• Rafael Pérez-Escamilla, Cecília Tomori, Sonia Hernández-Cordero, Phillip Baker, BarrosAluisio J DAJDInternational Center for Equity in Health, Federal University of Pelotas, Pelotas, Brazil., France Bégin, Donna J Chapman, Laurence M Grummer-Strawn, David McCoy, Purnima Menon, Paulo Augusto Ribeiro Neves, Ellen Piwoz, Nigel Rollins, Cesar G Victora, Linda Richter, and 2023 Lancet Breastfeeding Series Group.
• Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, CT, USA. Electronic address: rafael.perez-escamilla@yale.edu.
• Lancet. 2023 Feb 11; 401 (10375): 472485472-485.

AbstractIn this Series paper, we examine how mother and baby attributes at the individual level interact with breastfeeding determinants at other levels, how these interactions drive breastfeeding outcomes, and what policies and interventions are necessary to achieve optimal breastfeeding. About one in three neonates in low-income and middle-income countries receive prelacteal feeds, and only one in two neonates are put to the breast within the first hour of life. Prelacteal feeds are strongly associated with delayed initiation of breastfeeding. Self-reported insufficient milk continues to be one of the most common reasons for introducing commercial milk formula (CMF) and stopping breastfeeding. Parents and health professionals frequently misinterpret typical, unsettled baby behaviours as signs of milk insufficiency or inadequacy. In our market-driven world and in violation of the WHO International Code for Marketing of Breast-milk Substitutes, the CMF industry exploits concerns of parents about these behaviours with unfounded product claims and advertising messages. A synthesis of reviews between 2016 and 2021 and country-based case studies indicate that breastfeeding practices at a population level can be improved rapidly through multilevel and multicomponent interventions across the socioecological model and settings. Breastfeeding is not the sole responsibility of women and requires collective societal approaches that take gender inequities into consideration.© 2023 World Health Organization; licensee Elsevier. This is an Open Access article published under the CC BY 3.0 IGO license which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. In any use of this article, there should be no suggestion that WHO endorses any specific organisation, products or services. The use of the WHO logo is not permitted. This notice should be preserved along with the article's original URL.

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