Karachi: Manufacturers, importers, wholesalers and marketing firms found to have violated Sindh’s law regulating the promotion of breastmilk substitutes can face up to two years’ imprisonment and fines of up to Rs5 million, experts told health reporters on Tuesday.
The Sindh Protection and Promotion of Breastfeeding and Young Child Nutrition Act, 2023, also provides for penalties against retailers and departmental action against health workers, subject to the legal process and applicable professional rules, they said at a media awareness and sensitisation workshop held at the Karachi Press Club.
The workshop was organised by the Sindh Institute of Child Health and Neonatology (SICHN) in collaboration with UNICEF and the Sindh Health Department in connection with World Breastfeeding Week 2026.
Dr Muhammad Khalid Shafi, who briefed participants on the law, said the 2023 legislation strengthened the earlier Sindh law by extending its coverage from children up to 12 months to those up to 36 months.
He said the law covers designated products, including infant formula, follow-up and special formulas, as well as processed complementary foods. It seeks to protect breastfeeding by restricting direct promotion, cross-promotion, sponsorship and certain contacts between businesses dealing in these products and health professionals or the public.
Under the provisions explained at the workshop, manufacturers, importers, wholesalers and corporate marketing entities found to have contravened the law may face imprisonment of up to two years, fines ranging from Rs500,000 to Rs5 million, or both. Retailers may face imprisonment of up to two years, fines between Rs25,000 and Rs500,000, or both.
Dr Shafi said health workers were required to encourage, support and protect breastfeeding and could not accept or distribute samples of designated products to pregnant women, mothers, families or other persons. He said alleged violations by health workers could lead to minor or major penalties under government rules and referral to the relevant licensing or concerned authority.
He said the law envisaged an Infant and Young Child Nutrition Board to implement rules, monitor compliance, receive complaints, review reports and decide on warnings or penalties in accordance with prescribed procedures. The law also provides a procedure for the processing of complaints and appeals.
Prof Syed Jamal Raza, Executive Director of SICHN, said effective implementation of the law was essential because poor breastfeeding practices continued to endanger child health in Pakistan.
He said only around 20 per cent of newborns in Pakistan were breastfed within the first hour of life, while exclusive breastfeeding among infants under six months stood at about 48 per cent. This meant that more than half of infants in that age group were not receiving exclusive breastfeeding.
Prof Raza said infants under six months who were not breastfed faced an estimated 15 times higher risk of death than those who were exclusively breastfed, while partially breastfed infants faced about three times higher risk. He cited workshop data estimating that around 33,700 child deaths annually in Pakistan were attributable to inadequate breastfeeding, mainly through preventable illnesses such as diarrhoea and pneumonia.
He said bottle-feeding among children under two had risen from 32 per cent in 2006-07 to 48 per cent in 2024. Where safe water and hygienic preparation were not assured, bottle feeding could expose infants to infection and inadequate nutrition, he added.
Prof Raza said mothers needed support rather than blame. Families, health facilities, employers and communities all had a role in enabling early and exclusive breastfeeding, he said.
Prem Bahadur Chand, Chief of UNICEF’s Field Office for Sindh, said misinformation, social pressure and weak support systems frequently affected mothers’ ability to breastfeed. He urged journalists to report the issue accurately and consistently.
Prof Dr Halima Yasmeen, Chairperson of Obstetrics and Gynaecology at JPMC/JSMU, stressed the importance of counselling during pregnancy and after delivery, as well as family and workplace support. Dr Mazhar Iqbal of UNICEF highlighted the need for a “warm chain” linking families, health workers, workplaces and communities.
M. Waqar Bhatti, senior health and environment journalist, moderated the discussion and said sustained, evidence-based reporting could support public awareness and implementation of child-nutrition protections.