From Dr. Dickson Amugsi for The Conversation
Exclusive breastfeeding, the practice of giving only breast milk (no other food or water), is ideal for the first six months of an infant. Breast milk contains all the important nutrients that an infant needs at this stage.
Research has highlighted the long-term health benefits of exclusive breastfeeding for both mother and child. These benefits include reducing the risk of overweight and obesity in childhood and adolescence and certain NCDs later in life and improving human capital in adulthood. In addition, breastfeeding reduces the risk of breast and ovarian cancer, type 2 diabetes, and high blood pressure in mothers.
These are just a few of the benefits of breastfeeding only. Overall, it makes more of an impact on a baby’s health and survival than any other intervention. It is for this reason that the World Health Organization (WHO) included it as a best protection measure in the Global Plan of Action on Pneumonia and Diarrhea.
The WHO originally set a global target of 50 percent exclusive breastfeeding by 2025. It was recently updated to a prevalence of at least 70 percent by 2030. This means that each member country is expected to have an exclusive breastfeeding prevalence of at least 70. will reach percent by the end of 2030.
However, previous research has shown that the proportion of exclusively breastfed children remains low in many low and middle income countries.
As part of the Global Burden of Disease study, my colleagues and I recently published our analysis of data from 94 low and middle income countries over two decades (2000-2018). We examined the trends and prevalence of exclusive breastfeeding and forecast countries’ performance against the WHO goals. This type of analysis can help countries formulate the strategies and interventions necessary to promote breastfeeding practices.
Findings from our study
The overall prevalence of exclusive breastfeeding increased in the study period (2000-2018) in all countries (27 percent to 39 percent). However, we found significant differences between countries and within regions. This indicates intraregional inequalities that managers need to be aware of.
The countries included in the study made significant progress. For example, 57 of the 94 countries had an aggregate rate of exclusive breastfeeding of less than 30 percent in half of their basic administrative units (referred to as provinces in this study) in 2000; these countries (8) rose closer to 50 percent, with most provinces have at least 45 percent exclusive breastfeeding. In 34 countries, at least one province had increased the prevalence of exclusive breastfeeding by more than 45 percent by the end of 2018.
Of the African countries, Chad and Somalia showed the highest annual rates of decline in exclusive breastfeeding practices during the study period.
Progress towards the 70 percent target
To estimate future prevalence, we assumed that current trends would continue. We initially forecast based on the original target of 25 percent by 2025, followed by an updated target of at least 70 percent by 2030. In general, exclusive breastfeeding practices in countries are expected to increase from 39 percent in 2018 to 43 percent Percent by 2025. The practical share will increase to 45 percent by the end of the new target period of 2030. While this is positive progress, it misses the 70 percent target.
Our analysis predicted that six countries – Burundi, Cambodia, Lesotho, Peru, Rwanda and Sierra Leone – will achieve 70 percent of the exclusive breastfeeding prevalence by 2030.Only three countries (Burundi, Lesotho and Rwanda) will achieve this goal in all of their subnational units (Provinces and districts) expected to reach.
Reasons for low rates of exclusive breastfeeding
Several reasons may be responsible for countries’ poor performance in achieving the goal. They include, but are not limited to:
– manipulative marketing or promotion of breast milk substitutes
-A lack of support in the workplace for optimal breastfeeding practices
– lack of participation in prenatal care
– Lack of qualified breastfeeding support or breastfeeding advice in health facilities
-social or cultural beliefs that favor mixed feeding.
Keep it up
Breastfeeding requires a great deal of effort from mothers and the support of wider networks, including their families, communities, workplaces, health systems, and governance.
Advocacy at global, national and subnational levels is vital and needs to be pursued by national and subnational governments. For example, the global breastfeeding advocacy toolkit outlines seven key policy measures to improve breastfeeding practices. These include:
-Increase in funding to support exclusive breastfeeding and breastfeeding up to 2 years
-full adoption and supervision of the International Code for the Marketing of Breast Milk Substitutes
-Adoption of breastfeeding guidelines in the workplace and paid family leave
-Implementing the ten baby-friendly hospitals steps to successful breastfeeding
-Improving access to qualified breastfeeding advice in health facilities
– Strengthening links between health facilities and communities in support of breastfeeding
-Strengthen monitoring systems to keep track of progress.
These documented strategies can help policy makers monitor the success of breastfeeding policies and program investments.
In summary, our study found that only six of the 94 low- and middle-income countries are on track to meet the WHO target of at least 70 percent exclusive breastfeeding prevalence by 2030. This means that 94 percent of the countries included in our study will barely achieve the goal. This predicted poor performance requires conscious efforts to encourage exclusive breastfeeding to improve the child’s health and well-being. Robust policy interventions could still allow some of these low- and middle-income states to meet the target by 2030.
(The author is from the African Population and Health Research Center.)
Check out the latest videos from DH:
