From Tokyo to the African Union: Advancing World Breastfeeding

By Nadra Franklin, Managing Director, and Anna Kotenko, Associate Director of Advocacy & Communications

Today, in the wake of rising food price hikes, climate change, and ongoing conflict in the Ukraine, women and girls continue to be the hardest hit. For centuries, women have been protecting their babies and children in challenging circumstances – and there is perhaps no other more evident act of care than breastfeeding. In the face of conflict, poverty, and climate displacement, it is still commonplace for a woman who is not the mother of a new-born to offer her own milk to a baby who would otherwise be at severe risk of malnutrition. That women and babies are placed in this predicament today is difficult to comprehend.

Regardless of circumstance, breastmilk is nature’s first line of natural defence. It is critical to preventing diarrhoea and pneumonia – two major causes of child mortality[1]. The nutrients in breastmilk provide unparalleled source of nutrition to support a babies’ brain and cognitive development, impacting educational attainment, participation in the workforce and lifetime earnings[2]. As such, evidence suggests that every $1 invested in breastfeeding yields $35 in economic returns[3].

Why, then, are we not doing enough to support women – no matter their circumstance, to breastfeed their babies?

In December last year, the government of Japan held Nutrition for Growth – a pledging moment for national governments and donor countries, multilaterals, civil society, and business constituencies to come together and commit to meeting World Health Assembly targets on nutrition, including a target to advance exclusive breastfeeding in the first six months of life.

Nutrition for Growth demonstrated increased commitment to end malnutrition, with approximately one third of all stakeholders explicitly including women, maternal or adolescent girl nutrition or gender sensitivity in their commitment. Yet, we need to go much further, scale innovations, and harmonize collaborations if we are to meet the WHA target to increase the rate of exclusive breastfeeding to 50% by 2025.

This year, the baton is being passed to the African Union in the AU’s Year of Nutrition in 2022. The theme across Africa is human capital development, which sends a salient message for policy makers looking to optimize efficiencies in the workforce to become a global competitor in rapidly changing markets.

This message is particularly important for breastfeeding advocates in a world where only 41% are exclusively breastfed[4]. Social norms, suboptimal workforce policies, economic and time constraints, weak health care infrastructure, and the lack of access to information all contribute to low breastfeeding rates.

At FHI Solutions, through Alive & Thrive, we are working to change this. In Vietnam, we are partnering with the government to improve quality of health care and outcomes for mothers and babies. Our Centers of Excellence for Breastfeeding (COE) are examples of best practice for breast feeding support, and only qualify for COE status once they have fulfilled established criteria necessary to support mothers with early and exclusive breastfeeding and ensure proper early essential new born care practice.

In these hospitals, the Mothers’ Experience Survey provides an external monitoring system critical for establishing and maintaining quality care. It supports mothers to voice their experiences during childbirth, including feedback on hospital care and support to establish exclusive breastfeeding and skin to skin contact. To date, our surveys are impacting performance and breastfeeding rates and our model is being scaled.

Alongside innovations that are taking place in Vietnam, we continue work with communities, government, and local innovators across the world to change harmful social norms, improve health care delivery through national systems and generate powerful advocates. At the policy level, through 1,000 Days, we are advocating for policy change, alongside greater investment in proven interventions.

Given the impressive commitments made at Nutrition for Growth, and the renewed focus on human capital development across Africa, the political climate this year provides impetus to governments and all stakeholders to recognise that enabling women to exclusively breastfeed her baby is not additive to national agendas. It is essential. In the wake of COVID-19, the climate crisis, and rising cost of living, exclusive breastfeeding is optimal for resilience building – for people, for economies and for the planet.

Let’s make sure any momentum generated this World Breastfeeding Week and National Breastfeeding Month (US) continues well beyond August.



[1] Victoria, C., R. Bahl, A. Barros, G. V. A. França, S. Horton, J. Krasevec, S. Murch, M. J. Sankar, N. Walker, and N. C. Rollins. 2016. “Breastfeeding in the 21st Century: Epidemiology, Mechanisms and Lifelong Effect.” The Lancet 387 (10017):475-490

[2]Breastfeeding and Childhood IQ: The Mediating Role of Gray Matter Volume.” Luby, Belden, Whalen, Harms, Barch. J. Am. Acad Child Adolescent Psychiatry. 2016 May


[4] WHO. 2019. Simplified approaches for the treatment of child wasting