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World Breastfeeding Week: 20 Years of Promoting Best Practices in Infant Feeding

Today marks the start of the 20th annual World Breastfeeding Week which runs every year August 1-7.  WBW is a project of the World Alliance for Breastfeeding Action and is designed to call attention to practices and policies that support and promote breastfeeding.  This also marks the 10-year anniversary of the Global Strategy for Infant and Young Child Feeding, a joint initiative of the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF).  The Global Strategy

has identified a clear need for optimal infant feeding practices in reducing malnutrition as well as poverty. It is based on a human rights approach and calls for the development of comprehensive national policies on infant and young child feeding. It provides guidance on how to protect, promote and support exclusive breastfeeding for first six months, and continued breastfeeding for two years or beyond together with adequate, appropriate and indigenous complementary feeding starting from the age of six months.

What does breastfeeding look like around the world?  According to the WHO’s Global Database on Breastfeeding, on 35% of the world’s infants are exclusively breastfed between birth and 4 months of age.   This suggests that we have a long way to go before meeting the WHO’s recommendations for breastfeeding:  Exclusive breastfeeding for 6 months, and breast milk along with appropriate complementary foods until at least age 2.

Statistics complied by UNICEF and La Leche League tell a similar story – there are few places in the world where the 4 month exclusive breastfeeding rate breaks the 50% mark (the US sits at 33%) much less approaches the goal of 100% set by the WHO recommendations.

The health benefits of breastfeeding for both mother and child are indisputable – among other things, breast milk carries antibodies to ward off disease and breastfeeding lowers a mother’s later risk of developing certain cancers.  Breastmilk has properties we are just beginning to understand; among these, the presence of  stem-cells which have potential applications in medicine beyond breastfeeding. The “liquid-gold” moniker frequently ascribed to breastmilk is well earned. The best nutrition for human babies is that biologically designed for human babies – human milk.  Even in industrialized nations like the US, it is estimated that increases in the breastfeeding rate would save lives (and health care costs).

In many places in the world, breastfeeding truly is a matter of life or death; unsafe drinking water makes safe formula use nearly impossible.  Aggressive formula marketing in the developing world necessitated the 1981 WHO International Code of Marketing of Breastmilk Substitutes which seeks to promote breastfeeding by discouraging predatory practices of formula marketing.  The WHO code has yet to be adopted by many countries (including the US where formula companies are in flagrant violation).  A related measure, the Baby Friendly Hospital Initiative (another joint project of the WHO and UNICEF) seeks to implement practices in hospitals that encourage and support breastfeeding, including a ban on formula marketing within hospitals.   Although such measures are not without critics – as demonstrated by the recent controversy over the Latch On NYC initiative – breastfeeding is clearly a critical public health issue in all parts of the world.

Even within the US, there are striking disparities in access to education about and support for breastfeeding.   But there is progress being made.   Here in the US, the American Academy of Pediatrics has recently passed a resolution advising pediatricians to cease the practice of distributing formula “freebies” from their offices.   And just today, a provision of the Affordable Care Act went into effect that requires insurance companies to provide coverage for breastfeeding support, supplies, and counseling among other aspects of women’s preventative health care.   There is, however, still much to accomplish.

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Published in Breastfeeding