Rationale and definition:
Optimal breastfeeding of infants under two years of age has the greatest potential impact on child survival of all preventive interventions, with the potential to prevent over 800,000 deaths (13 percent of all deaths) in children under 5 in the developing world.1
Breastfed children have at least a six-times greater chance of survival in the early months than non- breastfed children. An exclusively breastfed child is 14 times less likely to die in the first six months of life than a non-breastfed child, and breastfeeding drastically reduces deaths from acute respiratory infection and diarrhea, two major child killers.2 The potential impact of optimal breastfeeding practices is especially important in developing country situations with a high burden of disease and low access to clean water and sanitation. Exclusive breastfeeding also has a protective effect against obesity and certain non-communicable diseases later in life.3
In 2012, the World Health Assembly Resolution 65.6 endorsed a Comprehensive implementation plan on maternal, infant and young child nutrition4), which specified six global nutrition targets for 2025. The World Health Organization and UNICEF recommendations on breastfeeding are as follows: initiation of breastfeeding within the first hour after the birth; exclusive breastfeeding for the first six months; and continued breastfeeding for two years or more, together with safe, nutritionally adequate, age appropriate, responsive complementary feeding starting in the sixth month. This indicator will specifically measure the percentage of children less than six months old who are fed breast milk alone.
This indicator can be disaggregated by the mother’s age, household income, education level, and urban/rural.
Comments and limitations:
There is little contention about the high priority to be given to this indicator.
Primary data source:
Household surveys (DHS, MICS, NSS, NNS).
Potential lead agency or agencies:
UNICEF and WHO.
Black, R.E. RE, et al (2013). Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet 382:427–51. doi:10.1016/S0140-6736(13)60937-X.
UNICEF. “Breastfeeding.” UNICEF: New York, 2014.
Horta BL, Victora CG (2013). Long-term effects of breastfeeding: a systematic Review. Geneva: World Health Organization; 2013.
World Health Organization (2012). Resolution WHA65.6. Comprehensive implementation plan on maternal, infant and young child nutrition. Sixty-fifth World Health Assembly Geneva, 21–26 May 2012. Resolutions and decisions, annexes. Geneva: World Health Organization; 2012:12–13.