Affiliations 

  • 1 Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA. Electronic address: rafael.perez-escamilla@yale.edu
  • 2 Johns Hopkins University School of Nursing, Baltimore, MD, USA
  • 3 Research Center for Equitable Development (EQUIDE), Universidad Iberoamericana, Mexico City, Mexico
  • 4 Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
  • 5 International Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil
  • 6 UNICEF, Malabo, Equatorial Guinea
  • 7 Windsor, CT, USA
  • 8 Department of Nutrition and Food Safety, WHO, Geneva, Switzerland
  • 9 International Institute for Global Health, United Nations University, Kuala Lumpur, Malaysia
  • 10 International Food Policy Research Institute, New Delhi, India
  • 11 Washington, DC, USA
  • 12 Department of Maternal, Newborn, Child and Adolescent Health, WHO, Geneva, Switzerland
  • 13 Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa
Lancet, 2023 Feb 11;401(10375):472-485.
PMID: 36764313 DOI: 10.1016/S0140-6736(22)01932-8

Abstract

In this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions drive breastfeeding outcomes, and what policies and interventions are necessary to achieve optimal breastfeeding. About one in three neonates in low-income and middle-income countries receive prelacteal feeds, and only one in two neonates are put to the breast within the first hour of life. Prelacteal feeds are strongly associated with delayed initiation of breastfeeding. Self-reported insufficient milk continues to be one of the most common reasons for introducing commercial milk formula (CMF) and stopping breastfeeding. Parents and health professionals frequently misinterpret typical, unsettled baby behaviours as signs of milk insufficiency or inadequacy. In our market-driven world and in violation of the WHO International Code for Marketing of Breast-milk Substitutes, the CMF industry exploits concerns of parents about these behaviours with unfounded product claims and advertising messages. A synthesis of reviews between 2016 and 2021 and country-based case studies indicate that breastfeeding practices at a population level can be improved rapidly through multilevel and multicomponent interventions across the socioecological model and settings. Breastfeeding is not the sole responsibility of women and requires collective societal approaches that take gender inequities into consideration.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.