Transitioning to Good Health and Well-Being: The Essential Role of Breastfeeding

The world is facing unprecedented public health challenges, including changes, due to climate change, that will affect every continent, and limitations on global food and water supplies together with an increasing epidemic of non-communicable disease. The United Nations Sustainable Development Goal 3, “good health and well-being”, includes targets for child mortality, maternal mortality and reducing chronic disease. Breastfeeding is one of the most cost-effective public health interventions available for countries at all levels of development. In the first year of life, appropriate infant nutrition (exclusive breastfeeding to around six months) reduces infant mortality and hospital admissions in infancy by 50% or more. Breastfeeding followed by the introduction of appropriate complementary foods at around six months establishes a healthy microbiome, has a long-term association with reduced rates of childhood illnesses, hospitalizations, obesity and later chronic disease, while improving cognitive development. It is consistent with the historical cultural practices of all societies. While the development of infant formula has been of benefit to some infants, its inappropriate promotion has resulted in a decline of breastfeeding in recent decades, and, as a result, recent health gains in many countries have not been as great as they could have been. Formula use increases health care costs through increased illnesses and hospital admissions. The specific target for non-communicable disease in SDG 3 is to reduce premature mortality from chronic disease by one third by 2030. The Global Burden of Disease project has confirmed that the majority of risk for these targets can be attributed to nutrition related targets, and it is estimated that annually 15 million people between the ages of 30 and 69 years die from a non-communicable disease (NCD), the majority from cardiovascular causes. Healthy life course nutrition, beginning in the first 1000 days of life, is a major public health priority in answering this challenge. Breastfeeding, exclusively for about six months, and appropriate complementary feeding, establishes a healthy developmental trajectory. Children are the population segment most susceptible to the effects of climate change, bearing an estimated 80% of the increased burden of disease associated with climate change. The health benefits of breastfeeding will provide some protection against the health effects of climate change, including projected increases in some infectious diseases. Increased breastfeeding will avoid the high environmental costs associated with the production of infant formula, including the use of large quantities of potable water and energy. In contrast, breastfeeding, as well as being the best infant feeding intervention, has a very low environmental impact. An important part of the sustainable development agenda should be to promote breastfeeding and its benefits and to reverse the inappropriate promotion of infant formula.