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Peer-reviewedCC BY-NC 4.0The European Journal of Public Health

Strengthening breastfeeding protection through micro-credential education based on NetCode findings

Abstract

Background: Breastfeeding is a major public health priority supported by WHO recommendations and the International Code of Marketing of Breast-milk Substitutes. Despite these frameworks, exposure to marketing of breast-milk substitutes in healthcare settings persists. A national NetCode study conducted in the Czech Republic (2024) found that 25% of mothers reported exposure to promotional activities in healthcare facilities, highlighting the need to strengthen competencies in recognising marketing practices and supporting breastfeeding protection in clinical and public health practice.

Objectives: The programme was implemented in the academic year 2025/2026 within a university-based health sciences environment in cooperation with healthcare facilities and regional public health authorities. It addressed nursing students, neonatal and paediatric healthcare professionals, and staff involved in routine public health surveillance. The intervention links empirical surveillance data with structured education and is transferable to other countries due to its multi-level design spanning academic, clinical, and regulatory settings.The programme introduced a micro-credential format to extend structured training beyond formal curricula.

Results: A total of 160 nursing students, 40 healthcare professionals, and 20 public health inspectors were trained. Pre- and post-test evaluation demonstrated improved knowledge and enhanced ability to identify marketing practices of breast-milk substitutes in line with the International Code.

Conclusions: The programme demonstrated improved competencies in recognising marketing practices and supporting Code implementation. Targeted education through healthcare students and professional groups appears more effective than general public outreach. Involvement of public health inspectors enables identification of potential non-compliance during routine activities in healthcare facilities and supports preventive and corrective public health action.

Key messages: • Evidence-based training improved participants’ ability to identify marketing of breast-milk substitutes across students, clinicians and public health inspectors.

• Linking NetCode surveillance findings with micro-credential education provides a scalable model for strengthening breastfeeding protection across healthcare systems.

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BibTeX
@article{zemanova2026strengthening,
  title = {{Strengthening breastfeeding protection through micro-credential education based on NetCode findings}},
  author = {M Zemanová and L Micikova and B Vaverkova and A Hujova and A Petrakova and A Lemrova and M Vostrý and M Lulkova and M Rothova and K Ticha},
  journal = {The European Journal of Public Health},
  year = {2026},
  month = oct,
  doi = {10.1093/eurpub/ckag169.1334},
  url = {https://doi.org/10.1093/eurpub/ckag169.1334},
  note = {CC BY-NC 4.0},
}
RIS
TY  - JOUR
TI  - Strengthening breastfeeding protection through micro-credential education based on NetCode findings
AU  - M Zemanová
AU  - L Micikova
AU  - B Vaverkova
AU  - A Hujova
AU  - A Petrakova
AU  - A Lemrova
AU  - M Vostrý
AU  - M Lulkova
AU  - M Rothova
AU  - K Ticha
PY  - 2026
DA  - 2026/10/01
JO  - The European Journal of Public Health
DO  - 10.1093/eurpub/ckag169.1334
UR  - https://doi.org/10.1093/eurpub/ckag169.1334
AB  - Background: Breastfeeding is a major public health priority supported by WHO recommendations and the International Code of Marketing of Breast-milk Substitutes. Despite these frameworks, exposure to marketing of breast-milk substitutes in healthcare settings persists. A national NetCode study conducted in the Czech Republic (2024) found that 25% of mothers reported exposure to promotional activities in healthcare facilities, highlighting the need to strengthen competencies in recognising marketing practices and supporting breastfeeding protection in clinical and public health practice.  Objectives: The programme was implemented in the academic year 2025/2026 within a university-based health sciences environment in cooperation with healthcare facilities and regional public health authorities. It addressed nursing students, neonatal and paediatric healthcare professionals, and staff involved in routine public health surveillance. The intervention links empirical surveillance data with structured education and is transferable to other countries due to its multi-level design spanning academic, clinical, and regulatory settings.The programme introduced a micro-credential format to extend structured training beyond formal curricula.  Results: A total of 160 nursing students, 40 healthcare professionals, and 20 public health inspectors were trained. Pre- and post-test evaluation demonstrated improved knowledge and enhanced ability to identify marketing practices of breast-milk substitutes in line with the International Code.  Conclusions: The programme demonstrated improved competencies in recognising marketing practices and supporting Code implementation. Targeted education through healthcare students and professional groups appears more effective than general public outreach. Involvement of public health inspectors enables identification of potential non-compliance during routine activities in healthcare facilities and supports preventive and corrective public health action.  Key messages: • Evidence-based training improved participants’ ability to identify marketing of breast-milk substitutes across students, clinicians and public health inspectors.  • Linking NetCode surveillance findings with micro-credential education provides a scalable model for strengthening breastfeeding protection across healthcare systems.
SN  - 1101-1262
SN  - 1464-360X
ER  -