Breastfeeding

Updated: September 2014

Key facts

  • Breastfeeding is the best source of nourishment for infants and young children. It contributes to a lifetime of good health, growth and development.
  • Globally, more than 13 children under five years old die every minute from preventable causes and under-nutrition contributes to almost half these deaths.
  • Globally, exclusive and continued breastfeeding could help prevent 13% of deaths of children under five years old.
  • Of the 135 million babies born every year, only 42% are breastfed within the first hour of life, only 38% of mothers practice exclusive breastfeeding during the first six months and 58% of mothers continue breastfeeding up to the age of two years.
  • Optimal breastfeeding saves lives, prevents childhood diseases (pneumonia, diarrhoea, etc.), increases intelligence by 3-5 IQ points and reduces the risks of obesity and Type II diabetes later in life. For the mother, it reduces the risk of ovarian and breast cancer.
  • Optimal breastfeeding means:
    • Initiation of breastfeeding within the first hour of birth;
    • Exclusive breastfeeding for the first six months of life;
    • Continued breastfeeding for two years and beyond; and
    • Introduction of adequate and appropriate complementary foods from six months onwards.

Key facts – Western Pacific Region

  • In the Western Pacific Region, undernutrition alone contributes to 187000 preventable deaths of children under 5 years of age annually.
  • Breastfeeding initiation within the first hour of life in the Western Pacific Region is not yet optimal across several countries. The rates in the following countries are as follows: Samoa (88%), Nauru (76%), Solomon Islands (75%), Vanuatu (72%), the Marshall Islands (73%), Mongolia (71%), Cambodia (65%), Fiji (57%), the Philippines (54%), China (41%), Viet Nam (40%), the Lao People’s Democratic Republic (30%) and Tuvalu (15%).
  • Exclusive breastfeeding practice rates vary in the Region with Cambodia (74%), Solomon Islands (74%), Kiribati (69%), Nauru (67%), the Federated States of Micronesia (60%), Mongolia (59%), Papua New Guinea (56%), Samoa (51%), Republic of Korea (50%), Fiji (40%), Vanuatu (40%), Tuvalu (35%), the Philippines (34%), the Marshall Islands (31%), China (28%), the Lao People’s Democratic Republic (26%), Japan (21%) and Viet Nam (17%).
  • In the Region, a slow decline of breastfeeding rates was recorded for children at the age of two years in Kiribati (82%), Samoa (74%), Papua New Guinea (72%), Solomon Islands (67%), Mongolia (66%), Nauru (65%), the Marshall Islands (53%), Tuvalu (51%), the Lao People’s Democratic Republic (48%), Cambodia (43%), the Philippines (34%), Vanuatu (32%) and Viet Nam (19%).

Status of implementation of key actions that make a difference in the Region

  • National infant and young child feeding policies (stand-alone or integrated) for breastfeeding are implemented in 17 countries and areas: Brunei Darussalam, Cambodia, China, Fiji, Kiribati, the Lao People’s Democratic Republic, Malaysia, the Commonwealth of the Northern Mariana Islands, the Marshall Islands, Mongolia, Palau, Papua New Guinea, the Philippines, Samoa, Solomon Islands, Vanuatu and Viet Nam.
  • 9713 (54%) of hospitals with maternity services in the Region have been certified at least once as Baby-Friendly Hospitals.
  • Eleven countries have passed national legislations to implement the recommendations of the International Code of Marketing of Breast-Milk Substitutes. However, only Fiji, Palau and the Philippines are implementing the International Code in full.
  • In the Region, 17 countries offer paid maternity leave, but only Australia (12 months) and Viet Nam (six months) offer paid maternity leave for more than the 14 weeks minimum recommended by the International Labour Organization (ILO).
  • Paid breastfeeding breaks (time off to breastfeed/express breast-milk) as recommended by the ILO Maternity Protection Convention of 2000, are provided in 13 countries.

Why not infant formula?

Infant formula does not contain the antibodies found in breastmilk and is linked to some risks, such as water-borne diseases that arise from mixing powdered formula with unsafe water (many families lack access to clean water). Malnutrition can result from over-diluting formula to “stretch” supplies. Further, frequent feedings maintain the breastmilk supply. If formula is used but becomes unavailable, a return to breastfeeding may not be an option due to diminished breastmilk production.

Formula is expensive compared to breastmilk and diverts a family’s income from other needs.

HIV and breastfeeding

Breastfeeding, and especially early and exclusive breastfeeding, is one of the most significant ways to improve infant survival rates. However, a woman infected with HIV, can transmit the virus to her child during pregnancy, labour or delivery, and also through breastmilk. In the past, the challenge was to balance the risk of infants acquiring HIV through breastfeeding versus the higher risk of death from causes other than HIV, in particular malnutrition and serious illnesses such as diarrhoea and pneumonia, when infants were not breastfed.

The evidence on HIV and infant feeding shows that giving antiretroviral drugs (ARVs) to either the HIV-infected mother or the HIV-exposed infant can significantly reduce the risk of transmitting HIV through breastfeeding. This enables HIV-infected mothers to breastfeed with a low risk of transmission (1-2%). These mothers can therefore offer their infants the same protection against the most common causes of child mortality and the benefits associated with breastfeeding.

Even when ARVs are not available, mothers should be counselled to exclusively breastfeed in the first six months of life and continue breastfeeding thereafter unless environmental and social circumstances are safe for, and supportive of, replacement feeding.

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