Law for the Promotion and Protection of Breastfeeding

PURPOSE. The purpose of this Law is to establish the necessary measures to protect and promote breastfeeding and optimal feeding practices for infants, girls and young children.

APPLICABILITY. This Law applies throughout the national territory for the protection, promotion and support of all persons, products and activities related to breastfeeding and optimal feeding of infants, girls and young children.

COMPETENT AUTHORITY. The competent authority for the application of this Law and its Regulations is the Secretary of State in the Office of Health, in coordination with other relevant legal bodies.

DEFINITIONS. In its application, the terms used in this Law shall be understood as follows:

• 1)

  COMPLEMENTARY FOOD: Any food product manufactured or processed, industrialized and marketed to supplement the feeding of infants over six (6) months of age;

• 2)

  CHILD CARE CENTER: Any public or private institution that directly or indirectly provides child care services to infants;

• 3)

  HUMAN MILK COLLECTION CENTER: Any space designated for the collection and storage of human milk;

• 4)

  COMMERCIALIZATION: The activities of promotion, distribution, sale, advertising and information services related to a designated product;

• 5)

  DONATION: The free supply of a designated product given by a natural or legal person;

• 6)

  CONTAINER: Any form of packaging of products for sale, including its wrapping;

• 7)

  HEALTH ESTABLISHMENT: Any public or private institution, group or individual, that directly or indirectly provides health services to the general public;

• 8)

  LABEL OF A DESIGNATED PRODUCT: Any seal, mark, label or other descriptive graphic indication, written, printed, marked, engraved in high or low relief, fixed or placed within a container of a designated product;

• 9)

  STARTER FORMULA: Any milk or dairy product of animal or vegetable origin industrially manufactured in accordance with the Codex Alimentarius Standards, intended to satisfy the nutritional needs of infants from birth until the first six (6) months of age;

• 10)

  FOLLOW-UP FORMULA: Any milk or dairy product of animal or vegetable origin industrially manufactured in accordance with the Codex Alimentarius Standards, presented as appropriate for feeding infants over six (6) months of age;

• 11)

  INTRODUCTION OF COMPLEMENTARY FEEDING: The addition of other liquids or solid foods, in the period after six (6) months of age when the nutritional needs of infants are not satisfied by breast milk alone, and must be carried out gradually and hygienically, according to medical indication, preferably;

• 12)

  INFANT: The girl or boy up to the age of twenty-four (24) months (2 years) completed;

• 13)

  EXCLUSIVE BREASTFEEDING: The feeding of infants exclusively with breast milk during the first six (6) months of age, without the addition of water, juices, tea, or other liquids or foods;

• 14)

  LOGO: Designates the emblem, design or characters by which a product or manufacturer is identified;

• 15)

  BRAND: The commercial name of a designated product;

• 16)

  SAMPLE: The unit or small quantity of a product that is provided free of charge to promote its consumption;

• 17)

  YOUNG GIRL AND BOY: The girl or boy from the age of twenty-four (24) months (2 years) completed until thirty-six (36) months (3 years);

• 18)

  CODEX ALIMENTARIUS STANDARDS: A collection of internationally recognized standards, codes of practice, guides and other recommendations relating to foods;

• 19)

  TO SPONSOR: To provide any type of financial, logistical or material support to public or private services or establishments;

• 20)

  HEALTH PERSONNEL: All persons in charge of providing assistance in any health establishment, whether public or private, whether remunerated or not, including those in the process of academic training, health professionals who act independently without being linked to a health establishment;

• 21)

  DESIGNATED PRODUCT: Any starter formula, follow-up formula, complementary foods and products marketed or in any way presented as appropriate for feeding infants, which includes bottles, teats, pacifiers and nipple adapters among others;

• 22)

  PRODUCER AND/OR DISTRIBUTOR: Any natural or legal person who directly or indirectly produces and/or markets any of the designated products and includes their employees and natural or legal persons that producers or distributors hire or subcontract when they perform activities covered by the provisions of this Law;

• 23)

  PROMOTION: The activity aimed at making known or creating the need for a designated product or of encouraging, directly or indirectly, a person to purchase or use a designated product; and,

• 24)

  ADVERTISING: The activity of presentation, by any means, for the purpose of promoting the sale or use of a designated product, including but not limited to:

  • a)

    Written advertising, by television, radio, film, electronic transmission, video, telephone among others;

  • b)

    The display of notices, billboards, signs, posters or notifications;

  • c)

    The display of images or models that idealize feeding with a designated product;

  • d)

    Door-to-door visits;

  • e)

    Samples in consumer centers; and, f) Visits to health units.

INFORMATION AND COUNSELING. Every person has the right to obtain from health personnel adequate information and counseling to facilitate knowledge of the advantages and benefits of breastfeeding, so that they can make an informed and responsible decision.

SUPPORT. Mothers have the right to be supported during the pregnancy and breastfeeding process by their families, society and the State, to promote their confidence in the ability to bear and feed their children; through adequate prenatal care, dignified childbirth care and early initiation of breastfeeding. Their right to breastfeed when working outside the home must be guaranteed as well as the subsequent follow-up of the girl or boy through Child Care Centers or other modalities. To facilitate mothers who express milk, a Human Milk Collection Center must be established in the place where they work, as well as adequate the necessary time to exercise this right. In addition, in special situations such as climatic and catastrophic events, breastfeeding must be prioritized, providing spaces that allow effective breastfeeding and adequate and timely counseling.

FEEDING. Infants, girls and young children have the right to receive the best form of nutrition. During the first years of life, breastfeeding is the foundation for achieving healthy growth and development; representing also a crucial element for their survival. The practice of breastfeeding should be exclusive during the first six (6) months of age and is recommended to continue it at least until two (2) years of age, accompanied by the adequate introduction of Complementary Food.

NATIONAL COMMISSION ON BREASTFEEDING AND COMPLEMENTARY FEEDING OF HONDURAS (CONALMA). The National Commission on Breastfeeding and Complementary Feeding of Honduras (CONALMA) is hereby created, as a permanent body, attached to the Secretary of State in the Office of Health.

POWERS AND FUNCTIONS OF THE NATIONAL COMMISSION ON BREASTFEEDING AND COMPLEMENTARY FEEDING OF HONDURAS (CONALMA). CONALMA has the following powers and functions:

• 1)

  To advise the Secretary of State in the Office of Health on matters of national policy for the promotion and protection of breastfeeding;

• 2)

  To establish and promote institutional mechanisms to develop broad educational and advertising programs and campaigns that encourage mothers to give breast milk, given the advantages it provides to the immune system of infants among other multiple benefits;

• 3)

  To establish regional committees to carry out its functions at the regional level, as determined;

• 4)

  To examine educational and informational materials to verify if they comply with the requirements established in this Law and, if necessary, to formulate the appropriate recommendations to the Secretary of State in the Office of Health who must approve or reject such materials; and,

• 5)

  To assume the other functions and powers that the Secretary of State in the Offices of Health attributes to it.

COMPOSITION OF THE BOARD OF DIRECTORS OF CONALMA. CONALMA is composed of the following institutions:

• 1)

  Secretary of State in the Office of Health, who shall preside over it;

• 2)

  Secretary of State in the Offices of Industry and Commerce;

• 3)

  Secretary of State in the Offices of Labor and Social Security;

• 4)

  Secretary of State in the Offices of Indigenous and Afro-Honduran Peoples;

• 5)

  Secretary of State in the Office of Social Development;

• 6)

  National Patronage of Children (PANI);

• 7)

  Public Prosecutor's Office;

• 8)

  Association of Municipalities of Honduras (AMHON);

• 9)

  Medical College of Honduras;

• 10)

  College of Nursing Professionals of Honduras;

• 11)

  Honduran Institute of Childhood and Family (INHFA);

• 12)

  Family Assistance Assignment Program (PRAF);

• 13)

  Honduran Social Security Institute (IHSS); and,

• 14)

  National Institute for Women (INAM). The institutions that make up CONALMA must prepare an action plan for this Commission and ensure its compliance, facilitating its management at the highest political level. It must submit an annual report of its work to the President of the Republic. Such institutions shall be represented by their highest-ranking executives or by whoever they delegate.

BREASTFEEDING POLICY. All public and private health establishments in which prenatal services, childbirth care and child care are provided are obligated to implement the official policy and breastfeeding standards established by the Secretary of State in the Office of Health.

TRAINING OF HEALTH PERSONNEL. All personnel working in health establishments where prenatal services, childbirth care and child care are provided must be trained in the management of breastfeeding, as well as in the standards and policies related to it, to support mothers and their families during the process. Training must be permanent and provided by Training Units certified by the Secretary of State in the Office of Health.

FORMATION OF COMMUNITY SUPPORT GROUPS. The formation of community support groups for breastfeeding must be promoted through sanitary regions and community organizations, with the participation of training units, Non-Governmental Organizations (NGOs) and other instances of Civil Society. It is the responsibility of public Health Establishments to support these groups; a system of referral and counter-referral shall be organized so that mothers and their families can receive counseling services, by qualified personnel, for the proper management of breastfeeding.

COMPETENCE FOR THE DEMONSTRATION OF THE USE OF DESIGNATED PRODUCTS. Demonstrations of the preparation and use of starter formula or follow-up formula must be performed solely by Health Personnel and is directed exclusively and individually to mothers or members of their family who need it. The information provided must include a clear explanation of the risks that may result from the incorrect preparation and use of such products.

INCORPORATION OF THE BREASTFEEDING TOPIC IN FORMAL EDUCATION. The Secretary of State in the Office of Education and the Council of Higher Education must incorporate the topic of breastfeeding in their study programs. In the study programs, the advantages and superiority of breastfeeding must be clearly and visibly explained, making use of the scientific and methodological advances proposed by the World Health Organization and the strategic plans of the Secretary of State in the Office of Health.

INFORMATIONAL AND EDUCATIONAL MATERIALS REGARDING NUTRITION. Informational and educational materials, whether printed, audio, or visual, regarding nutrition intended for pregnant women, breastfeeding mothers, their children, and families, must comply with the appropriate norms and standards stipulated by this Law and its Regulations.

INFORMATIONAL AND EDUCATIONAL MATERIALS REGARDING INFANT FORMULA, FOLLOW-UP FORMULA, AND UTENSILS FOR THEIR ADMINISTRATION. These materials in all cases must clearly explain that the use of Formulas is of an exceptional nature, subject to medical prescription. It is mandatory to provide information regarding the approximate monthly cost of feeding infants and children with the product in the recommended quantities.

INFORMATION PROVIDED TO HEALTH PERSONNEL. The information that Producers and/or Distributors provide to Health Personnel for product launches, reformulation of previously presented products, and any other information regarding existing products, must be limited to technical and objective data regarding the Designated Product. TITLE III REGULATION OF DESIGNATED PRODUCTS CHAPTER I OBLIGATIONS AND PROHIBITIONS OF PRODUCERS, DISTRIBUTORS OF DESIGNATED PRODUCTS, ESTABLISHMENTS, AND HEALTH PERSONNEL

COMMERCIALIZATION OF UNREGISTERED PRODUCTS. The commercialization of Designated Products that are not registered in the corresponding Sanitary Register is prohibited, as well as the sale of Designated Products in containers different from the original packaging.

COMPETENCE OF THE SECRETARIAT OF STATE FOR THE HEALTH DEPARTMENT. It is the competence of the Secretariat of State for the Health Department, in addition to those established by Law, to regulate pre-existing commercial practices at the time this Law enters into force and that relate to the commercialization of Designated Products. This competence includes the authority to declare a new product as a designated product for the purposes of this Law.

ADVERTISING AND PROMOTION. The regulation of advertising for Designated Products is subject to the contents of Articles 15 and 17 of this Law. Any advertising must contain in a prominent manner the legend contemplated in Article 27 in its entirety, in no less than ten percent (10%) of the total area or time of the advertising.

REGULATION OF PROMOTION AND DONATION IN HEALTH ESTABLISHMENTS. The promotion and donation of Designated Products in Health Establishments, including the display of posters, billboards, calendars, notebooks, labels, samples of these products, articles or utensils that discourage breastfeeding practice and promote the use of or objects that bear the name or logo of Producers and/or Distributors must be regulated in the Regulations of this Law.

RESPONSIBILITIES OF PRODUCERS AND/OR DISTRIBUTORS. It is the responsibility of Producers and/or Distributors of Designated Products to know and comply with the contents of this Law and its Regulations.

PROHIBITIONS FOR HEALTH PERSONNEL AND ESTABLISHMENTS. It is prohibited for personnel and establishments of the Secretariat of State for the Health Department to accept gifts, contributions, or benefits from those who manufacture, distribute, or represent a Designated Product. Likewise, it is prohibited to place advertising for this type of product in any area of public or private health establishments. As well as the presence of sales representatives of these products in the consultation areas or maternal and child care areas of said establishments.

DONATION OF EQUIPMENT, MATERIALS, AND GRANTING OF BENEFITS BY PRODUCERS AND/OR DISTRIBUTORS. All donations of equipment, material, or financial support or any other type of benefit provided by Producers and/or Distributors must be regulated in the Regulations of this Law. CHAPTER II LABELING

LABELING OF DESIGNATED PRODUCT. Every designated product, prior to being commercialized in the national territory, must bear on the container or on a label affixed to it, precise instructions for the preparation and appropriate use of the product according to the age of the infant, notice of possible risks in its preparation, ingredients, composition and nutritional analysis; storage conditions, date of manufacture and expiration date, batch number, name and address of the producer and/or national distributor of the product. Graphic representations or phrases such as "humanized milk," "infant formula milk," "equivalent to breast milk" or any other similar term must not be included.

LEGEND FOR DESIGNATED PRODUCT. Every Designated Product must bear on the container or attached to it a label that contains in letters of no less than two (2) millimeters in height and in capital letters, the phrase "IMPORTANT NOTICE," and below it must appear the legend: "Breastfeeding is the best option for the girl or boy. Breast milk is the ideal food for the healthy growth and development of infants, children, and young girls and boys and strengthens the defenses of the human body to prevent diarrhea and other diseases." No Producer and/or Distributor must offer Designated Products without proper labeling.

LABELING OF OTHER NON-DESIGNATED PRODUCTS. The labels of skimmed milk, condensed milk, and whole milk, whether in powder or liquid form, must bear the following legend: "This product should not be used in the feeding of a child under six (6) months of age." TITLE IV SANCTIONS AND FINAL PROVISIONS CHAPTER I SANCTIONS

GENERAL SANCTIONS. Violations of this Law must be sanctioned by the Secretariat of State for the Health Department through the Directorate of Sanitary Regulation, without prejudice to the civil or criminal liability that corresponds to the violator. The sanctions must be progressive, taking into account the frequency and severity thereof, in accordance with what is established in the Regulations of this Law, and are as follows:

• 1)

  Minor Sanction: With written warning when the violation is committed for the first time;

• 2)

  Serious Sanction: When there is recurrence in committing a violation, with a fine equal to the minimum salary being applied; and,

• 3)

  Very Serious Sanction: When there is recurrence of subsection b) above, proceeding to the cancellation of the sanitary registration of the corresponding product.

CONFISCATION OF DESIGNATED PRODUCTS. When the sanction is very serious, the Secretariat of State for the Health Department shall request from the corresponding authority the confiscation of the respective product.

SANCTIONS OF HEALTH PERSONNEL. Non-compliance with the norms contained in this Law by health personnel working in public institutions gives rise to the sanctions established in the Civil Service Law or in the Labor Code, as appropriate. CHAPTER II FINAL PROVISIONS

ADMINISTRATIVE PROCEDURE. Everything not expressly provided for in this Law must comply with the provisions of the related national legislation.

COMPLIANCE WITH THIS LAW. Producers and/or Distributors of Designated Products have a period of ninety (90) calendar days from the date of entry into force of this Law to adjust the labels, informational and educational materials, and marketing practices to the provisions hereof.

REGULATIONS. The Secretariat of State in the Office of Health must issue the Regulations of this Law within ninety (90) calendar days after its entry into force.

ENTRY INTO FORCE. This Law shall enter into force as of its publication in "La Gaceta", Official Gazette of the Republic. Given in the city of Tegucigalpa, municipality of the Central District, in the Session Hall of the National Congress, on the eighteenth day of the month of September in the year two thousand thirteen. ALBA NORA GÚNERA OSORIO PRESIDENT, BY THE LAW RIGOBERTO CHANG CASTILLO SECRETARY JARIET WALDINA PAZ SECRETARY To the Executive Branch. Wherefore: Let it be executed. Tegucigalpa, M.D.C., December 10, 2013. PORFIRIO LOBO SOSA PRESIDENT OF THE REPUBLIC THE SECRETARY OF STATE IN THE OFFICE OF HEALTH. JOSÉ SALVADOR PINEDA PINEDA Supreme Electoral Tribunal AGREEMENT No. 12-2013 THE SUPREME ELECTORAL TRIBUNAL, WHEREAS (1): That in accordance with Article 51 of the Constitution of the Republic, for everything related to electoral acts and procedures there shall be a Supreme Electoral Tribunal, autonomous and independent, with legal personality, with jurisdiction and competence throughout the Republic, whose organization and functioning shall be established by the Constitution and the Law, which shall likewise establish the provisions relative to the other electoral bodies. WHEREAS (2): That the Supreme Electoral Tribunal, through Agreement Number 005-2013 dated May 23rd of the year two thousand thirteen and published on May 24, 2013, in the Official Gazette La Gaceta number 33,132, called upon the Honduran citizenry to the General Elections to be held on November 24, 2013 to elect a President and Designees to the Presidency of the Republic, 20 Deputies to the Central American Parliament with their respective alternates, 128 Deputies to the National Congress with their respective alternates, and 298 Municipal Corporations. WHEREAS (3): That in accordance with the Constitution of the Republic and the Electoral Law and of Political Organizations, for the election of President of the Republic, Designees to the Presidency of the Republic the simple majority system is applied. WHEREAS (4): That Article 172 of the Constitution of the Republic establishes that the President of the Republic shall place the Armed Forces at the disposal of the Supreme Electoral Tribunal, from one month before the elections until their declaration. WHEREAS (5): That the Supreme Electoral Tribunal shall make on this date the declaration only of the presidential level and of the Designees to the Presidency of the Republic and of the other levels on a different date but within the terms established by the Law.