Journal of Public Health Policy

, Volume 40, Issue 1, pp 35–65 | Cite as

The World Breastfeeding Trends Initiative: Implementation of the Global Strategy for Infant and Young Child Feeding in 84 countries

  • Arun GuptaEmail author
  • Shoba Suri
  • J. P. Dadhich
  • Marta Trejos
  • Barbara Nalubanga
Original Article


Breastfeeding could save the lives of more than 820,000 children and 20,000 women. Worldwide, despite evidence of the importance of both, only 42% women begin breastfeeding within an hour of birth, and 41% practice exclusive breastfeeding. In 2002, to mobilise action and support optimal breastfeeding, the World Health Assembly adopted the Global Strategy for Infant and Young Child Feeding. The WHO identified the need to assess implementation of policies and programmes at the national level and provided an assessment tool. International Baby Food Action Network Asia adapted the tool to launch the World Breastfeeding Trends Initiative (WBTi). The WBTi facilitates measurement of the status of implementation of policy and programmes, and stimulates local action towards positive changes. Results of assessments from 84 countries reveal lack of attention to policy in almost all areas. Repeat WBTi assessments allowed us to analyse trends that showed positive changes towards strengthening the policy and programmes to support women to be successful in breastfeeding.


Breastfeeding Global strategy Infant and young child feeding Policy and programmes Nutrition Child health 



We thank all the regional coordinators of IBFAN for leading this work. We are extremely grateful to all the country coordinators for undertaking the WBTi assessment and sharing their reports. We thank Ms.Alison Linnecar (Convener, IBFAN global working group on chemical and microbiological contamination of infant feeding products) and Ms. Irena Zakarija-Grkovic (Country Coordinator IBFAN-Croatia) for reviewing the paper and for their valuable input. We acknowledge and thank the staff at BPNI for their IT and logistical support. We appreciate the support of the Swedish International Development Agency and the Norwegian Agency for Development Cooperation.


  1. 1.
    Victora CG, Bahl R, Barros AJD, Franca GVA, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC, for the Lancet Breastfeeding Series Group. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387:475–90.CrossRefGoogle Scholar
  2. 2.
    Victora CG, Horta BL, de Mola CL, Quevedo L, Pinheiro RT, Gigante DP, Goncalves H, Barros F. Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: a prospective birth control study from Brazil. Lancet Glob Health 2015; 3: e199–205.
  3. 3.
    Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, Piwoz EG, Richter LM, Victora CG, on behalf of the Lancet Breastfeeding Series Group. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387:491–504.CrossRefGoogle Scholar
  4. 4.
    UNICEF. Infant and Young Child Feeding-Global Database. 2017.
  5. 5.
    Kavle JA, LaCroix E, Dau H, Engmann C. Addressing barriers to exclusive breast-feeding in low- and middle-income countries: a systematic review and programmatic implications. Public Health Nutr. 2017;20:3120–34.CrossRefGoogle Scholar
  6. 6.
    Breastfeeding: a missed opportunity for global health. Lancet 2017;390:532.
  7. 7.
    Gupta A, Holla R, Dadhich JP, Suri S, Trejos M, Chanetsa J. The status of policy and programmes on infant and young child feeding in 40 countries. Health Policy Plan. 2012;28:279–98.CrossRefGoogle Scholar
  8. 8.
    WHO 2012. Resolution WHA 65.6. Comprehensive implementation plan on maternal, infant and young child nutrition. In: Sixty-fifth World Health Assembly Geneva, 21–26 May 2012. Resolutions and decisions, annexes. Geneva: World Health Organization; 2012:12–13.
  9. 9.
    The Global Breastfeeding Collective.
  10. 10.
    WHO/UNICEF. Tracking progress for breastfeeding policies and programmes: Global breastfeeding scorecard. 2017.
  11. 11.
  12. 12.
    Global Nutrition Report 2017. Nourishing the SDGs.
  13. 13.
  14. 14.
    WHO 2003. Infant and young child feeding—a tool for assessing national practices, policies and programmes.
  15. 15.
    Asia Pacific Conference on Breastfeeding and National Convention of BPNI. 2003
  16. 16.
    Are we doing enough for our babies—trends analysis in infant and young child feeding policies, programmes and practices in South Asia;2013:16-38.
  17. 17.
    WBTi—World Breastfeeding Trends Initiative 2016. Has your nation done enough to Bridge the Gaps? 84-country report on status and progress of implementation of the Global Strategy for Infant and Young Child Feeding 2008–2016.
  18. 18.
  19. 19.
    World Bank 2016. An investment framework for nutrition: reaching the global targets for stunting, anaemia, breastfeeding and wasting.
  20. 20.
    Holla R, Iellamo A, Gupta A, et al. Investing in breastfeeding—the world breastfeeding costing initiative. Int Breastfeed J. 2015;10:8.CrossRefGoogle Scholar
  21. 21.
    Walters D, Horton S, Siregar AYM, et al. The cost of not breastfeeding in Southeast Asia. Health Policy Plan. 2016;31:1107–16.CrossRefGoogle Scholar
  22. 22.
    Lutter CK, Morrow AL. Protection, promotion, and support and global trends in breastfeeding. Adv Nutr. 2013;4:213219.CrossRefGoogle Scholar
  23. 23.
    Haroon S, Das JK, Salam RA, et al. Breastfeeding promotion interventions and breastfeeding practices: a systematic review. BMC Public Health. 2013;13:S20.CrossRefGoogle Scholar
  24. 24.
    Kushwaha KP, Sankar J, Sankar MJ, et al. Effect of peer counselling by mother support groups on infant and young child feeding practices: the Lalitpur experience. PLoS ONE. 2014;9(11):e109181.CrossRefGoogle Scholar
  25. 25.
    Khan AI, Kabir I, Eneroth H, et al. Effect of a randomised exclusive breastfeeding counselling intervention nested into the MINIMat prenatal nutrition trial in Bangladesh. Acta Pediatrica. 2017;106:49–54.CrossRefGoogle Scholar
  26. 26.
    Monteiro FR, Buccini G, Venancio SI, et al. Influence of maternity leave on exclusive breastfeeding. J Pediatr (Rio J). 2017;9:475–81.CrossRefGoogle Scholar
  27. 27.
    Nandi A, Hajizadeh M, Harper S, et al. Increased duration of paid maternity leave lowers infant mortality in low and middle income countries: a Quasi experimental study. PLoS Med. 2016;13:e1001985.CrossRefGoogle Scholar
  28. 28.
    de Carvalho ML, Boccolini CS, de Oliveira MIC, et al. The baby-friendly hospital initiative and breastfeeding at birth in Brazil: a cross sectional study. Reprod Health. 2016;13:119.CrossRefGoogle Scholar
  29. 29.
    Perez-Escamilla R, Martinez JL, Segura-Perez S. Impact of the baby-friendly hospital initiative on breastfeeding and child health outcomes: a systematic review. Matern Child Nutr. 2016;12:402–17.CrossRefGoogle Scholar
  30. 30.
    Sinha B, Chowdhury R, Sankar MJ, et al. Interventions to improve breastfeeding outcomes: a systematic review and meta-analysis. Acta Pediatr. 2015;104(S467):114–34.CrossRefGoogle Scholar
  31. 31.
    Heymann J, Raub A, Earle A. Breastfeeding policy: a globally comparative analysis. Bulletin of the World Health Organization 2013;91:398–406.
  32. 32.
    Bosi ATB, Eriksen KG, Sabko T, et al. Breastfeeding practices and policies in WHO European Region Member States. Public Health Nutr. 2015;19:753–64.CrossRefGoogle Scholar
  33. 33.
    Perez-Escamilla R, Curry L, Minhas D, et al. Scaling up of breastfeeding promotion programs in low- and middle-income countries: the “Breastfeeding Gear” model. Adv Nutr. 2012;3:790–800.CrossRefGoogle Scholar
  34. 34.
    UNICEF 2010. Consolidated report of six-country. Review of Breastfeeding Programme.

Copyright information

© Springer Nature Limited 2018

Authors and Affiliations

  • Arun Gupta
    • 1
    Email author
  • Shoba Suri
    • 1
  • J. P. Dadhich
    • 1
  • Marta Trejos
    • 2
  • Barbara Nalubanga
    • 3
  1. 1.Breastfeeding Promotion Network of India (BPNI)/IBFAN AsiaNew DelhiIndia
  2. 2.IBFAN Latin America and CaribbeanSan JoseCosta Rica
  3. 3.IBFAN AfricaPretoriaSouth Africa

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