High

The primary responsibility for monitoring the implementation of the code rests with governments. Enforcement is most effective when this responsibility is shared among the main government agencies involved throughout the various stages of product commercialization.
- National legislation on the Code should indicate which government agencies are in charge of overseeing this and how it should be done.
- Manufacturers and vendors of human milk substitutes should monitor their own marketing practices at all levels.

Early childhood (from birth to 8 years of age) is key to achieving the maximum development of the human being. This stage comprises the most sensitive period for brain development and extends from pregnancy (during organogenesis), until 3 years after birth, when the greatest number of neural connections and circuits are formed and the maturation of the central nervous system gets completed.

Early childhood (birth to 8 years of age) is key to achieving a human being’s maximum developmental potential. This stage comprises the most sensitive period for brain development. This is the time of life when children's developmental potential is most susceptible to environmental stimuli and early experiences, which influence learning, health, behavior and, in the long term, adult social relationships and well-being.

Neural tube defects (NTDs) are the most common defects of the central nervous system, with a strong impact on infant morbidity and mortality.
These are some of the milestones that can be highlighted about their evolution:
- 70s: advances in medical/surgical therapies lead to a significant reduction of sequelae and disability.

According to the World Health Organization (WHO), every year, about 8 million children are born with a birth defect in the world. Congenital anomalies cause 10 per cent of all newborn deaths and many of the babies who survive are at risk of carrying a lifelong disability if they do not have timely access to high-quality care.

However, the burden of death and disability differs by place of birth and is disproportionately high in low- and middle-income countries.

Banked human milk (BHM) is the alternative of choice for feeding preterm infants (PTNB) as it provides the opportunity for them to receive a diet consisting of exclusive human milk when the milk of the baby’s own mother is unavailable, scarce or contraindicated.
In terms of its benefits, BHM is somewhat inferior to the mother's own, but superior to artificial formula.

After childbirth, it is usual for some mothers to suffer from depression or anxiety. This is due to multiple causes and, in no case should the woman going through these situations be judged. It usually appears as feelings of sadness, irritability, difficulty falling asleep or extreme tiredness.
It is very important to attend to the mother's mental health and social well-being. Referral to a specialist may be advisable.
It is also important to involve the father, sexual partner or other companions, both in the care of the child and in supporting the mother.

According to the evidence available, vaccination against Covid 19 disease during pregnancy is safe for both mother and baby.
It is important to discuss this with the health care professional that cares for that pregnancy to promote an informed decision about immunization.
Unvaccinated pregnant women are at increased risk of becoming seriously ill, needing intensive care, and even dying. When they get Covid, birth may be triggered prematurely.
It is very important to discuss vaccinations with the professional who is monitoring pregnancy.
 

Sometimes, several vaccines must be administered simultaneously during pregnancy; such is the case of Tdap (tetanus and diphtheria toxoids with acellular pertussis vaccine) and influenza vaccine, for instance.
In studies that enrolled non-pregnant individuals to assess the safety of concurrent administration of Tdap and influenza vaccines, compared to their separate use, there was no evidence of increased risk of adverse events.

Several vaccines can be safely administered during pregnancy. In 2014, the WHO Global Advisory Committee on Vaccine Safety conducted a comprehensive assessment of the existing scientific data on the safety of vaccines during pregnancy, concluding that:
- Pregnancy should not prevent pregnant women from receiving a vaccine.
- Although live or attenuated microbial vaccines, such as the MMR vaccine, might pose a theoretical risk to the fetus, no major vaccination-associated adverse outcomes have been reported.