Achieving Exclusive Breastfeeding Globally

Purpose: To offer the rationale, a literature review and analysis on the factors associated with exclusive breastfeeding, and resulting policy and program implications.

Data sources: Pubmed and other search engines were used to identify literature on exclusive breastfeeding (EBF) in the US, in the situation of endemic HIV/AIDS, and globally.

Methods: Literature was analyzed by reproductive time period and by health care practice, social and political, and media influence for the US data. Literature was explored for the latest on HIV and EBF. In addition, statistical transformation of data was carried out to set EBF as the normative practice.

Results: A series of obstacles were identified. Specifically, and most common, is the lack of awareness of the importance of EBF for child health and survival, including reduction of MTCT, for reproductive health and for lifetime health. Additional gaps identified for the US include the need for:

• development of EBF-specific clinical and counseling skills;

• attention to and planning for family and social support and work accommodation needed to reach a tipping point and to create this as normative behavior;

• funding for research to elucidate how best to support EBF for all mothers in all settings;

• protection of the public from misinformation and the misconception that “some” formula carries no risks; and

• attention to development of self-regulation and/or legislation of advertising, marketing and media.

Additional gaps identified for Global response include the need for:

• inclusion of multiple systems in planning for action

• increased funding for global action

• prioritization of lactation support in emergencies

• active education of the HIV community re: the importance of breastfeeding, especially EBF, to fight the HIV pandemic.

Recommendations: Related policy and program interventions were extrapolated, including ten suggestions for the US setting and ten for global approaches.