Opinion: breastfeeding makes all the difference between life and death for children all over the world

By Marie McGrath, London School of Hygiene and Tropical Medicine and Aisling Daly, TU Dublin

None of us need reminding that we are in all manner of crises worldwide - wars, food crisis, pandemics, climate change. This is nothing new for millions of people around the world for whom things have just got worse.

Those hardest hit are the youngest of the young and the smallest of the small. Nearly 25 million or one-fifth of babies under six months of age are malnourished worldwide, and nearly 15% of babies are born too early or too small. These babies are at much higher risk of death, or poor growth and development. If we ever going to have a chance of realising the 2030 global target to eliminate global hunger, we need to act now.

So what can we do? Imagine if some entrepreneur invented a food/fluid combo, bespoke, just for you, on tap 24/7. It had a responsive composition, personalised immune support and was sterile. It required no container, had no carbon footprint, and enveloped you in a caring satisfying warmth every time you took a sip. That's breastfeeding in a nutshell: a safe, sustainable, climate-friendly resource on tap.

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From RTÉ Radio 1's Today With Claire Byrne, interview with Aoibhinn Ni Shuilleabhain, member of the Baby Feeding Law Group Ireland and the mother representative on the National Maternity Hospital Infant Feeding Steering Committee

Breastfeeding makes all the difference between life and death for children all over the world. Scaling up of breastfeeding practices could prevent 823,000 annual deaths, or 14% of deaths of children under two years. Exclusive breastfeeding - meaning no water, formula, or food - for infants under six months is especially critical, as non-exclusive feeding can reduce protection and introduce infection. Mothers and babies come as a duo and the survival and nourishment of a baby is intimately linked to the nutrition and health of their mother.

Despite the evidence, the penny still hasn't dropped. Breastfeeding is not a nice 'to do’; it is a need to do. All mothers and babies will reap huge benefits from breastfeeding, but there is so much more to gain and lose for babies who are born small or are malnourished. They need urgent skilled care. Indeed, last October, during National Breastfeeding Week, President Michael D Higgins asked "what is it that is stopping governments and policy makers from seeing that recovering and promoting breastfeeding could make one of the greatest, perhaps the greatest, contribution to children’s health, nutrition, development?"

At the Nutrition 4 Growth summit in Japan in late 2021, 396 new nutrition commitments were made by 78 countries in a critical, last ditch attempt to get back on track to achieving zero hunger by 2030. Ireland stood out in pledging support for innovative programming approaches for the prevention and treatment of wasting with a particular focus on tackling wasting for infants under six months, backed up by programming targeted at small and nutritionally at-risk infants and children.

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From RTÉ Archives, George Devlin reports for RTÉ News on the La Leche League Ireland's annual conference on breastfeeding in 1986

Ireland is already at the forefront of making this a reality in challenging contexts around the world. For many years, Ireland has supported a global "Warm Chain of Support", through the MAMI Global Network led by Emergency Nutrition Network (ENN). Ireland has supported development of the MAMI Care Pathway Package by this network, which integrates skilled breastfeeding counselling in the care of small and nutritionally-at risk infants under six months and their mothers.

Breastfeeding supports are not only needed for developing countries where emergencies or disasters "typically" occur, but all countries need systems of protection and support in place. For example, the international community galvanised to safeguard breastfeeding for mothers fleeing from the war in Ukraine, many of whom are now in Ireland.

A recent report by WHO/UNICEF shows the powerful marketing strategies infant formula companies invest billions in, pulling on our emotional strings and subtly and effectively undermining breastfeeding worldwide. Ireland has recently proposed innovative digital advertising controls that could be a game-changer on this front. Research has highlighted that breastfeeding support was not only already lacking, but has got even worse during Covid-19 restrictions.

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From RTÉ Radio 1's Drivetime in October 2020, Nicola O'Byrne on why Ireland has one of the lowest breastfeeding rates in Europe

Ireland has now funded research to develop an Infant Feeding in Emergencies plan to ensure that all children and their mothers are protected and empowered to nourish their infants throughout any emergency they may face in the future. This continues the warm chain of support to mothers around the world and back here in Ireland.

World Breastfeeding Week is an opportunity for us to match Ireland’s global leadership with solid steps on our home turf. Let us ensure Ireland is not a hostile or risky care environment for mothers born here, mothers who relocate here, mothers who flee here. Many arrive to our shores stressed, fearful, unsure with vulnerable babies. Let them be greeted with open arms and prompt, skilled support so that we truly extend a warm Céad Mile Fáilte and not set them up for a Céad Mile Failure.

Marie McGrath is a PhD student at the London School of Hygiene and Tropical Medicine and Technical Director at Emergency Nutrition Network. Aisling Daly is a PhD researcher at the School of Biological Sciences at TU Dublin


The views expressed here are those of the author and do not represent or reflect the views of RTÉ