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The Breastfeeding Paradox

Despite the multiple benefits of breastfeeding for both baby and mother, a new UNICEF report reveals that 1 in 5 babies in high-income countries are not breastfed.
10 May 2018
Sumona Akhtar Juthie, holds her 47-day-old baby daughter Muskan at the Special Care Newborn Units in Dhaka, Bangladesh.


(11 May 2018) This Mother’s Day, UNICEF is calling attention to the importance of breastfeeding, particularly in high-income countries. A UNICEF report released yesterday, Breastfeeding: A Mother’s Gift to Every Child, reveals that worldwide, approximately 7.6 million babies a year are not breastfed.

UNICEF has long been at the forefront of mother and baby care. Notably, together with the World Health Organisation, UNICEF introduced the Baby-friendly Hospitals Initiative in 1991, providing practical steps maternity and newborn facilities worldwide should take to protect, promote and support breastfeeding.

Breastfeeding is one of the most powerful practices for promoting child survival and wellbeing. It also promotes healthy growth and boosts early child development, including brain development. Breastfeeding is not just good for babies but also benefits mothers, having shown to protect against post-partum haemorrhage, postpartum depression, ovarian and breast cancer, heart disease and type 2 diabetes. In short, breastfeeding is among the most effective ways to protect maternal and child health and promote healthy growth and optimal development in early childhood.

Almost 30 years after the Baby-friendly Hospitals Initiative, and despite the myriad of benefits for both baby and mother, UNICEF’s latest report reveals that 1 in 5 babies in high-income countries are not breastfed, compared to 1 in 25 babies in low- and middle-income countries.

Explore the Breastfeeding Scorecard to see your country’s policy actions and breastfeeding practices

Percentage of newborns ever breastfed by country income group, 2017. Source: Breastfeeding: A Mother’s Gift for Every Child, UNICEF

Within high-income countries, there are wide variations in the proportions of babies who are breastfed. In Sweden, Oman, and Uruguay, almost all babies are breastfed, in comparison to the USA and Ireland with 74% and 55% of babies receiving breast milk respectively. Similar variations are not observed in low- and middle-income countries.

Commenting on the results, UNICEF’s Deputy Director a.i, Shahida Azfar says ”These breastfeeding gaps across income levels are a strong indication that countries, regardless of the level of wealth, are not informing and empowering every mother to breastfeed her baby.”

Differences in breastfeeding rates also occur between rich and poor groups within countries. Evidence suggests that in high-income countries, mothers from poorer households are less likely to breastfeed. Paradoxically, in low- and middle-income countries, the small percentage of mothers who do not breastfeed tend to come from wealthier households. These results suggest the influence of socio-economic factors on breastfeeding behavior.

Many other factors contribute to a positive environment for breastfeeding, including policies guaranteeing parental leave, the right to breastfeed in the workplace, information on breastfeeding within health facilities, social norms that encourage breastfeeding, support from community members, and restrictions on the marketing of breast milk substitutes. The report gives information on how governments, private sector, civil society and communities can address these factors to encourage and support breastfeeding locally.

This Mother’s Day, UNICEF is urging countries worldwide to empower and enable women to breastfeed in order to keep every child alive and to build healthy, smart and productive societies. Improving breastfeeding rates around the world could save the lives of more than 820,000 children under age 5 every year, as well as preventing an additional 20,000 maternal deaths from breast cancer. There are also financial incentives to promoting breastfeeding; according to an estimate in the Lancet in 2016, if the US were to improve breastfeeding rates from existing levels to 90%, treatment costs of childhood diseases would be reduced by at least $2.45 billion.

Amina Garba breastfeeding her youngest child in Mafari, Niger.


The fact that breastfeeding rates remain low in many contexts, with substantial gaps between income groups, suggests that countries are not providing women with sufficient information and support. This requires urgent attention. “Breastfeeding is the best gift a mother, rich or poor, can give her child, as well as herself,” says Azfar. When women are informed, empowered and supported to breastfeed, the benefits extend to their children, to themselves and to society as a whole.

You can download the full report here