Breastfeeding is a smart investment in people and economies: The Lancet

Breastfeeding is traditionally known for child’s benefit, but The Lancet says it has both social and economic impacts and suggests countries to make it a separate ‘indicator’ in pursuing the new sustainable development goals.

In a first comprehensive analysis of breastfeeding impacts, the influential British medical journal says the evidence on breastfeeding “leaves no doubt that it is a smart and cost-effective investment in a more prosperous future”.

But it warned countries that the reach and influence of the breast milk substitutes (BMS) industry is “growing fast”, and that not to consider breastfeeding “cost free”.

“It is not free. Breastfeeding requires investment to overcome the socio-political barriers that exist in many countries through the effective approaches and practices”.

The Lancet Breastfeeding Series, released on Friday in Washington, included 28 systematic reviews and 22 meta-analyses commissioned specifically for the Series.

In total, more than 1,300 studies were reviewed to provide the most exhaustive look at the benefits, determinants, and trends in breastfeeding to date.

It finds that globally the costs of lower cognitive ability associated with not breastfeeding amount to more than $300 billion each year, a figure comparable to the entire global pharmaceutical market.

About 820,000 child deaths could be prevented annually, which is about 13 percent of all under-5 child deaths, by improving breastfeeding rates, in addition to the lives already saved by current breastfeeding practices.

“Supporting breastfeeding makes economic sense for rich and poor countries and this latest breastfeeding study proves it,” said Series co-lead, Dr. Cesar Victora, emeritus professor from the International Center for Equity in Health, Post-Graduate Programme in Epidemiology, Federal University of Pelotas in Brazil.

The Lancet shows why breastfeeding is one of the highest impact interventions providing benefits for children, women, and society.

Breastfeeding reduces infant morbidity and mortality, increases Intelligence Quotient (IQ) score, improves school achievement, and boosts adult earnings —all essential for reducing poverty.

It also contributes to equity by giving all children a nutritional head start for success in life.

The Lancet says that in the context of ending poverty by 2030 as envisaged in the new SDGs, the breastfeeding agenda is “more timely” now.

“The omission of breastfeeding from the Millennium Development Goals, and the resultant lost opportunities to improve child survival, must not be repeated in the Sustainable Development Goals, for which the indicators will be decided in early 2016,” an author commented.

The new SDG has 17-goals and 169 targets. Countries will now decide their own indicators to reach those targets.

The Lancet says nearly half of all diarrhea episodes and one-third of all respiratory infections would be prevented with breastfeeding.

For each of the first two years a mother breastfeeds over her lifetime, she decreases her risk of developing invasive breast cancer by six percent. She also benefits from reduced ovarian cancer risk.

Approximately 20,000 breast cancer deaths are prevented each year by breastfeeding; improved rates could prevent another 20,000 deaths each year.

Nutrition Specialist of UNICEF Bangladesh Dr Md Mohsin Ali told bdnews24.com that this was the first such analysis that saw “all dimensions” of breastfeeding.

“Breastfeeding should be taken as a development indication. Apart from nutrition aspect, it has impact on education, economy and peoples’ life”.

The breastfeeding rate in Bangladesh after a long plateau jumped to 64 percent in 2011, but the rate later declined.

Dr Ali said Bangladesh “prioritised” breastfeeding in its policy, but there were “shortcomings” in programming to promote this.

“Many think it’s a natural process, it will occur automatically. But in reality it’s not true. It needs support. The Lancet showed the evidence (the need of investment).”

The journal says active and aggressive promotion of BMS by their manufacturers and distributors “continues to be a substantial global barrier to breastfeeding”.

It presented Bangladesh as one of the six countries, citing a Save the Children report, where the BMS code is “inadequately implemented and enforced”.

In direct contravention to the code, some representatives of BMS companies in many countries promote their products directly to pregnant women and new mothers, undermining their confidence about breastfeeding, the journal says.

In many low-income and middle-income countries, growth in sales of BMS exceeds 10 percent annually and the retail value of the industry is projected to reach $70.6 billion by 2019.

Global sales of milk formula including infant formula and follow-on milks have increased from a value of about $2 billion in 1987 to about $40 billion in 2013, and account for two-thirds of all baby food sales internationally.

But breastfeeding is nutritionally, immunologically, neurologically, endocrinologically, economically, and ecologically superior to BMS, and does not require quality control of manufacture, transport, storage, and feeding mechanisms.

“Genuine and urgent commitment is needed from governments and health authorities to establish a new normal: where every woman can expect to breastfeed, and to receive every support she needs to do so,” The Lancet writes in the editorial of the series.