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Lancet. 2016 Jan 30;387(10017):491-504. doi: 10.1016/S0140-6736(15)01044-2.

Why invest, and what it will take to improve breastfeeding practices?

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Department of Maternal, Newborn, Child and Adolescent Health (MCA), WHO, Geneva, Switzerland. Electronic address:
Centre for Health Research and Development, Society for Applied Studies, New Delhi, India.
FHI 360, Hanoi, Vietnam.
Department of Economics, University of Waterloo, ON, Canada.
Department of Noncommunicable Diseases and Mental Health, WHO, Geneva, Switzerland.
Centre for Intervention Science in Maternal and Child Health (CISMAC), Centre for International Health, University of Bergen, Norway.
Global Development Program, Bill & Melinda Gates Foundation, Washington, DC, USA.
DST-NRF Centre of Excellence in Human Development, University of the Witwatersrand, Johannesburg, South Africa.
International Center for Equity in Health, Post-Graduate Programme in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.


Despite its established benefits, breastfeeding is no longer a norm in many communities. Multifactorial determinants of breastfeeding need supportive measures at many levels, from legal and policy directives to social attitudes and values, women's work and employment conditions, and health-care services to enable women to breastfeed. When relevant interventions are delivered adequately, breastfeeding practices are responsive and can improve rapidly. The best outcomes are achieved when interventions are implemented concurrently through several channels. The marketing of breastmilk substitutes negatively affects breastfeeding: global sales in 2014 of US$44·8 billion show the industry's large, competitive claim on infant feeding. Not breastfeeding is associated with lower intelligence and economic losses of about $302 billion annually or 0·49% of world gross national income. Breastfeeding provides short-term and long-term health and economic and environmental advantages to children, women, and society. To realise these gains, political support and financial investment are needed to protect, promote, and support breastfeeding.

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