More than 820,000 lives (87% of them infants under 6 months of age) would be saved annually with increased breastfeeding. Lancet Breastfeeding Series, 2016
Importance of Breastfeeding
Exclusive breastfeeding (a diet of breast milk only with no other liquids or solids, not even water) for the first six months of a child's life is one of the most important and cost-effective interventions to ensure a child's survival, healthy growth and development. It maximises a child’s physical and mental potential by supporting the rapid growth and critical brain development that occurs from birth to two years of age. Appropriate breastfeeding has a high impact on reducing infant and child mortality. Babies not exclusively breastfed in the first six months of life have a 14 times higher risk of death than infants who are exclusively breastfed.
Breast milk is free of charge and universally available, even in very resource-constrained settings, yet only 38% of babies globally are exclusively breastfed.
Breastfeeding should start immediately (within the first hour of birth) for the infant to benefit from the mother’s colostrum (first milk, or ‘immune milk’, which is extra rich in carbohydrates, proteins and antibodies). Infants should be breastfed exclusively on demand until six months old and then continue breastfeeding until at least two years old (appropriate complementary and solid foods should be introduced at around six months of age in addition to breastmilk).
World Vision's Position
World Vision protects, promotes and supports exclusive breastfeeding from birth until six months of age and continued breastfeeding with appropriate complementary feeding until two years of age and beyond, as per WHO/UNICEF infant feeding recommendations. These are priority interventions essential to the well being of infants and young children, and include:
- initiating breastfeeding during the first hour after delivery;
- exclusive breastfeeding for the first six months of life (no other liquids or solids, apart from medicines as directed by a doctor);
- continued breastfeeding up to two years and beyond (with the introduction of appropriate complementary foods beginning at six months of age).
"If breastfeeding did not already exist, someone who invented it today would deserve a dual Nobel Prize in medicine and economics. For while “breast is best” for lifelong health, it is also excellent economics. Breastfeeding is a child's first inoculation against death, disease, and poverty, but also their most enduring investment in physical, cognitive, and social capacity." Keith Hansen, Lancet 2016 Breastfeeding Series
How does World Vision protect, promote and support breastfeeding?
trains Community Health Workers
The Global Strategy for Infant and Young Child Feeding states that "even though it is a natural act, breastfeeding is also a learned behaviour. Virtually all mothers can breastfeed, provided they have accurate information and support within their families and communities, and from the healthcare system. They should also have access to skilled practical help from, for example, trained health workers, lay and peer counsellors, and certified lactation consultants, who can help to build mothers' confidence, improve feeding technique, and prevent or resolve breastfeeding problems."
Key ways World Vision works to do this are by training Community Health Workers to support exclusive breastfeeding counselling for pregnant and lactating women and by promoting peer (parent/mother-to-mother) support groups.
Learn how World Vision Community Health Workers support breastfeeding in Afghanistan
Watch a video about breastfeeding and parent support groups in Uganda
Read the inspiring story of how an Indonesian mother’s determination to breastfeed helped others
Breastfeeding support groups in Indonesia helped one mother to overcome cultural myths surrounding breastfeeding
Mother to mother support groups in Ghana helped this family
Learn more about World Vision's work with Community Health Workers
workS with FATHERS and grandmothers, as well as mothers
Read how a World Vision staff member advocated within his own family to support his wife in exclusively breastfeeding their newborn daughter, demonstrating the critical role fathers can play in ensuring their children get the best start in life.
World Vision also recognizes the key role grandmothers play in caring for young children and advising and educating younger women on all aspects of family well-being. We are working to intentionally involve grandmothers and empower them in their traditional roles, so they can be more effective in improving the nutrition, health and development of their families and subsequent generations. Check out the recently released Grandmother Guide.
Appropriate breastfeeding has been a vital component in all World Vision nutrition-related programmes. The following examples demonstrate how World Vision was successful in increasing exclusive breastfeeding through the MICAH Programme in Ghana and Senegal.
Properly trained grandmothers can play a positive leading role in households and in the community in promoting good nutritional practices and addressing malnourished children. World Vision credits the involvement of grandmothers in improving breastfeeding practices in their projects in Senegal.
protects breastfeeding in fragile contexts and emergency settings
In fragile contexts or emergency settings, World Vision sets up breastfeeding corners or spaces to provide safe places for mothers and their children, together with counselling on breastfeeding. Watch what World Vision Uganda is doing to respond to support South Sudanese refugee mothers. World Vision supported breastfeeding in Nepal following the 2015 earthquake by setting up women and young child spaces in affected communities.
World Vision has developed guidance on using baby-friendly spaces or tents to protect and promote breastfeeding in challenging emergency situations.
World Vision’s internal policy regarding the procurement and use of milk and milk products emphasizes that World Vision protects, promotes and supports breastfeeding and safe and appropriate infant and young child feeding practices and upholds the provisions of the International Code of Marketing of Breast Milk Substitutes. It also includes clear guidelines regarding the distribution of breast milk substitutes.
Advocates for Infant and young child nutrition, including exclusive breastfeeding
World Vision actively supports the global goal of increasing the prevalence of exclusive breastfeeding to 50 per cent by 2025. Enabling more mothers to exclusively breastfeed will require significant changes in national policy as well as increased support by competent breastfeeding counsellors at the community level.
World Vision Armenia recently collaborated on a successful advocacy campaign, resulting in the adoption of new national legislation "Promotion of breastfeeding and marketing infant food"
In August 2014, World Vision worked with other organizations and Filipino Senator Pia Cayetano to organize a senate briefing on Infant and Young Child Nutrition in order to uphold the Philippines Milk Code. Here's a videoclip about the event and ongoing breastfeeding advocacy in the Philippines.
Exclusive breastfeeding practices in Cambodia have significantly improved over the last decade. However, current violations of legislation on marketing of breast milk substitutes threaten exclusive and continued breastfeeding practices and contribute to increased usage of infant formula as a substitute for breast milk. World Vision prepared an information brief presenting an overview of baby formula products available in Cambodian stores along with an analysis of the products' adherence to national legislation on infant and young child feeding (Sub-decree 133). In 2014, World Vision, along with Save the Children, Helen Keller International (HKI), UNICEF and WHO, released a Joint Statement on Breast-Milk Substitutes in Cambodia. In 2015, together with HKI, World Vision produced a research report on Breast-milk Substitute Promotion and Labeling Violations.
World Vision's report, Stop at Nothing: What it will take to end preventable child deaths, prepared for the 2015 Global Week of Action takes an in-depth look at the issues in 31 nations, and draws attention to where greater action is needed. The countries differ greatly according to whether they are likely to reach the proposed SDG target by 2030 or not, based on recent trends:
World Vision's Best Start: Saving children's lives in their first 1,000 days report looks at how positive nutrition outcomes for mothers and children can be delivered at community level, and calls on governments around the world to make the changes necessary to make this a reality.
Mother Baby Friendly Office Movement
The need to return to paid employment is one major barrier to exclusive breastfeeding faced by mothers around the world. Workplace support for breastfeeding encompasses the three core elements of time, space and support. Here are some insights on Breastfeeding and Work from World Vision's Nutrition Director.
A number of World Vision offices in the Asia Pacific Region have taken important steps to support employees who are breastfeeding mothers through initiating a Mother-Baby Friendly Office (MBFO) movement. As an organization dedicated to child well-being, World Vision is leading by example in ensuring that the children of staff members have full access to the same life-saving and health-strengthening benefits of breastfeeding that are promoted in the communities in which World Vision works. Read more!
Guidelines for Breastfeeding in an HIV Context
The risk of transmitting HIV through breast milk has presented the health community and HIV-positive mothers in developing countries with a difficult dilemma. While no mother wants to risk passing on the virus to her child, completely avoiding breastfeeding is not a safe or feasible option for most HIV-positive mothers in resource-poor areas. Using infant formula and other breast milk substitutes in such situations can greatly increase the child’s risk of illness and death due to other preventable causes, including malnutrition, pneumonia and diarrhoea. Implementing the most recent recommendations (2010) from the World Health Organization (WHO) can reduce mother-to-child transmission from 35% to less than 5% in breastfeeding populations. World Vision has summarized the WHO recommendations in the Nutrition Guidelines on Infant Feeding in an HIV Context, 2011.
World Vision Nutrition Guidelines on Infant feeding in an HIV context, 2011
WHO Guidelines on HIV and Infant Feeding, 2010
Cost of Programming
Cost analysis of breastfeeding programmes range from $0.05 to $0.95 per capita annually. World Vision has found that the cost decreases as programmes scale up; in programmes with 150,000 to 250,000 participants, experience indicates a cost of $0.25 per child.
Breastfeeding is an essential component of any integrated community nutrition and health education or promotion. The approximate cost of programmes that include such baskets of interventions (community organisation; household education about breastfeeding, complementary feeding, and handwashing; micronutrient distribution; monitoring growth and referral) is approximately $15 per household according to the World Bank.
Breastfeeding Resources and Infographics
See the Lancet Breastfeeding Series 2016 for up-to-date research
UNICEF Report From the First Hour of Life: Making the case for improved infant and young child feeding everywhere, provides a global status update on infant and young child feeding practices adn puts forth recommendations for improving them. Part 1 focuses on breastfeeding.
WHO/UNICEF/1000 Days Breastfeeding Policy Brief
See Key Breastfeeding Facts for more information and links to additional resources
Download UNICEF/WHO's Early Initiation of Breastfeeding brochure, endorsed by 17 organizations, including World Vision
Global Health Media Project Breastfeeding Video Series - tailored to the needs of health workers and populations in low-resource settings, these include are a set of videos for health workers, and an adapted set for mothers. Topics include Breastfeeding Positions, Breastfeeding in the first hours, How to increase milk supply, How to express breast milk, Breast Pain, Nipple Pain, etc.
Guidelines for Nursing Mothers of Newborns Infographic - Visual re how often a mom should breastfeed a newborn, baby's stomach size, etc.
World Vision's Report entitled The Best Start:Saving Children's Lives in their First Thousand Days looks at how positive nutrition outcomes for mothers and children can be delivered at community level, and calls on governments around the world to make the changes necessary to make this a reality.
World Vision's Policy on Breast-milk Substitutes
The Nutrition Marketplace: Profiling World Vision's Best Practices in Nutrition, Section 2 (pp. 33-42) provides guidance on breastfeeding programs, cost and advocacy
World Vision's Mother Baby Friendly Office Movement
UNICEF's Breastfeeding on the Worldwide Agenda report
WHO Global Targets Breastfeeding Infographic
UNICEF/WHO Breastfeeding Advocacy Initiative Strategy
Other Breastfeeding Resources related to Maternity Leave/Protection
- WABA WBW Resource - What Women Need for Maternity Protection
- WABA Status of Maternity Protection by Country
- IBFAN Statement on Maternity Protection at Work
- World Policy Forum Map: Is Paid Leave Available for Mothers of Infants
- WABA Maternity Protection Campaign Kit
- National Business Group on Health: Investing in Workplace Breastfeeding Programs and Policies
- WHO Bulletin (2013), Breastfeeding Policy: A globally comparative analysis
- Country implementation of the International Code of Marketing of Breast-milk Substitutes: Status Report 2011
For more information, please contact World Vision expert:
Loria Kulathungam, Nutrition Knowledge Management
loria_kulathungam [at] wvi [dot] org