxygen-rich blood from your placenta has boosted your baby's circulation. In CS births, after step 1, the health worker performs properly-timed cord clamping then initiates early skin-to-skin contact.
  • Non-separation of Newborn from Mother for Early Breastfeeding
    • The fourth step is keeping you and your baby together (non-separation) for breastfeeding to take place within an hour after birth. Immediate and continuous skin-to-skin contact also allows a mother to provide warmth to her newborn in a fine-tuned process called thermosynchrony.
  • Infant, term or preterm, delivered normally or by Cesarean section (CS), must be breastfed within 60-90 minutes after birth at the delivery room / birthing area
  • Infant, term or preterm, delivered normally or by CS, must continue to initiate breastfeeding at the recovery room / birthing area
  • Infant, delivered normally or by CS, must not be separated from the mother during the entire stay in the hospital after birth without medical indication
  • Prematurity
  • Severe respiratory distress requiring mechanical ventilation
  • Severe medical condition that requires neonatal intensive care monitoring and treatment
  • Very low birth weight (less than 1500 grams)
  • extremely low birth weight (less than 1000 grams)
  • seriously ill;
  • taking medications contraindicated to breast-feeding;
  • violent psychotics; or
  • whose conditions do not permit breast-feeding and rooming-in as determined by the attending physician.

Provided, that these infants shall be fed expressed breastmilk or wet-nursed as may be determined by the attending physician.
Mothers can acquire expressed breastmilk from DOH accredited human milk banks.
It is a service established for the purpose of collecting, screening, processing, storing and distributing donated human milk to meet the specific medical needs of individuals for whom human milk is prescribed.

Human milk banks should be registered, licensed and monitored by the Department of Health (Bureau of Health Facilities and Services). It must follow the guidelines set by the Department of Health defining the proper donor screening, collection, storage, transport, processing and distribution of human milk. Training on milk banking will be provided by reference human milk banks accredited by the Department of Health.
Yes. Donors must pass the screening procedures set forth by the Department of Health. Moreover, human milk donors may come from, but not limited to the following:
  • Lying-in clinics/maternity clinics
  • Health Centers
  • Community Support Group
  • Government agencies and Private enterprises with lactation stations
  • Private individuals
Unjustifiable refusal to set up a lactation station and non-observance of lactation breaks for nursing or lactating employees are some of the most common violations.
Section 16 of RA 10028 provides the following sanctions:
  • First offense: A fine of Php50,000 – Php200,000
  • Second offense: A fine of Php200,000 – Php500,000
  • Third offense: A fine of Php500,000 – Php1,000,000 and the cancellation or revocation of business permits or licenses to operate
The DOH Secretary has the authority in imposing the penalties.
A monitoring team, composed of the following, is created and established:
  1. National level:
    • Department of Health (DOH)
    • Council for the Welfare of Children (CWC)
    • PhilHealth
    • Department of Social Welfare and Development (DSWD)
    • Department of Interior and Local Government (DILG)
    • Department of Labor and Employment (DOLE)
    • Bureau of Internal Revenue (BIR)
    • Civil Service Commission
    • Government/Non- Government Organizations Civil Societies without any conflict of interest with the breastfeeding culture, and/or direct or indirect connection, financial or otherwise, or with commercial interest within the scope of the Act
    • Ad Hoc International Agencies such as the United Nations Children's Emergency Fund (UNICEF) and/or the World Health Organization (WHO)
  2. Regional/Provincial/City Municipal/Barangay levels (in collaboration with their respective Local Government Units):
    • Center for Health Development Offices
    • National Nutrition Regional Offices
    • Regional DSWD, DILG, DOLE, CWC
    • Provincial Health Offices
    • City Health Offices
    • Licensing Units and Offices
    • Municipal Health Offices/Rural Health Units
    • Barangay Health Office
    • GOs/NGOs/CiviI Societies
The Monitoring Team shall have the following functions:
  • Monitor compliance as well as problems encountered in the implementation of the Act.
  • Review/act on reports of violations of the provisions of the Act.
  • Verifies reports of violations of the Act.
  • Recommend sanctions or punitive actions for violations of the Act to the Secretary of Health.
  • Submit regular reports on the status of the implementation of the Act to the Secretary of Health.
Violations can also be reported online through SMS, this website: (to follow), and mobile application (to follow).

References:

  • Republic Act No. 10028 Implementing Rules and Regulations (2011)
  • Republic Act No. 7600 (The Rooming-in and Breastfeeding Act of 2002)
  • DOLE Department Order No.143, Series of 2015: Guidelines Governing Exemption of Establishments from Setting Up Workplace Lactation Stations
  • Q & A on Guidelines Governing Exemption of Establishments from Setting Up Workplace Lactation Stations (DOLE Department Order No.143, Series of 2015)