Empowering Global Health Systems to Protect, Promote and Support Optimal Breastfeeding

Breastfeeding is a critical public health strategy for optimal child development and maternal health across the life course. The 2021 Global Burden of Diseases, Injuries and Risk Factors Study reveals that, despite reductions in mortality and disability-adjusted life years (DALYs) attributed to suboptimal breastfeeding practices-namely, non-exclusive breastfeeding during the first 6 months or early discontinuation within the first 2 years-low- and middle-income countries (LMICs) continue to bear a staggering 50-fold higher burden compared to high-income nations. This inequity signals a pressing global health priority. Hence, we propose to address these challenges by first, expanding the Baby-Friendly Hospital Initiative (BFHI) reach through community-driven efforts such as the Baby-Friendly Community Initiative (BFCI) to enhance breastfeeding support in both clinical and community settings; second, embedding breastfeeding counselling within national health and social protection programmes to fill in gaps in culturally competent care, drawing on large scale breastfeeding peer counselling programme experiences like the one being implemented by the US Supplemental Nutrition Program for Women, Infants and Children (WIC); third, improving maternity leave policies and workplace accommodations for breastfeeding women and fourth, stringent regulation of exploitative commercial milk formula (CMF) marketing to combat misinformation and reduce health inequities. Governments must implement strong, evidence-driven policies-such as strict monitoring and regulation of product labelling and digital media marketing-to establish safeguards against the powerful influence of the CMF industry. Collectively, these strategies will enhance breastfeeding outcomes, reduce health disparities and drive progress across countries towards meeting the UN Sustainable Development Goals.