Breast milk gives infants all the nutrients they need for healthy development.
Experts say that it is safe and contains antibodies that help protect infants from common childhood illnesses such as diarrhoea and pneumonia, the two primary causes of child mortality worldwide.
In addition, breast milk is readily available and affordable, which helps to ensure that infants get adequate nutrition.
The United Nations Children’s Fund (UNICEF) deputy executive director, Geeta Rao Gupta, said that there is no other single health intervention that has such a high impact for babies and mothers as breastfeeding and which costs so little for governments.
She said, “Breastfeeding is a baby’s first immunization and the most effective and inexpensive life-saver ever.”
“Children who are exclusively breastfed are 14 times more likely to survive the first six months of life than non-breastfed children. Starting breastfeeding in the first day after birth can reduce the risk of new-born death by up to 45 per cent.”
Breastfeeding also supports a child’s ability to learn and helps prevent obesity and chronic diseases later in life.
Recent studies in the United States and United Kingdom point to large health care savings resulting from breastfeeding, given that breastfed children fall ill much less often than non-breastfed children.
Apart from the benefits to the baby, mothers who breastfeed exclusively are, according to medical experts, less likely to become pregnant in the first six months following delivery, recover faster from giving birth, and return to their pre-pregnancy weight sooner.
Evidence shows that they experience less post-partum depression and also have a lower risk of ovarian and breast cancers later in life.
However, UNICEF notes that despite these well documented benefits of breastfeeding worldwide, only 39 per cent of children aged less than six months were exclusively breastfed in 2012.
According to the global agency, this global figure has improved very little for the past several decades, due in part to large countries where the breastfeeding rate is low and to the general lack of a supportive environment for breastfeeding mothers.
UNICEF observed that Nigeria has made no improvement over many years, while some of the lowest rates in the world are in Somalia, Chad and South Africa.
However, says a statement by the UNICEF communications specialist, Mr Geoffrey Njoku, countries with supportive policies and comprehensive programmes that reach all communities have been able to increase their breastfeeding rates significantly.
He said China, which recently attracted media attention because its strong consumer demand for baby formula caused shortages in other countries, has an exclusive breastfeeding rate of only 28 per cent.
Njoku said that in a bid to boost such low rates in the world’s most populous country, UNICEF and the National Centre for Women’s and Children’s Health in May launched a “10m2of Love” campaign to locate, register, certify and publicize breastfeeding rooms in order to raise awareness and support for breastfeeding.
“The campaign has established a web portal (unicef.cn/10m2) where any organization can register breastfeeding rooms for staff, patrons or customers that adhere to simple international standards. A mobile phone application to map the locations of all 10m2of Love facilities is under development.”
Cambodia has had notable success in raising exclusive breastfeeding rates from 11.7 per cent of infants less than six months in 2000 to a very high 74 per cent in 2010. Togo and
Zambia also increased the rates from 10 and 20 per cent respectively in the late 1990s to over 60 per cent by 2000.
At the other end of the scale, Tunisia’s exclusive breastfeeding rate fell dramatically from 46.5 per cent in 2000 to only 6.2 per cent by the end of the decade, while the exclusive breastfeeding rate in Indonesia is declining.
The communications specialist noted that such examples reflect insufficient global leadership on breastfeeding, as it continues to be undervalued relative to its importance in the life of child.
“There needs to be higher prioritization and commitment, targeted policies and greater consensus to engage the world in promoting this life-saving and vital practice.”
Similarly, the World Health Organisation also stated that only 37 countries, or 19 per cent of those reporting, have passed laws reflecting all the recommendations of the International Code of Marketing of Breast-milk Substitutes.
“Full implementation of the Code is vital for reducing or eliminating all forms of promotion of breast-milk substitutes, including direct and indirect promotion to pregnant women and mothers of infants and young children,” said Dr Carmen Casanovas, breastfeeding expert with WHO’s Department of Nutrition for Health and Development Casanovas.
“WHO supports countries with implementation and monitoring of the Code and the comprehensive implementation plan on maternal, infant and young child nutrition” which aims to increase the global rate of exclusive breastfeeding for six months to at least 50% by 2025.”
This year, the WHO has called for more support for breastfeeding mothers, creating graphics detailing what mothers, fathers, family/friends and the workplace can do to increase support.
“Nearly all mothers are physically able to breastfeed and will do so if they have accurate information and support,” said Casanovas, “But in many cases, women are discouraged from doing so, and are misled to believe that they are giving their children a better start in life by buying commercial substitutes.”
According to the WHO, mothers are often inundated with incorrect and biased information both directly, through advertising, health claims, information packs and sales representatives, and indirectly through the public health system.
“For example, distribution of educational materials on breastfeeding produced by manufacturers of infant formula have a negative impact on exclusive breastfeeding especially on mothers of first-born children and those with less formal education. The distribution of samples of infant formula also has an adverse impact on breastfeeding.
Njoku stated that although breastfeeding is natural and may seem instinctive, it is essential to create an enabling environment for it to become the norm.
“Mothers benefit from the help of skilled health providers and community workers to support them to breastfeed, as well as culturally-sensitive communication, and protective laws and policies, particularly around the marketing of breastmilk substitutes and maternity leave,” said he.
Implementation of the Code
Only 37 of the 199 countries (19%) reporting to WHO on implementation of the Code have passed laws reflecting all of its recommendations. For example:
69 countries (35 per cent) fully prohibit advertising of breast-milk substitutes;
62 (31 per cent) completely prohibit free samples or low-cost supplies for health services;
64 (32 per cent) completely prohibit gifts of any kind from relevant manufacturers to health workers;
83 (42 per cent) require a message about the superiority of breastfeeding on breast-milk substitute labels;
Only 45 countries (23 per cent) report having a functioning implementation and monitoring system.
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