Despite volumes of evidence that nutrients from breast milk are ideal for mothers and babies, there is a major discrepency at play worldwide: Among babies born in the United States, about 26% are never breastfed. Elsewhere, particularly in middle- and low-income countries, virtually every baby is breastfed for some period of time.
So, what explains this significant "breastfeeding gap" and its persistence in high-income countries like the United States? According to a wide-spanning new report from UNICEF, "cultural and political contexts" continue to disadvantage mothers and babies in places like America, Ireland and France. Not only are the fixes theoretically simple, but they are also undeniably effective—as the examples of high breastfeeding rates in other countries goes to show.
"In higher-income countries, we see that the proportion of children who have never been breastfed is significantly higher than the number of children in low- and middle-income countries. That is a fact," Victor Aguayo, UNICEF's Chief of Nutrition, tells CNN. "We need to create environments—including in the US—that make breastfeeding the norm."
According to the report from UNICEF's Global Database, the breastfeeding rate tops 99% in countries like Bhutan, Peru and Madagascar. At the other end of the spectrum, the rate is just 55% in Ireland and 71% in France—contributing to an average 79% of babies in countries designated as "high-income" receiving breast milk versus an average 96% in middle- or low-income countries.
Worldwide, UNICEF estimates improving breastfeeding rates would save the lives of some 820,000 children annually due to the positive influence of breast milk on growth, development and immunities. The organization also notes there are ample benefits for breastfeeding mothers, including protection against postpartum hemorrhaging, depression and some forms of cancer.
"Breastfeeding is the best gift a mother, rich or poor, can give her child, as well as herself," says Shahida Azfar, UNICEF's Deputy Executive Director, in a press release.
But, as the statistics suggest, whether or not a woman will breastfeed is a complicated matter. The report states:
"Positive social norms that support and encourage breastfeeding, including in public spaces, serve to empower mothers to breastfeed. In communities, support from trained counsellors and peers, including other mothers and family members plays a key role. The support of men, husbands and partners cannot be underestimated."
The report notes that factors such as the cost of formula and lower rates of women in the workplace also contribute to higher breastfeeding rates in some countries. However, previously reported case studies from communities around the world prove that social support is also key.
For example, among the Himba people in Namibia, older family members basically serve as lactation counselors when helping new moms establish breastfeeding. And while women there reported the same struggles commonly associated with nursing anywhere else—trouble with latching, pain, supply issues, etc.—they were largely able to overcome them thanks to guidance from other women.
There seems to be a trend toward this happening in the United States, where a growing number of digital tools aim to support mothers' breastfeeding goals—and may have something to do with the rising breastfeeding rates among new moms.
Still, there's no denying that more needs to be done to normalize and facilitate breastfeeding. In the report, UNICEF officials recommend doing more to establish breastfeeding as soon as possible after birth, enacting paid parental leave and workplace breastfeeding protections, regulating the marketing of infant formula and just generally doing a better job of empowering women with breastfeeding.
This report focused primarily on the rates of babies who were ever breastfed, which is important as studies have shown that breastfeeding any amount during the first two months of a baby's life cuts the SIDS risk in half. UNICEF as well as the World Health Organization (WHO) and American Academy of Pediatricians (AAP) recommends exclusively breastfeeding for the first six months and continuing to provide breast milk through the child's second birthday. (The AAP says one year versus two.)
Weighing in on the report, Pamela Mulder, assistant professor at the University of Iowa's School of Nursing, tells CNN it is important to recognize and promote the "benefits of breastfeeding." She adds, "They can also combine breast milk and infant formula feedings, and they can breastfeed for the time they choose, whether that be two weeks or six months."
It's also worthwhile to recognize that breastfeeding rates are improving in the United States—and that trajectory will likely only continue to improve with more awareness brought to the subject through reports like this.