Best practices in breastfeeding support: Controversies and recommendations

Introduction: Global support for breastfeeding has increased over the last 30 years as more evidence accumulated confirming the substantial impact of early, exclusive and continued breastfeeding on maternal and child health and survival.

Background: While the first global efforts concentrated on reducing aggressive marketing of breast-milk substitutes, by 1990 it was recognized that programmatic intervention in health services and active support for mothers was necessary to achieve measurable impacts on breastfeeding rates.

Methods: DHS data, UNICEF review documents, and published reports were reviewed and analyzed to identify lessons learned and best practices.

Findings: UNICEF reviews of best practices published in the late 1990s/early 2000s identified successful program approaches. Since that time, global funding for breastfeeding diminished significantly. As a result, support for breastfeeding has increasingly been offered in UNICEF programming as one option of several measures that could be included in integrated program services. Other programs, especially those supported by USAID, have actively included breastfeeding as a focus in concentrated community nutrition efforts.

Conclusions: Exploration of breastfeeding trends in countries with both multiple DHS surveys and documented program histories reveals possible differences in impact of various programs, the importance and impact of building upon previous efforts, and suggestions as to what combination of programming is most effective in improving breastfeeding rates.