Global advocates for breastfeeding were evident since the International Code of Marketing of Breast-Milk Substitutes (BMS Code) was adopted in 1981 and fostered by subsequent relevant World Health Assembly resolutions, using a framework that promotes, supports and protects breastfeeding. Global partners provided comprehensive support for countries to achieve breastfeeding targets while progress was closely monitored. This review identifies breastfeeding policy and implementation gaps in Thailand. Although Thailand implemented three Thai voluntary BMS Codes, ineffective enforcement results in constant violations by BMS industries. In light of strong resistance by the BMS industries and their proxies, it was not until 2017 that the Code was legislated into national law; however regulatory enforcement is a protracted challenge. A Baby-Friendly Hospital Initiative (BFHI), mostly in public hospitals, was successfully applied and scaled up nationwide in 1992, but it later became inactive due to lack of continued support. Several community-based and workplace programmes, which supported breastfeeding, also faced challenges from competing agendas. Although the Labor Protection Law offers 98 days maternity leave with full pay, the conducive environment for successful six- month exclusive breastfeeding (EBF) needs a significant boost. These gaps in policy were exacerbated by a lack of multi-sectoral collaboration, ineffective implementation of existing interventions, inadequate investment, and lack of political will to legislate six-month maternity leave. As a result, the progress of EBF rate during the first 6 months as measured by previous 24 h was erratic; it increased from 12.3% in 2012 to 23.1% in 2015 and decreased to 14% in 2019. There was a deterioration of early initiation from 49.6% in 2006 to 34% in 2019. These low performances hamper the achievement of global targets by 2030. We recommend the following. First, increase financial and human resource investment, and support successful exclusive breastfeeding in BHFI, communities and workplaces through multi-sectoral actions for health. Second, implement the active surveillance of violations and strengthen law enforcement for timely legal sanctions of violators. Third, revitalize the BFHI implementation in public hospitals and extend to private hospitals.

中文翻译：

---

在泰国实现全球母乳喂养目标：差距分析和解决方案

自 1981 年通过《国际母乳代用品销售守则》（BMS 守则）并由随后的世界卫生大会相关决议推动以来，全球对母乳喂养的倡导者显而易见，使用促进、支持和保护母乳喂养的框架。全球合作伙伴为各国实现母乳喂养目标提供全面支持，同时密切监测进展情况。该审查确定了泰国的母乳喂养政策和实施差距。尽管泰国实施了三项泰国自愿性 BMS 规范，但执法不力导致 BMS 行业不断违规。鉴于 BMS 行业及其代理人的强烈抵制，直到 2017 年该守则才被立法写入国家法律；然而，监管执法是一项长期挑战。爱婴医院计划（BFHI），主要是在公立医院，1992 年在全国范围内成功应用和推广，但后来由于缺乏持续支持而停止活动。一些支持母乳喂养的社区和工作场所计划也面临来自相互竞争议程的挑战。尽管《劳动保护法》提供了 98 天的全薪产假，但需要大力推动成功实现六个月纯母乳喂养 (EBF) 的有利环境。由于缺乏多部门合作、现有干预措施的无效实施、投资不足以及缺乏立法六个月产假的政治意愿，这些政策差距进一步加剧。因此，前 6 个月 EBF 率的进展以前 24 小时衡量是不稳定的；从2012年的12.3%上升到2015年的23.1%，2019年下降到14%。早期启动率从2006年的49.6%恶化到2019年的34%，这些低绩效阻碍了到2030年全球目标的实现。我们推荐以下内容。首先，增加财政和人力资源投资，并通过多部门卫生行动支持 BHFI、社区和工作场所成功的纯母乳喂养。二是对违法行为实施主动监测，加强执法力度，及时对违法者进行法律制裁。三是振兴公立医院实施BFHI，向民营医院延伸。这些低绩效阻碍了到 2030 年实现全球目标。我们建议如下。首先，增加财政和人力资源投资，并通过多部门卫生行动支持 BHFI、社区和工作场所成功的纯母乳喂养。二是对违法行为实施主动监测，加强执法力度，及时对违法者进行法律制裁。三是振兴公立医院实施BFHI，向民营医院延伸。这些低绩效阻碍了到 2030 年实现全球目标。我们建议如下。首先，增加财政和人力资源投资，并通过多部门卫生行动支持 BHFI、社区和工作场所成功的纯母乳喂养。二是对违法行为实施主动监测，加强执法力度，及时对违法者进行法律制裁。三是振兴公立医院实施BFHI，向民营医院延伸。对违法行为实施主动监测，加强执法力度，及时对违法者进行法律制裁。三是振兴公立医院实施BFHI，向民营医院延伸。对违法行为实施主动监测，加强执法力度，及时对违法者进行法律制裁。三是振兴公立医院实施BFHI，向民营医院延伸。