The following is adapted from the introduction to the WHO and UNICEF’s 2018 Baby-Friendly Hospital Initiative Implementation Guidance. Please see this document for references.
“Breastfeeding is a vital component of realizing every child’s right to the highest attainable standard of health, while respecting every mother’s right to make an informed decision about how to feed her baby, based on complete, evidence-based information, free from commercial interests, and the necessary support to enable her to carry out her decision.
Breastfeeding is the biological norm for all mammals, including humans. Breastfeeding is critical for achieving global goals on nutrition, health and survival, economic growth and environmental sustainability. WHO and the United Nations Children’s Fund (UNICEF) recommend that breastfeeding be initiated within the first hour after birth, continued exclusively for the first 6 months of life and continued, with safe and adequate complementary foods, up to 2 years or beyond. Globally, a minority of infants and children meet these recommendations: only 44% of infants initiate breastfeeding within the first hour after birth and 40% of all infants under 6 months of age are exclusively breastfed. At 2 years of age, 45% of children are still breastfeeding.
Immediate and uninterrupted skin-to-skin contact and initiation of breastfeeding within the first hour after birth are important for the establishment of breastfeeding, and for neonatal and child survival and development. The risk of dying in the first 28 days of life is 33% higher for newborns who initiated breastfeeding 2–23 hours after birth, and more than twice as high for those who initiated 1 day or longer after birth, compared to newborns who were put to the breast within the first hour after birth. The protective benefit of early initiation extends until the age of 6 months.
Exclusive breastfeeding for 6 months provides the nurturing, nutrients and energy needed for physical and neurological growth and development. Beyond 6 months, breastfeeding continues to provide energy and high-quality nutrients that, jointly with safe and adequate complementary feeding, help prevent hunger, undernutrition and obesity. Breastfeeding ensures food security for infants.
Inadequate breastfeeding practices significantly impair the health, development and survival of infants, children and mothers. Improving these practices could save over 820,000 lives a year. Nearly half of diarrhoea episodes and one third of respiratory infections are due to inadequate breastfeeding practices. Longer breastfeeding is associated with a 13% reduction in the likelihood of overweight and/or prevalence of obesity and a 35% reduction in the incidence of type 2 diabetes. An estimated 20,000 maternal deaths from breast cancer could be prevented each year by improving rates of breastfeeding.
Recent analyses have documented that increasing rates of breastfeeding could add US$ 300 billion to the global economy annually, by helping to foster smarter, more productive workers and leaders. In Brazil, adults who had been breastfed for at least 12 months earned incomes that were 33% higher than for those who had been breastfed for shorter durations. Inadequate breastfeeding has a significant impact on the costs of health care for children and women. Mothers who feed their infants on formula are absent from work more often than breastfeeding mothers, owing to a higher frequency and severity of infant illness.
Breastfeeding is a non-polluting, non-resource intensive, sustainable and natural source of nutrition and sustenance. Breast-milk substitutes add to greenhouse gas emissions at every step of production, transport, preparation and use. They also generate waste, which requires disposal. Greenhouse gases include methane, nitrous oxide and carbon dioxide; a recent report estimated the carbon dioxide emissions resulting from manufacture of infant formula in Asia at 2.9 million tons.
In humanitarian settings, the life-saving potential of breastfeeding is even more crucial. All activities to protect, promote and support breastfeeding need to be increased in these situations.