Breastfeeding is essential for preventing the triple burden of malnutrition, infectious diseases, and mortality while reducing the risk of obesity and chronic diseases. However, despite recommendations from the World Health Organization (WHO) for exclusive breastfeeding for the first six months of life and continued breastfeeding for at least the first two years, many mothers face barriers to breastfeeding at all levels of the socioecological model.
These barriers include gender inequities, harmful sociocultural infant-feeding norms, income growth and urbanization, corporate marketing practices, and poor healthcare. According to new research published in The Lancet, it was breastfeeding human infants (aged ≤12 months) and young children (aged 12–36 months) can help them survive, grow, and reach their full potential.
Breast milk is said to have unique living properties that can improve brain development, prevent malnutrition, infectious diseases, and mortality, and reduce the risk of obesity and chronic diseases later in life. Breastfeeding supports birth spacing and protects mothers from chronic diseases such as breast and ovarian cancers, type 2 diabetes, and cardiovascular disease.
Other factors that affect breastfeeding include inadequate health care, including the medicalization of birthing and infant care, and labor markets that poorly accommodate women’s reproductive rights and care work. Moreover, families and communities often lack the resources and capabilities to support breastfeeding fully.
A new vision for addressing breastfeeding protection, promotion, and support at scale through multilevel, equitable approaches that address barriers and facilitators across all levels, from the structural to the individual.
Since the 2000s, early breastfeeding initiation has almost doubled globally, reaching 50% in 2019. Exclusive breastfeeding among infants younger than six months has also increased by 0.7 percentage points per year, reaching 49% in 2019. However, only some countries are on track to meet the World Health Assembly’s target of 70% of infants being exclusively breastfed by 2030. There are still significant disparities across and within countries, with declining breastfeeding trends in low-income countries.
More than a third of all neonates received pre-lacteal feeds during the first three days after birth, which is negatively associated with timely breastfeeding initiation and duration. Health-system and community-based interventions are needed globally to prevent the introduction of prelacteal feeds and counteract the harmful influence of commercial milk formula (CMF) marketing on health systems and communities.
Unsettled baby behaviors, including crying, posseting, and short nocturnal sleep duration, can prompt cessation of exclusive breastfeeding because many parents interpret them as inadequate breastmilk supply or infant pathology requiring unique feeding products. The CMF industry exploits and pathologizes standard infant development patterns in ways that exacerbate parental insecurities about feeding. This is a crucial reason for the introduction of CMF and the premature termination of breastfeeding.
Preventing these issues requires effective lactation management and social support during pregnancy, along with maternity facilities that follow policies and practices conducive to initiating breastfeeding without commercial influence. Supporting breastfeeding self-efficacy and combating CMF marketing influence through evidence-based information and support is paramount to preventing these problems.
Universal access to improved breastfeeding-supportive maternity care, evidence-based breastfeeding counseling, and public and health worker education is crucial for preventing common early lactation problems, avoiding attempts to address common behaviors of infant development by introducing CMFs, and helping mothers improve their breast milk production and self-efficacy.
The Baby-Friendly Hospital Initiative (BFHI), community-based peer counseling, and maternity benefits for mothers working in both the formal and informal sectors are evidence-based approaches to improving breastfeeding outcomes.
Maternity protection policies have improved in the past decade due to national laws informed by the International Labor Organization standards or via initiatives to improve the breastfeeding environment at the workplace, but more progress is needed. Absent, inadequate, or poorly enforced maternity protection policies undermine breastfeeding among working mothers through restricted access to paid maternity.
