Less than half of infants around the world under the age of six months are breastfed exclusively, finds a new report by UNICEF and the World Health Organization. In fact, no country in the world meets all the recommended standards for breastfeeding.

To mark the start of World Breastfeeding Week, WHO and UNICEF, along with the Global Breastfeeding Collective, released a scorecard evaluating the breastfeeding habits in 194 nations.

They found that only 40 per cent of children younger than six months are breastfed exclusively, meaning they are given nothing but breastmilk, as doctors now recommend.

Only 23 countries have exclusive breastfeeding rates above 60 per cent. None of those countries are in North America or Europe. They include Bolivia, Burundi, Cambodia, Democratic People’s Republic of Korea, Eritrea, Kenya, Malawi, Micronesia, Peru, and Sri Lanka.

There are many reasons why mothers cannot breastfeed for as long as health experts recommend -- even when they want to, the report authors found.

A key reason is because many women need to return to work and are forced to find alternatives to breastfeeding.

Just over 10 per cent of countries currently provide protection to new mothers that ensures they receive at least 18 weeks of maternity leave, and guarantees they can continue to receive their previous earnings once they return to work.

Another barrier to breastfeeding is the widespread promotion of breast-milk substitutes, the report authors say. Aggressive infant formula marketing “dissuades many mothers from breastfeeding and weakens their confidence in their ability to breastfeed,” they write.

That’s why World Health Assembly adopted an International Code of Marketing of Breast-Milk Substitutes in 1981, which aims to stop inappropriate marketing of breast-milk substitutes, to ensure that mothers make feeding choices “based on impartial information and free of commercial influences.”

The scorecard found that only 39 countries are enforcing all the provisions of that marketing code.

WHO experts have long promoted breast milk as the best food to offer infants, particularly during their first six months of life. They say breast milk is safe, clean, and contains antibodies that can help protect against common childhood illnesses, such as diarrhea and pneumonia.

Research has also found that breastfeeding can reduce the risk of obesity and diabetes for children later in lie. What’s more, mothers who breastfeed have a reduced risk of breast and ovarian cancer -- two leading causes of death among women.

UNICEF Executive Director Anthony Lake says breastfeeding is one of the most effective—and cost effective -- investments nations can make in the health of babies and the future health of their economies.

The authors of the scorecard say that every dollar invested in breastfeeding generates $35 in returns, because of reduced health care costs for newborns, their mothers, and illnesses later in life.

“By failing to invest in breastfeeding, we are failing mothers and their babies—and paying a double price: in lost lives and in lost opportunity,” Lake said in a statement announcing the scorecard findings.

The Global Breastfeeding Collective would like to see several changes to raise global breastfeeding rate, including:

  • Increased funding to programs that promote, support and protect breastfeeding
  • More paid family leave and workplace breastfeeding policies
  • More breastfeeding promotion in maternity health centres, including providing breast milk for sick newborns
  • Improved access to breastfeeding counselling in health facilities
  • Strengthened monitoring systems that track the progress of policies towards achieving breastfeeding targets
  • Full implementation of the International Code of Marketing of Breast-milk Substitutes through strong legislation.

The WHO and UNICEF recommend breastfeeding be initiated within one hour of birth, and that it continue with no other foods or liquids for the first six months of life.

They also recommend breastfeeding along with age-appropriate solid foods until a child reaches at least 24 months of age.