Report: Breastfeeding increase could save more than 800K lives annually

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Report: Breastfeeding increase could save more than 800K lives annually

By Kelly Wallace, CNN | Posted - Feb. 8, 2016 at 7:44 p.m.



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ATLANTA, Georgia (CNN) — A new study suggests thousands of lives could be saved worldwide if breastfeeding were more universally supported and accepted.

The two-part comprehensive report published Jan. 28 in the medical journal The Lancet is billed as the largest and most detailed analysis of the existing research on breastfeeding around the world. More than 1,300 studies were reviewed, including some commissioned specifically for this report, which focused on the levels, trends and benefits of breastfeeding.

Based on new estimates produced for the report, dramatically scaling up breastfeeding to near-universal levels for infants and young children could save 820,000 children's lives a year around the world, preventing 13 percent of all deaths of children under 5.

"Breast milk acts as a baby's first vaccine to help fight disease and illness," said Dr. Cesar Victora, emeritus professor of epidemiology at the Federal University of Pelotas in Brazil, one of the co-authors of the report, in response to questions via email.

One third of respiratory infections and about half of all diarrhea episodes could be avoided in low- and middle-income countries through breast-feeding, according to the report. In high-income countries, breast-feeding cuts the risk of sudden infant deaths by more than one-third.

Children who are breast-fed longer have been found to have higher intelligence than those who are breast-fed for shorter periods, the report said.


This is not some second-rate intervention we're trying to push on developed worlds, but this is really state-of-the-art, the gold standard intervention that's relevant anywhere in the world.

–Shawn Baker, Gates Foundation


"So both for ensuring kids' survival and then ensuring their future health and development, it's a huge intervention," said Shawn Baker, director of nutrition for the Bill & Melinda Gates Foundation, which provided a $650,000 grant to the World Health Organization to fund the report.

"I always characterize it that this is not some second-rate intervention we're trying to push on developed worlds, but this is really state-of-the-art, the gold standard intervention that's relevant anywhere in the world."

Benefits for mom

The health benefits extend to the mother as well, with reductions in risk of breast and ovarian cancer. Based on all the existing research and according to new estimates created for this report, hikes in breastfeeding could prevent an extra 20,000 deaths from breast cancer each year.

And yet, the rate of breastfeeding has been relatively stagnant for the past two decades, and the wealthier the country, the less likely mothers are to breast-feed. Currently, just one in five children in high-income countries are breast-fed to 12 months while one in three children are breast-fed exclusively for the first six months in low- to middle-income countries.

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"Breastfeeding is one of the few health and nutrition indicators for which poor countries are closer to international recommendations than rich ones," said Victora, who also coordinates the International Center for Equity in Health at the Federal University of Pelotas. For each doubling of a country's gross domestic product per capita, the prevalence of breast-feeding at 12 months drops by 10 percentage points, he said.

"What one is seeing in a number of countries, as they've emerged economically, is that ... perception, 'Well to be modern, one should move from breastfeeding to formula feeding,' and that can have a real knock-on effect of undermining the social norms around breastfeeding," said Baker of the Bill & Melinda Gates Foundation.

The formula market

Extensive marketing by formula makers remains a big barrier to increase the number of children who are breast-fed, the report said.

While there is an international code that was adopted in 1981 to protect the public from inappropriate marketing strategies, it has not been vigorously enforced, implemented and monitored, the report said. Plus, the report estimates enormous growth in the formula market, with sales projected to reach more than $70 billion in 2019, far more than countries spend to promote and support breastfeeding.

"The fact is that marketing by the infant-feeding industry and the availability of formula, including through the distribution of free samples, result in increased bottle-feeding," said Victora, the report's author. "Formula advertisements portray it as good as or better than breast milk, or present it as a lifestyle choice rather than a decision with health and economic consequences."

Social norms

Some people can't breastfeed for medical reasons, or they physically can't do it or don't feel comfortable breastfeeding. But for the people who are choosing to bottle feed over breastfeeding, and who might reverse course if they knew more about the benefits, could anything be done to help influence them to choose breast over bottle?

The report found it is possible to change social norms and behavior, even in emerging economies. For instance, the average duration of breastfeeding in Brazil jumped from 2.5 months in 1974, one of the shortest in any low- or middle-income country, to 14 months by 2006 to 2007.

Brazil rigorously monitored marketing by formula makers and set up a process to certify and re-certify hospitals as "baby friendly," meaning they provided breast-feeding supports to new moms, said Victora, one of the lead researchers behind the report. The country also added leave time for parents, he noted — 120 days for moms and five days for dads, according to the United Nations International Labour Organization.

"I do think that if you can see countries like Brazil that can make, with high-level political support, fundamental changes in the social norms throughout the whole system, I think it's probably possible anywhere," said Baker of the Bill & Melinda Gates Foundation. "It's creating the right conditions and I think that's what's also very important. You can't say, 'OK, we're just going to focus on the mom' without understanding what context that mom lives in."

Baker was recently in the field in Bangladesh and says one of the great innovations to change behaviors there are home visits, which include not just the mom, but also the dad and the mother-in-law. A mother's behavior, in any part of the world, can be extremely influenced by what her mother-in-law or her mother says when it comes to child feeding.

"I think that looking at the whole system, the environment in which the mom lives and addressing that is really quite important" in any part of the world, he added.

The-CNN-Wire ™ & © 2016 Cable News Network, Inc., a Time Warner Company. All rights reserved.

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