"My baby fell sick and suffered stomach upset several times after feeding it a breast-milk substitute. I was not aware of the substandard quality of the product," said Mithila Shahed, a schoolteacher, while shopping at a department store in Gulshan.

"The unregistered breast-milk substitutes may put child health and nutrition to risk," said renowned paediatrician and Bangladesh Breast Feeding Foundation Chairperson Prof MQK Talukder.

Many BMS distributors and marketers have been importing and marketing products either without any registration or with an expired one, said General Secretary of Consumers Association of Bangladesh (CAB) Quazi Faruque, citing the findings of a survey.

According to the survey conducted by the CAB in July last year, 20 of the 43 BMS brands were found unregistered, while 19 of 44 brands were found unregistered in the previous year.

To promote breast-feeding in the country, section 4/A of the Breast-Milk Substitute (Regulation of Marketing) Ordinance of 1984 declares, "No breast-milk substitute of any kind shall be imported, distributed, marketed, stored, sold, offered for sale or locally manufactured for sale unless it is registered under this Ordinance."

Again, section 4 of the BMS Ordinance provides, "No person shall promote any breast-milk substitutes either by advertisement or by offering or giving any gift, prize, discount coupon, or other free item or by any other means."

However, in clear violation of the BMS code, 86.36 percent of the total brands surveyed last year were found using encouraging and promotional language on their labels, alluring parents to feed their babies those products.

The CAB survey also found 67.44 percent of the brands with no mention of their importers and marketers.

Of the 43 BMS brands surveyed in 2004, My Boy Eldolac-F, Macil Babycare, Babycare-1 and 2, AR Iron Fortified, Enfapro, Humana, Heinz-Baby's First Rice Cereal, Gerber, Similac-Advanced, Pre-Biomil, Farex, Biomil Joy, Pediasure, Prosbee, Enfalac Iron, Enfalac Premature, Sustagen, Nestle Wheat Mixed Fruit, and Ensure Complete Balanced Nutrition were found unregistered.

According to the Institute of Public Health Nutrition (IPHN) sources, only nine BMS brands have valid registration at present.

The Nestle Bangladesh Ltd has a valid registration for Pre-Lactogen, Nestle Cerelac Dal Palak, Nestle Mixed Vegetables, Nestum Infant Cereal, AL-110 Lactose Free Formula, Cerelac Wheat Mixed Fruit and Cerelac Chicken and Rice.

Corporate Director of Nestle M Zulfiqar Hussain, however, claimed that all 13 BMS brands marketed by Nestle have up-to-date registration.

The HRC Products Ltd has renewed its registration for Bebelac-1 and 2 and Infant Formula.

An investigation by The Daily Star found that brands like Enfamil, Eldogrow, Biomil and Babycare-1 and 2, O-Lac, Sweet Baby, Enfapro, Enfalac, Justagen, Pediasure, Similac Advance, Nestle Nido, Nestle Cerelac, S-26 and Sma Progress are selling in the market without any registration.

Of these products, Nido and Cerelac of Nestle contain Arabic while S-26 contains Thai language on their labels violating the legal prohibition of use of any other language except Bangla and English to inscribe all the instructions and information.

Again, although My Boy Eldorin-1 and 2 and Biomil-1 and 2 bear registration numbers, the IPHN records do not corroborate them.

Marketing Manager of My Boy of the Lalmai Ltd Uttam Kumar Chowdhury claimed that Eldorin-1 and 2 and Eldogrow-3 are registered products whereas Eldolac-F does not require registration as it is meant for children aged above one year.

Marketing Manager of Enfalac Belal Ahmed said the nine BMS brands imported and marketed by his company do not have IPHN registration but are BSTI certified Bangladesh Standard Testing Institute.

He said his company took over the BMS business about one and a half years ago but he came to learn about the BMS ordinance only three months ago.

Ahmed initially said he was not aware of which authority he should obtain the registration from. Later, however, he said, "Why should we run after the registration authority? The IPHN never asked us to follow such obligations."

The inactive IPHN
Although the IPHN is responsible for issuance of registration and implementing the BMS codes, it has virtually remained inactive for the last couple of years, according to sources concerned.

IPHN Director Dr UH Farida Khatun expressed her ignorance over the unregistered BMS products flooding the market.

"The civil surgeons are responsible to report to the IPHN on violation of the BMS codes," she said, "only then can we act."

The institute has an advisory committee headed by the additional secretary to the health ministry to advise the government on harmful consequences of not feeding the baby breast-milk and monitor violation of the BMS codes.

"I don't know why the advisory committee is not functioning properly," said Dr Farida, who is the member secretary of the committee.

"I am not aware of how many BMS brands in the market are unregistered," said Dr Faruq Ahmed Khan of the committee, "because we don't have enough manpower to monitor the market."

Sources concerned also said the IPHN has been without a lawyer since the contract between it and Advocate Syed Mahbubur Rahman expired two years ago.

As decided at the 54th World Health Summit of the World Health Organisation (WHO) in 2001, a baby should only be breast-fed up to the age of six months.