Global Health Centre
26 November 2019

Breastfeeding: Beyond “What is best for your child”

Guest Commentary by Fédora Bernard, Programme Officer at the International Baby Foods Action Network IBFAN

This article provides an overview of the interconnections between breastfeeding and human rights.

While we may not always give importance to the way we were fed as a child, we all were, either by breastmilk, with a substitute or both. Infant and young child feeding affects every single human being and is also a matter of human rights for both the child and the mother. Albeit being considered as such in a joint statement by the UN Special Rapporteurs on the Right to Food, Right to Health, the Working Group on Discrimination against Women in law and practice, and the Committee on the Rights of the Child (CRC) in 2016, it is often forgotten.

Breastmilk is more than food. It contains anti-bodies and live cells that ensure the survival and healthy development of infants. Its composition also changes and adapts according to each baby’s specific needs. In the longer run, children who were breastfed have a lower risk of non-communicable diseases (NCDs) such as obesity, diabetes and certain cancers. This is why WHO currently recommends that infants should be exclusively breastfed for the first six months of life, followed by continued breastfeeding and complementary feeding until two years of age and beyond. When it comes to the benefits of breastfeeding from a human rights perspective, children’s rights "to life", "survival and development", as well as "to the highest attainable standard of health" easily come to mind. This was also introduced through the Innocenti Declarations (1990 and 2005) and mentioned in the text of the Convention on the Rights of the Child itself (art. 24) as well as addressed more extensively in two General Comments of the CRC Committee (No. 15 and 16).

Nevertheless, looking at breastfeeding only from a children’s rights perspective is insufficient, first of all because of its very nature: it is a relationship between a child and a mother. Protecting, promoting and supporting breastfeeding empowers women and contributes to the right to a safe and healthy environment.


A matter of women’s rights

Similarly to the child rights’ perspective, one could look at the benefits of breastfeeding from a maternal health point of view. For instance, breastfeeding right after birth prevents hemorrhages, offers protection against breast cancer, inhibits the return of ovulation and menstruation, therefore potentially protecting the mother from anemia. It also allows for child spacing when other forms of contraception are not available. However, the right to breastfeed, from a women’s rights perspective, goes beyond the protection of women’s health: it is a matter of women’s empowerment.

Breastfeeding is intimately linked to pregnancy and maternity, and as such, should be looked at as part of a woman’s reproductive cycle. From this angle, the right to breastfeed thus becomes a sexual and reproductive right, which implies that parents should be entitled to full information about breastfeeding, free from commercial influence as well as breastfeeding counseling, as part of quality reproductive health services. It also implies that a mother’s choice (whatever it is) always be respected, which is currently not the case throughout the world, for a number of reasons.

First, new parents are often targeted by aggressive marketing from the infant feeding industry, a $70 billion dollars worth industry, which seeks to convince mothers that their breastmilk is not superior - if not inferior - to formula and consequently abandon breastfeeding. To avoid this, the International Code of Marketing of Breastmilk Substitutes and subsequent relevant WHA resolutions exist, which Member States should incorporate into their legislation. Unfortunately, implementation is lacking in many countries, leaving parents vulnerable in face of the baby-food industry and the wrong information they convey.

Secondly, breastfeeding support, an important component of the reproductive right to breastfeed, is seldom guaranteed. Many women who want to breastfeed are not assisted in initiating breastfeeding in the first hour after birth, and very few countries ensure that they have access to the services of a lactation consultant, which can significantly improve the chances of successful breastfeeding.

Thirdly, women should not have to decide between work and the way they want to feed their children. The Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) recognizes the importance of maternity protection (Art. 11 and 12). In 1995, the Beijing Platform for Action also underlined multiple areas where women at work need protection, including when pregnant, on maternity leave, or re-entering the labor force after childbearing. Yet, according to the 2019 UN Women annual report globally, only 41.1% of mothers with newborns receive a maternity benefit. This means that, during the year, many women had to return to work before they were able to fully recover after the birth. This also has consequences on their choice to breastfeed. More often than not, breastfeeding mothers face a dilemma upon return to work from maternity leave, due to their workplace not allowing for breastfeeding breaks, or proper lactation rooms. After all, the world of work was shaped by men for centuries, and it is women who have had to adapt to it rather than the other way around.

Unfortunately, instead of holding the industry liable or blaming the current lack of support, too often than not, it is the mother who faces criticism for not having breastfed her child (whether she chose it or not) in spite of all the obstacles she may currently have to face to do so. Only in an environment where women are empowered and enjoy more equitable social relations will breastfeeding be easier to establish, rather than be seen as an added burden on women. This is why it is fundamental to keep women at the center of breastfeeding promotion. Only this way can it be understood how breastfeeding promotes equality and empowerment.


 ...And of our Planet’s

Breastfeeding is also linked to the right to a safe, healthy environment. You may have seen pictures of breastfeeding women during a "climate strike" in Brussels, or more recently, breastfeeding claims at the Extinction Rebellion protest. Many states now include a right to a safe, healthy environment in their constitution, but very often ignore how promoting, protecting and supporting breastfeeding could be an intervention to realize such right. Breastfeeding is in fact the most economical and environmentally friendly way to feed an infant and young child. Breastfeeding produces zero waste, zero greenhouse gases and almost zero water footprint. Factory-produced breast milk substitutes on the other hand, place a heavy burden on our planet and its environment. To produce 1Kg of formula, it is estimated that more than 4000 L of water are needed along the production pathway. Breastfeeding also produces no waste, contrary to formula. In the USA alone, 86,000 tons of metal, 550 million cans and 364,000 tons of paper used to package baby food products end up in landfills.  Promoting, protecting and supporting mothers’ right to breastfeed can therefore safeguard the health of our planet. Unfortunately, as previously mentioned, few governments and policy-makers understand the importance of interventions to protect, promote and support breastfeeding therefore failing to acknowledge the important contribution that breastfeeding women make to their own, their child’s and our planet’s health.


The importance of the Global Strategy on Infant and Young Child Feeding

The right to breastfeed should not be forgotten. Rather, it should be defended, and governments should uphold their commitment by implementing the WHO/UNICEF Global Strategy on Infant and Young Child Feeding to Protect, Promote and Support Breastfeeding.  The protection pillar includes adequate legislation on maternity protection, covering all working women and allowing them to optimally feed their babies; appropriate marketing and use of processed complementary foods, which should be safe, culturally acceptable, affordable and nutritionally adequate, in line with relevant Codex Alimentarius standards; full implementation and monitoring of the provisions of the International Code of Marketing of Breastmilk Substitutes and subsequent relevant WHA Resolutions. The promotion pillar implies that accurate and complete information about appropriate Infant and Young Child Feeding practices is available to the general public. The support pillar includes three branches: support from the health care system, support in the community and support in exceptionally difficult circumstances. This Global Strategy is fundamental to uphold the right of women to breastfeed their child, which can have long lasting consequences on women's health, their children and the planet.


Further information