How ‘global’ is breastfeeding?
By Tasneem Ahmed
Breastfeeding is thought to be a universal concept. Most mothers, regardless of their nationality or ethnicity, are able to produce breastmilk for their newborn babies with biology superseding all. However, we find that in actuality, breastfeeding rates differ significantly globally. To explore why, we must look at the finer nuancesbehind why some women breastfeed, and why others do not.
Breastfeeding has gained much attention in the medical field over the last two decades, with increased research investigating its numerous health benefits, including paediatric cognitive and immunological development. Studies have found that babies who are breastfed are also less prone to infections, diarrhoea,
obesity and cardiovascular diseases later in life (NHS, 2018). Babies who are weaned off breast milk prematurely are more likely to suffer from illnesses such as gastrointestinal infections, lower respiratory infections, as well as Sudden Infant Death Syndrome (Anstey et al., 2016). The protective health benefits to mothers are also manifold, including decreased risk in chronic conditions such as diabetes, hypertension, osteoporosis and ovarian and breast cancer (NHS, 2018).
‘Exclusive breastfeeding’ refers to mothers solely feeding their babies with breast milk. The introduction of formula milk or any other nutritional substance impacts the benefits that come from exclusively breastfeeding, particularly in the first 6 months of a baby’s life. This is reflected in the global guidelines set by the World Health Organisation (WHO & Unicef, 2009) which encourage exclusive breastfeeding for the first six months of life, thereafter supplementing breastfeeding with other nutritional sources up until two years of age. Despite the many benefits of breastfeeding for baby and mother, the UK has amongst the lowest breastfeeding rates in the world with 1% of mothers exclusively breastfeeding at 6 months (Fox et al., 2015). Comparatively, 25.4% of women in the US exclusively breastfeed at 6 months (CDC, 2019). Considering medical advancements in the west, it’s hard to believe something so crucial is going amiss.
In Bangladesh, breastfeeding is more common with 35.9% of mothers exclusively breastfeeding their child for the first six months (Hossain et al., 2018). One reason as to why this may be, is that breastmilk is free, naturally renewable and more accessible than formula milk. This is significant in the context of the population where one in five people live below the poverty line (Chaudry, 2020).
It is important to also consider the various social factors that can hinder or encourage women to breastfeed. Examples include a normalised culture to formula feeding, a lack of education on breastfeeding practices, mothers needing to return back to work or the negative social attitude towards breastfeeding which can make women feel embarrassed to breastfeed in public. Another big issue is the formula milk industry and their influence through lobbying their products. Large corporations such as Nestle aggressively target families and healthcare professionals to encourage formula milk, which is problematic for many reasons. Specific to Bangladesh, many babies are brought to hospital with diarrhoea which can be fatal because of reduced access to clean water. In general, it is illegal for formula companies to promote formula over breastmilk. Despite this, many doctors in Bangladesh have reported companies such as Nestle, approaching them with gifts and seeking for them to encourage formula feeding in new mothers (Moorhead, 2007).
Other barriers posed to breastfeeding, is how difficult breastfeeding can be practically. Mothers can suffer from cracked nipples or struggle to comfortably position their baby to latch onto their breast. In the UK and many other western countries, breastfeeding support is available, but these services are arguably often limited in reaching a sufficient number of new mothers. For example, younger mothers tend to be early in their careers, and may feel more pressure to go back to work sooner, making the exclusive breastfeeding period more difficult to achieve. However, it is worth noting that there has been a societal shift, that we can only hope will continue to grow where work places have made more of an effort to facilitate breastfeeding practises for their employees. Many companies have set aside quiet rooms where mothers can breastfeed in private. Cost-benefit analysis shows that companies will actually save money in the long run by not having to replace employees who often leave workplaces that are not accommodating to their new family dynamics.
To conclude, whilst many women around the world may be able to breastfeed, the reasoning behind whether they choose to breastfeed or not, can be complex. This results in many variations in the rates of breastfeeding worldwide. This is important to acknowledge and appreciate when we explore how breastfeeding rates differ in different contexts.
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