“Breastfeeding is today the single most effective preventive intervention for improving the survival and health of children”—WHO Secretariat, 2011.[i] Breastfeeding provides optimal nutrition for infants. Bhutta, writing for the Lancet 2013 Series on Maternal and Child Nutrition, cites a review that suggests that breastfeeding initiation within 24 hours of birth is associated with at least a 44% reduction in all-cause and infection-related neonatal mortality.[ii],[iii] Exclusive feeding with human milk in the first hour after birth has been shown to reduce newborn mortality by 22%.[iv] According to UNICEF, data indicate that only 36% of infants 5 months old or younger in the developing world are exclusively breastfed, and only 43% of newborns started breastfeeding within the first hour after birth.[v]
Mothers also benefit from breastfeeding. Immediately after delivery, the oxytocin released when a mother begins breastfeeding her child causes the uterus to contract, helping to minimize postpartum bleeding. Exclusive breastfeeding also delays the return of ovulation and menstruation. Longer term, breastfeeding reduces type 2 diabetes and breast, uterine, and ovarian cancer. Studies have also found an association between early cessation of breastfeeding and postnatal depression in mothers.[vi]
Health care providers should be aware of the elements of the Baby-Friendly Hospital Initiative (BFHI), a global effort launched by WHO and UNICEF in 1991 to implement practices that protect, promote, and support breastfeeding. BFHI materials were revised, updated, and expanded for integrated care in 2009.
Key Resources for Breastfeeding:
- LINKAGES Project (1996-2006) was a USAID-funded project that provided technical information, assistance, and training to organizations on breastfeeding, related complementary feeding and maternal dietary practices, and the lactational amenorrhea method, a modern postpartum method of contraception for women who breastfeed. Many useful publications and tools are still available on the project website.
- UNICEF, 2013. Nutrition: Breastfeeding
- MCHIP, 2014. Nutrition TRM
- WHO, 2003. Community-Based Strategies for Breastfeeding Promotion and Support in Developing Countries
 The LINKAGES Project ended in 2006, but its website has many good resources for supporting breastfeeding. Resources related to HIV and infant feeding, however, are out of date. Please see the WHO statement (2010) for current guidance.
[i] PAHO. 2011. Early Initiation of Breastfeeding: The Key to Survival and Beyond. https://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=15147&Itemid=270&lang=en
[ii] Bhutta, Z. et al. Evidence-based interventions for the improvement of maternal and child nutrition: what can be done and at what cost? Lancet 2013; 382:458
[iii] Debes A, et al. Time to initiation of breastfeeding and neonatal mortality and morbidity: a systematic review. BMC Public Health 2013;13(Suppl 3): S19.
[iv] American Academy of Pediatrics, 2013. Policy Statement: Breastfeeding and the use of human milk. http://pediatrics.aappublications.org/content/129/3/e827.full.html
[v] UNICEF, 2014. Infant and Young Child Feeding. https://www.unicef.org/nutrition/index_breastfeeding.html