The World Health Organization (WHO) recommends that mothers start breastfeeding within one hour of birth, exclusively breastfeed for the first six months of life, and continue breastfeeding with complementary foods until the child is two years or older.
These guidelines form WHO’s core breastfeeding recommendations, which are designed to optimize infant nutrition and health outcomes. WHO, as the global authority on public health, bases these recommendations on extensive research showing that following these guidelines provides the best start in life for babies while benefiting maternal health.
Understanding WHO’s Core Breastfeeding Recommendations
The benefits breastfeeding offers include optimal growth, brain development, and long-term health outcomes such as reduced risks of obesity and diabetes.
WHO has established three fundamental recommendations for breastfeeding. First, mothers should start breastfeeding within one hour of birth. Second, babies should receive only breast milk for the first six months of life. Third, breastfeeding should continue for up to two years or beyond, alongside appropriate solid foods after six months.
These recommendations are crucial for optimal infant and young child feeding practices, which are essential for reducing child mortality and morbidity.
Importance of Breast Milk
Breast milk is a cornerstone of infant and young child nutrition, offering a unique blend of essential nutrients, antibodies, and growth factors that support optimal growth, development, and health. The World Health Organization (WHO) underscores the importance of exclusive breastfeeding for the first six months of life, followed by continued breastfeeding alongside appropriate complementary foods up to two years or beyond. This natural nourishment is packed with thousands of protective agents, growth factors, and cells that not only combat infections but also aid in brain development and lay the foundation for future health. For mothers, breastfeeding provides significant health benefits, including a reduced risk of breast cancer, ovarian cancer, and type 2 diabetes. By adhering to these guidelines, both infants and mothers can enjoy a healthier start and long-term well-being.
The Critical First Hour After Birth
The first hour after birth, often called the “golden hour,” is crucial for establishing successful breastfeeding. During this time, babies are typically most alert and ready to feed. Immediate skin-to-skin contact helps regulate the baby’s temperature and breathing while promoting early breastfeeding initiation. Research shows that early initiation significantly improves breastfeeding success rates and infant survival.
Exclusive Breastfeeding in the First Six Months
Exclusive breastfeeding means providing only breast milk to infants for the first six months of life. Even water is unnecessary during this period, as breast milk contains all the hydration a baby needs. This recommendation is supported by evidence showing that breast milk alone provides all the required nutrients for optimal growth and development during this time.
Extended Breastfeeding Guidelines
After six months, WHO recommends continuing breastfeeding until age two or beyond. During this period, breast milk continues to provide significant nutritional and immunological benefits. Studies show that children who breastfeed longer have better health outcomes and cognitive development.
Workplace policies that support breastfeeding and provide supportive environments can significantly improve health outcomes for mothers and infants, benefiting both businesses and employees by increasing retention, performance, loyalty, productivity, and morale.
Recommended Breastfeeding Frequency
WHO advocates for feeding on demand, letting babies determine when and how long to nurse. This typically means 8-12 feeds per 24 hours in the early months. Babies should be allowed to feed whenever they show hunger signs, including during the night. This approach helps establish and maintain milk supply while ensuring babies receive adequate nutrition.
Guidelines for Appropriate Complementary Foods
At six months, babies should begin receiving solid foods while continuing to breastfeed. These foods should be safe, adequate, and locally available. The introduction of solids helps meet the growing nutritional needs of infants while maintaining the benefits of breast milk.
Feeding in Exceptionally Difficult Circumstances
In exceptionally difficult circumstances, such as emergencies or regions with high levels of malnutrition, breastfeeding remains the preferred method of infant feeding. Early and exclusive breastfeeding is one of the most effective ways to enhance infant survival rates in these challenging situations. For mothers living with HIV, antiretroviral treatment (ART) can significantly reduce the risk of transmission through breastfeeding while also improving maternal health. The World Health Organization (WHO) recommends that all individuals living with HIV, including pregnant and lactating women, commence ART for life as soon as they are diagnosed. This approach ensures that both mother and child receive the best possible care and protection.
Scientific Evidence Behind WHO Recommendations
Research supporting WHO’s guidelines is extensive. Studies show that following these recommendations leads to significant health benefits. Children who are breastfed, according to WHO guidelines, have lower rates of respiratory infections, gastrointestinal problems, and chronic diseases.
Health Benefits for Infants
Breastfed infants have a 3.6 times lower risk of hospitalization for respiratory infections and 2.8 times lower risk of gastrointestinal infections. They also show reduced rates of ear infections, pneumonia, and sudden infant death syndrome. Long-term benefits include lower risks of obesity, diabetes, and certain childhood cancers like leukaemia.
Maternal Health Benefits
Mothers who breastfeed experience significant health advantages. The risk of premenopausal breast cancer decreases by 30%, while ovarian cancer risk reduces by 27%. Additionally, breastfeeding helps with postpartum weight loss and lowers the risk of type 2 diabetes and metabolic syndrome. Studies also show a 1.3 times lower risk of myocardial infarction among breastfeeding mothers.
Global Health Impact
Following WHO breastfeeding recommendations have substantial global implications. Current data shows that not following these guidelines results in 595,379 childhood deaths annually from preventable conditions like diarrhoea and pneumonia. Additionally, 98,243 maternal deaths occur yearly from breast and ovarian cancers and type II diabetes that could be prevented through breastfeeding.
The economic impact is also significant. Healthcare treatment costs related to suboptimal breastfeeding reach US$1.1 billion annually. Cognitive losses amount to US$285.4 billion yearly, with total economic losses reaching US$341.3 billion – equivalent to 0.70% of global gross national income.
Implementation and Promotion Strategies
Implementing and promoting breastfeeding requires a comprehensive approach involving health workers, policymakers, and communities. The Baby-Friendly Hospital Initiative (BFHI) is a global program designed to enhance breastfeeding rates by providing guidance on the implementation, training, monitoring, assessment, and re-assessment of the Ten Steps to Successful Breastfeeding. Health workers play a pivotal role in supporting breastfeeding and must be equipped with the necessary knowledge and skills. Responsive feeding, where caregivers respond promptly and appropriately to a baby’s hunger cues, and educating parents on the use of bottles and pacifiers are also crucial for successful breastfeeding. Additionally, creating an enabling environment for breastfeeding, including policies and guidelines that uphold quality standards in health facilities, is essential for achieving universal health coverage. By fostering a supportive atmosphere, we can ensure that breastfeeding practices are promoted, protected, and sustained.
Common Challenges and Solutions
Many mothers face initial breastfeeding challenges. Common issues include difficulty with latch, concerns about milk supply, and pain during feeding. Solutions include seeking help from lactation consultants, ensuring proper positioning and attachment, and understanding normal newborn feeding patterns. Working mothers may need support in maintaining breastfeeding while returning to work through proper milk expression and storage.
Supporting Breastfeeding Success
Healthcare providers play a crucial role in supporting breastfeeding success. This includes providing accurate information, practical support, and timely interventions when needed. Family support is equally important, particularly in the early weeks. Community resources like breastfeeding support groups and lactation consultants can provide additional assistance.
WHO aims to increase exclusive breastfeeding rates in the first six months to at least 50% by 2025. This goal is supported by the Global Breastfeeding Collective, a partnership between WHO and UNICEF that works to increase political, legal, financial, and public support for breastfeeding worldwide.
Conclusion
WHO’s breastfeeding recommendations provide a clear framework for optimal infant feeding practices. Following these guidelines offers significant health benefits for both mothers and babies while contributing to substantial public health and economic advantages globally. For individual success, mothers should seek support from healthcare providers and community resources while following WHO’s evidence-based recommendations.
