Increased breastfeeding could save 820K lives every year worldwide

Strong political commitments and substantial economic investments at all levels, from national governments to local communities, are required to support and promote breastfeeding across the globe, which has the potential to save 820,000 lives, according to the authors of a two-part series published in The Lancet.

With just one in five children in high-income countries breastfed to 12 months, and one in three in low- and middle-income nations exclusively breastfed for the first 6 months, millions are failing to receive the benefits of breastfeeding, the authors wrote. According to their data, near-universal breastfeeding for infants and young children worldwide could save the lives of more than 800,000 children per year, or approximately 13% of all deaths in children younger than 2 years. In addition, it could prevent 20,000 deaths from breast cancer annually, they wrote.

“There is a widespread misconception that the benefits of breastfeeding only relate to poor countries,” Cesar Victora, MD, professor at the Federal University of Pelotas, in Brazil, and series coauthor, said in a press release. “Our work for this series clearly shows that breastfeeding saves lives and money in all countries, rich and poor alike. Therefore, the importance of tackling the issue globally is greater than ever.”

The researchers examined data from 28 systematic reviews and meta-analyses; 22 were commissioned specifically for the series. In the first paper, they concluded that breastfeeding has, among other health benefits, dramatic effects on life expectancy. In high-income countries, researchers found that breastfeeding reduces the risk of sudden infant deaths by more than one-third. In low- and middle-income countries there was a 50% decrease in diarrhea episodes and a one-third decrease respiratory infections.

The researchers also found breastfeeding could increase intelligence, and may protect against obesity and diabetes later in life. Mothers who breastfed over a longer duration also had a reduced risk for breast and ovarian cancer.

“Findings from the epidemiology and biology studies substantiate the fact that the decision to not breastfeed a child has major long-term effects on the health, nutrition and development of the child and on women’s health,” Victoria and colleagues wrote. “Possibly, no other health behavior can affect such varied outcomes in the two individuals who are involved: The mother and the child.”

In the second paper in the series, the researchers state an economic case for promoting breastfeeding. According to the researchers’ models, economic losses through lower cognition caused by the dearth of breastfeeding reached $302 billion in 2012, or approximately 0.49% of world gross national income. In high-income countries, such losses amounted to $231.4 billion, or 0.53% of gross national income.

In addition, the authors stated that increasing breastfeeding rates for infants younger than 6 months to 90% in the United States, China and Brazil, and to 45% in the United Kingdom, could reduce treatment costs of common childhood illnesses, saving health care systems $2.45 billion, $223.6 million, $6 million and $29.5 million in those nations respectively.

The researchers also point to the increasing popularity of breastmilk substitutes, stating that global sales of the product are expected to reach $70.6 billion by 2019, as an undermining factor in promoting breastfeeding.

According to the series, nations can significantly improve breastfeeding practices by increasing known interventions, policies and programs, such as instituting a 6-month maternity leave for mothers, health-worker training, community mobilization and media campaigns, as Bangladesh has done, resulting in 13% increase in the breastfeeding rate.

“Breastfeeding is not explicitly mentioned in the [WHO] Sustainable Development Goals, but our series shows that improvements in breastfeeding would help achieve the targets for health, food security, education, equity, development and the environment,” Nigel Rollins, MD, of the WHO department of maternal, newborn, child and adolescent health, and colleagues wrote. “Without commitment and active investment by governments, donors, and civil society, the promotion, protection and support for breastfeeding will remain inadequate and the outcome will be major losses and costs that will be borne by generations to come.” – by Jason Laday

Disclosure: Rollins reports that the WHO has received funds from the Bill and Melinda Gates Foundation. See the full studies for all other authors’ relevant financial disclosures.