More mothers are breastfeeding worldwide. Exclusive breastfeeding in a baby's first six months rose from around 37 percent in 2012 to more than 47 percent. The figures come from a joint statement by UNICEF and the WHO ahead of World Breastfeeding Week, which runs from 1 to 7 August. It was signed by UNICEF Executive Director Catherine Russell and WHO Director-General Tedros Adhanom Ghebreyesus. Over the past five years, breastfeeding that continues to a child's second birthday also rose, from 38 to 50 percent.
The stakes behind those percentages are unusually concrete. Scaling breastfeeding up further could prevent almost 400,000 child deaths a year, and around 140,000 maternal deaths, the two agencies say. They put the economic return at an estimated 59 dollars for every dollar invested. That figure comes from lower health-care costs, better cognitive development and higher lifetime earnings. Mothers who breastfeed also face a reduced risk of breast and ovarian cancer and of type 2 diabetes.
Progress is uneven. Many countries remain behind the global targets. Support services reach too few families, policies are enforced inconsistently, and quality is often poor in low-income, fragile and humanitarian settings. What works is well established: skilled support inside health systems, community-based counselling, maternity protection at work, and shielding parents from the exploitative marketing of commercial formula.
Three myths from the first days
Some of the advice given on maternity wards is itself part of the problem. That is the finding of a study from Sapienza University in Rome, published in The Journal of Maternal-Fetal & Neonatal Medicine. The authors reviewed 78 studies, among them work from the United States, Germany, Australia, India and Mexico. They identified three widespread misconceptions.
The first is the belief that too little milk is produced in the early days. Parents who believe it introduce formula prematurely. "Our research suggests that colostrum is generally sufficient to meet a newborn's needs," said lead author Maria Di Chiara, a neonatology specialist. She means the first, highly concentrated milk produced after birth.
The second myth is the advice to avoid pacifiers in the first weeks. Using one shortens neither the duration of breastfeeding nor exclusive breastfeeding, Di Chiara says. Germany's midwives' association still recommends waiting four to six weeks. The third concerns electric pumps. They should not be used routinely in the days after birth. Where milk must be expressed, hand expression is the better method.
"What struck me most was how often well-meant, routine advice is not yet based on scientific evidence," Di Chiara said. "Small changes in those first three days could make a real difference for families."
Germany shows how slowly the direction changes. Rates there have been rising since a historic low in the early 1970s. In the national KiGGS survey, 68 percent of infants were exclusively breastfed immediately after birth, and 40 percent still were at the end of the fourth month. The WHO recommends six months of exclusive breastfeeding, with no additional water. Solid food should follow, while breastfeeding continues to the age of two or beyond.