2021 World Health Day: Improve global breastfeeding practices

With our partner World Alliance for Breastfeeding Action, we have developed the following joint statement in celebration of this year’s World Health Day on 7 April.

2021 World Health Day: Improve global breastfeeding practices for a fairer, healthier world

The COVID-19 pandemic poses enormous challenges for the global community and has exposed many inequalities within and across our societies. Ensuring a healthier and fairer future for all is all the more important. Breastfeeding is foundational to creating a healthier and fairer world, providing an optimal start for infants and children; enhancing their developmental potential and wellness, regardless of social or financial status. Breastfeeding provides a readily available food source that is both nutritionally superlative and fits the developmental needs of their child/children. The WHO and UNICEF recommend that infants are exclusively breastfed for the first six months of life and continue to breastfeed for two years and beyond with nutritionally adequate complementary food. Globally about 41% of all babies are breastfed exclusively for six months and only 45% continue to breastfeed up to two years. However, there are also large differences in breastfeeding rates across regions, between and within countries.

The Importance of Breastfeeding

The importance of breastfeeding is well-known, positively impacting the health and well-being of children, mothers and families, and the larger communities and populations they comprise. Breastfeeding helps children to combat infectious diseases, decrease incidence and severity of diarrhoea, lower respiratory infections and acute otitis media, prevent dental caries and malocclusion, and attain optimal cognitive development. Breastfeeding builds stronger and more responsive immune systems in children, which is especially important during this current global pandemic. Breastfeeding plays a significant role in maternal health and wellbeing, including reducing the risk of maternal breast and ovarian cancer, osteoporosis, cardiovascular disease, and diabetes.

Furthermore, breastfeeding has long-term, positive impacts on households, and on national and global communities, both medically and economically. Less health-related issues allow for less time spent away from work, less medical costs and less stress on medical systems and local economies. Thus all countries benefit from increasing breastfeeding rates, and reports indicate that “the total global economic losses of not breastfeeding are estimated to be US$341.3 billion”.

It is estimated that feeding a child with an economy brand of formula for the first 2 years of life instead of breastfeeding would cost on average over 6.1% of a household’s wages. Breastfeeding contributes to the family’s food security by supporting the health and safety of the infant and lessening the household economic burden, especially important for low-income households. During times of crises such as the COVID-19 pandemic many households face job insecurity and loss of income further worsening inequalities. Breastfeeding helps to reduce household expenditure, to ensure optimal nutrition and health, and to reduce inequities.

barriers to breastfeeding

Breastfeeding supportive healthcare policies and practices increase the initiation of breastfeeding, yet inequities persist, including access to baby-friendly hospitals. The Baby-Friendly Hospital Initiative (BFHI) was launched in 1991. Its purpose was to protect breastfeeding by removing barriers for mothers and families to successfully initiate breastfeeding in the hospital and to help them with support for sustained breastfeeding after discharge. However, as of 2017, only 10% of infants in the world were born in a facility currently designated as “Baby-friendly.” Many marginalised and vulnerable mothers and families do not have access to supportive practices that protect breastfeeding in the hospital or maternity facility. In addition, even within baby-friendly hospitals, disparities in breastfeeding support have been reported. Lack of trained healthcare staff to support breastfeeding is another related challenge. 2021 is the International Year of Health and Care Workers. We need to advocate for improving the education, competencies and working conditions for frontline health and care workers who are also providing breastfeeding support.

Return to work is a major barrier to exclusive and continued breastfeeding. Paid maternity leave and supportive workplace practices are known to overcome this barrier, but many families do not have adequate access to them. This is especially true in the large and unorganised informal sector. Lack of family and community understanding and support is another key reason why people stop breastfeeding earlier than they planned. Therefore public health campaigns that extend breastfeeding education to the extended family and the general public will help to anchor breastfeeding as an issue for the whole of society. Tailored actions need to be developed to address the needs and challenges of vulnerable populations and situations.

call towards a fairer, healthier world

As the pandemic continues, World Health Day 2021 reminds us that our world is an unequal one and calls us to work towards building a fairer, healthier world. Optimal breastfeeding along with nurturing care decreases the inequities that can affect child growth and development and gives a child the best opportunity for a healthy life. La Leche League International (LLLI) and the World Alliance for Breastfeeding Action (WABA) call upon governments, UN agencies, health systems, trade unions, workplaces, communities and civil society organisations to:

  • Ensure that a public health perspective is taken to strengthen BFHI and breastfeeding counselling among the general population including during emergencies.
  • Implement maternal social protection that includes measures such as paid leave and workplace support, for both the formal and informal work sectors, to support breastfeeding and protect against discrimination at work
  • Advocate for all women/parents with young children to have access to skilled breastfeeding counselling from health facilities and communities.
  • Reinforce support for breastfeeding dyads that informs all members of the family and the community by developing appropriate and consistent communication messages.

World Health Day statement 2020