Breastfeeding is good for babies, it's good for mothers, it's good for economies, and it's good for our planet. Supporting and enabling mothers to breastfeed is one of the best ways to promote an equitable, prosperous and sustainable world for every child.
France Begin, Senior Adviser, Nutrition, UNICEF
Breastfeeding is also highly beneficial to maternal health. Evidence suggests that breastfeeding is associated with a decreased risk of breast and ovarian cancers (3). Furthermore, breastfeeding plays a beneficial role in reducing maternal depression and promoting mother-child bonding (3). With growing awareness across Africa of the impact of mental health on physical health, the mental health benefits of breastfeeding support the fundamental role that the practice should play in UHC advocacy efforts.
Downstream impacts of breastfeeding on child and maternal health throughout the life cycle
The first 1,000 days of a child’s life lay the foundation for their cognitive and physical development which serve as a basis for lifelong health (4). During this time, proper nutrition, which can be delivered primarily through breastfeeding, is critical for reducing morbidity and mortality
in the short and long term. Breastfeeding is protective against many chronic diseases and associated with lower rates of obesity, type 2 diabetes, and childhood leukemia (5). With the growing threat of climate change, breast milk also offers a sustainable means for nourishing infants. Like other sustainable practices, this has tertiary benefits for health in that it reduces greenhouse gas emission and promotes planetary health. In this way, breastfeeding serves as an efficient and effective method of health promotion in Low and Middle Income (LMIC) African countries. By improving long-term health outcomes and reducing healthcare costs, breastfeeding can support higher quality of life and economic productivity (4,6).
Downstream impacts of breastfeeding on health system burden and malnutrition
Breastfeeding reduces the burden of illness on health systems through several pathways. First, by promoting proper infant and child nutrition, breastfeeding combats stunting and wasting, conditions related to malnutrition which affected 58.7 million African children under the age of 5 in 2017 (8). Proper nutrition therefore reduces health system and family expenditures on therapeutic foods and treatments as well as hospitalization for malnutrition or precipitating illnesses. In addition, studies show that in comparison to children that were not breastfed, children who were exclusively breastfed have a lower risk of hospitalization for respiratory illnesses and of diarrhea mortality (9).
By reducing the burden of these illnesses, breastfeeding can both reduce strain and costs on the health system and improve the quality of children’s lives. The role of breastfeeding in preventing obesity, heart disease, and diabetes during adolescent years and adulthood further reduces health system burden, especially as LMICs face an increasing prevalence of these non-communicable diseases (3). Through these pathways, investing in breastfeeding education and promotion will ultimately reduce overall health system treatment costs.
Discussions around Universal Health Coverage in Africa cannot ignore breastfeeding. Its utility as a source of essential nutrition for children and as a method of illness prevention for children and mothers make it indispensable for improving health outcomes and reducing health system burdens, especially in low-resource settings. Integrating breastfeeding education into existing health programs that reach pregnant and lactating women can optimize resource utilization while multiplying benefits. This World Breastfeeding Week, those who advocate for Health for All should support breastfeeding education, counseling, and support as a fundamental component of all Universal Health Coverage agendas.
Throughout World Breastfeeding Week, it is important to reflect on the value of breastfeeding in efforts to design and sustain Universal Health Coverage agendas, especially in low-resource settings across the African continent. A building block of maternal and child health, breastfeeding promotes general wellbeing and confers a range of benefits, including protection against common child and maternal diseases. In Africa, only 37% of infants are exclusively breastfed for the first six months of life (1). Meanwhile, the leading causes of infant death are inadequate nutrition and immune system development. Investing in breastfeeding promotion as an upstream determinant of health reduces disease burden on health systems by preventing illness before it arises. The upstream benefits of breastfeeding also support planetary health, as a sustainable and waste-free resource for children. For these reasons, UHC advocacy efforts must integrate breastfeeding education, counseling, and support into the minimum basket of care promised by Universal Health Coverage.
Health benefits of breastfeeding
Breastfeeding provides invaluable health benefits to both children and mothers. First and foremost, breastfeeding can serve as a complete source of nutrition to infants. Sufficient nutrition is imperative for child health, demonstrated by the fact that undernutrition accounts for 45% of all child mortality (2). In 2015, Sub-Saharan African countries accounted for one third of undernourished children globally, leading to higher rates of stunting and malnutrition (2). These challenges point towards the importance of interventions that promote sustainable nutrition across the continent, including breastfeeding promotion and education. In addition to being a source of essential nutrients, a mother’s milk provides immunological and antibacterial benefits, which bolster the child’s developing immune system and protects them against infectious diseases such as pneumonia, urinary tract infections, and diarrheal diseases (3).