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The Challenge

While progress to date has been encouraging, significantly more than half of the world's children are not as yet being optimally breastfed.

Participating in the "Kangaroo Mother" programme at the Mother Child Institute in Bogota, Colombia, a mother holds her premature, sleeping infant securely against her chest.

Optimal breastfeeding practices include exclusive breastfeeding (breastmilk with no other foods or liquids) for the first six months of life, followed by breastmilk and complementary foods (solid or semi-solid foods) from about six months of age on, and continued breastfeeding for up to at least two years of age at beyond, while receiving appropriate complementary foods.

According to several studies, improves cognitive development and intelligence. Breastfeeding aids in digestion and provides all the micronutrients and water a baby needs.

Breastmilk alone is the ideal nourishment for infants for about the first six months of life, combining the three fundamentals of sound nutrition – food, health and care. Breastmilk alone contains all the nutrients, antibodies, hormones and antioxidants an infant needs to thrive.

It protects babies from diarrhoea and acute respiratory infections, stimulates their immune systems and response to vaccination, and, according to some studies, confers cognitive benefits as well. Continued breastfeeding to two years, accompanied by appropriate complementary feeding, maintains good nutritional status and continues to help prevent diarrhoea.

It has been estimated that improved breastfeeding practices could save some 1.5 million children a year. Yet few of the 129 million babies born each year receive optimal breastfeeding and some are not breastfed at all. Early cessation of breastfeeding in favour of commercial breastmilk substitutes, needless supplementation, and poorly timed complementary practices are still too common. Professional and commercial influences combine to discourage breastfeeding, as do continued gaps in maternity legislation.

Strategies to promote and protect exclusive breastfeeding aim at the creation of appropriate national structures; implementation of the International Code of Marketing of Breastmilk Substitutes (International Code); adoption of protective maternity legislation; and implementation of the ‘Baby-Friendly Hospital Initiative’ (BFHI) to ensure that all hospitals and maternity facilities become centres of breastfeeding support, including the refusal to accept, distribute or promote free or low-cost breastmilk substitutes. Governments are also obliged, under Article 24 of the Convention on the Rights of the Child, to ensure that all sectors of society know about the benefits of breastfeeding.

For HIV/AIDS-positive women, where such benefits must be weighed against the risk of mother-to-child transmission of the virus, current policies aim to continue support for breastfeeding, while ensuring informed choice on infant feeding options, with further research into the exact mechanisms of transmission to inform guidelines on this issue.