ATNI believes that it is essential for companies to contribute to optimal infant and young child nutrition. From conception to two years old, nutrition within the first 1,000 days of a child's life is particularly important.


Nutrition within the first 1,000 days of a child’s life, from conception to two years old, is critically important. Breastfeeding is a crucial element of infant and young child nutrition. Scaling up breastfeeding to near universal levels could prevent the deaths of over 820,000 children under five each year. It is for this reason that WHO recommends that babies everywhere are breastfed exclusively for the first six months, at which point safe, appropriate complementary foods should be introduced to meet the children’s evolving nutritional requirements. WHO also notes that complementary foods should not be used as breast-milk substitutes, and infants and young children should continue to be breastfed until they are two or older.

International policy framework

Optimal infant and young child nutrition is also critical to achieving global nutrition goals, such as those set by the World Health Organization (WHO) for 2025 on reducing wasting and stunting, and other goals related to combating growing levels of overweight and obesity and reducing deaths and illness related to diet-related chronic diseases. It is also key to delivering SDG 2- Zero Hunger and 3 – Good Health and Wellbeing, which in turn underpins the achievement of many other SDGs. Currently, only two out of every five infants under six months are exclusively breastfed, as recommended.

The International Code of Marketing of Breast-milk Substitutes and all subsequent relevant World Health Assembly (WHA) resolutions set out recommendations for appropriate marketing of both breast-milk substitutes and complementary foods.

Inappropriate marketing of breast-milk substitutes (BMS) and complementary foods (CF) can undermine optimal infant and young child nutrition. Each Global Access to Nutrition Index therefore includes a sub-ranking that assesses the world’s largest baby food manufacturers’ marketing of BMS and CF, the results of which feed into the scores for BMS and CF manufacturers’ Global Index score.

ATNI’s BMS Marketing methodology consists of two parts.

BMS 1: Each company’s policies, practices and disclosure relating to these products are assessed using ATNI’s methodology to determine the extent to which they are marketed in line with the recommendations of the International Code of Marketing of Breast-milk Substitutes and all subsequent relevant World Health Assembly (WHA) resolutions, including WHA 69.9 adopted in May 2016.

BMS 2:  ATNI selects two countries for each Index where studies are conducted of companies’ marketing practices using the NetCode Protocol. ATNI contracts the international health research company Westat to conduct these studies.

Companies’ scores on each element are combined to generate their overall score. The scoring system is set out in the methodology.


ATNI’s 2016 and 2018 Global Indexes included four food and beverage sector companies – Danone, FrieslandCampina, Kraft Heinz and Nestlé – and two other companies – Abbott and RB/Mead Johnson Nutrition (RB/MJN). From 2020 onwards, ATNI will assess the nine largest baby food manufacturers to cover a larger share of the global baby foods market. Along with the aforementioned companies, the new entrants are: Feihe International, Inner Mongolia Yili Industrial Group and China Mengniu Dairy.


While the findings and combined results of BMS 1 and BMS 2 can be found in the Global Index reports, ATNI releases summary reports of each in-country assessment, and publishes Westat’s full reports. Detailed Scorecards for each company can be found here.

Global Index 2018 - BMS Chapter

In recent years, ATNI and FTSE Russell have conducted similar but separate in-country assessments and verifications of companies’ baby food companies’ marketing. From 2019 onwards, ATNI will provide FTSE Russell with data from our studies, to feed into its approach to determining whether these companies meet its criteria for inclusion in its FTSE4Good Indexes.

For its own Indexes, ATNI will continue to apply its own criteria and methodology as previously.

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Frequently Asked Questions

All news and updates linked to our BMS work will be published in this section.

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