Breastfeeding: A formula to advance health and promote sustainable development

How to empower and enable parents to give their newborns the best start possible

Breastfeeding is on the rise across the WHO South-East Asia Region. The Region’s newborns will be better for it. Last year, approximately 54% of all infants were exclusively breastfed up to the age of six months. That’s up from 47% in 2015 and 50% in 2017, and compares to 38% of newborns across the world and just 18% in industrialised countries. The Region’s average is the highest of any WHO region, and is already above the 2025 global target of ensuring at least 50% of newborns are exclusively breastfed for the first six months of life.

We can be proud of the Region’s leadership, which reflects several of its Flagship Priorities, including ending preventable newborn and child deaths and preventing noncommunicable diseases. We should also look at how the Region’s leadership can be sustained and accelerated, and at the innovative policies that can make that happen. The benefits of breastfeeding are, after all, substantial, with WHO recommending each newborn be breastfed within the first hour of life, that they be exclusively breastfed for the first six months, and that they be breastfed while taking appropriate complementary food for at least 18 months thereafter. 

For newborns, breastfeeding strengthens the immune system and protects against chronic and infectious diseases. It also enhances sensory and cognitive development and helps prevent malnutrition – including obesity – throughout the life-course. For mothers, breastfeeding helps space children and increases health and well-being by reducing the risk of ovarian cancer and breast cancer among other benefits. For communities and countries, breastfeeding is a sustainable way to increase family and national resources. Inadequate breastfeeding is estimated to cost the global economy around $ 302 billion annually.

As natural as breastfeeding is, however, and as strong as the evidence may be for its increased uptake, it is a learned behaviour. As such, it requires active support to establish and sustain. Crucially, that support should apply to both parents, with an inclusive approach needed to ensure all families are empowered and enabled to give their newborns the best start possible. WHO is committed to supporting Member States do precisely that, including by focusing on three key areas of action.

First, Member States should augment the commendable work already being done to protect and support breastfeeding. That means increasing awareness and knowledge beyond mothers and sensitising fathers, families and communities on the importance of breastfeeding and the need to actively support it. It also means enhancing the efficiency of breastfeeding counselling in pre-conception and antenatal programmes, and strengthening baby-friendly practices in maternity care facilities using WHO and UNICEF’s new joint guidance and programme tools. As part of this, increasing the number, skills and capacity of health workers is vital.

Second, Member States should accelerate the implementation of the International Code of Marketing Breast-milk Substitutes, as well as several World Health Assembly resolutions and decisions aimed at protecting breastfeeding from commercial interests. Though the Region already has some of the strongest legislation in the world to protect and support breastfeeding, there is room for further gains, particularly on the promotion of breast-milk substitutes and related products to health workers and in health care settings, as well as via digital marketing. Doing so is crucial to pushing back against the commercial determinants of newborn and child health, and to protecting and supporting breastfeeding and the many benefits it brings.

And third, health authorities Region-wide should work across sectors to promote breastfeeding and support the development of innovative policies that help families practice it. Given that workplace pressures are a leading motive for early weaning, for example, the implementation of paid maternity leave for at least six months would be a game-changer, as would be paid paternity leave. This is especially so in the informal sector, where employer insurance and social protection schemes hold immense potential to deliver such policies. These and other mechanisms should be explored and, where appropriate, pursued. Equally important is the uptake of parent-friendly workplaces and gender-equitable social protection, both of which enable breastfeeding and promote its social value.

We must continue to strive for those outcomes. Though the South-East Asia Region is already the world’s leader in the promotion and uptake of breastfeeding, there is always progress to be made and new ways to make it. To that end, WHO will continue to provide actionable support to Member States via technical and operational assistance, and will continue to advocate for all families to be empowered and enabled to give their newborns the best start possible. Breastfeeding is humanity’s oldest and most powerful formula to advance newborn health and promote sustainable development. It is a formula we must harness to maximum effect.

(The writer is Regional Director, WHO South-East Asia.)