The countries where 1 in 5 children are never breastfed electricity usage

A new UNICEF report released Wednesday that ranks countries by breastfeeding rates shows that in high-income countries, more than one in five babies is never breastfed, whereas in low- and middle-income countries, one in 25 babies is never breastfed.

"In higher-income countries, we see that the proportion of children who have never been breastfed is significantly higher than the number of children in low- and middle-income countries. That is a fact," he said. "We need to create environments — including in the US — that make breastfeeding the norm."

The new report included data on breastfeeding prevalence among 123 countries. Those data came from several sources, including UNICEF’s global databases, the US Centers for Disease Control and Prevention, The Lancet and studies published in scientific journals such as Acta Paediatrica.

The high-income countries in the report were Australia, Barbados, Canada, Chile, Finland, France, Germany, Ireland, Italy, Norway, Oman, Qatar, Singapore, South Korea, Spain, Sweden, the United Kingdom, Uruguay and the United States. The data for those countries were based on breastfeeding rate estimates from 2010 or more recently.

"The overall report by UNICEF is accurate and represents current research about breastfeeding rates around the world in countries with varied development and among different socioeconomic groups," said Pamela Mulder, assistant professor at the University of Iowa’s College of Nursing, who was not involved in the report.

"At first glance, the data about breastfeeding rates may seem contradictory. Given the many benefits of breastfeeding, it may seem odd that some high-income countries have the lowest rates of breastfeeding … while others have very high rates," Mulder said.

"Societies change," he said. "As women join the formal or the informal work force, we see that in some countries, there is a tendency, among some women, to not breastfeed their babies anymore. If a significant proportion of women are not breastfeeding their children, it is, by and large, because mothers and woman and families aren’t getting the support they need to do so."

"Maternity leave and maternity protection are key for mothers in their breastfeeding choice, that is if women are given a six-month maternal leave so that they can stay home with their babies and breastfeed them exclusively, as we are recommending," Aguayo said.

"We also need to support women to be able to breastfeed in public places. Breastfeeding needs to be common more; breastfeeding should be supported by people in airports," for instance, he said. "The health system has a major role to do and to play in supporting mothers before delivery, during delivery and after delivery. So health professionals need to be trained to support mothers in attempting to breastfeed."

In the United States and other high-income countries, many of the babies who are less likely to breastfeed disproportionately come from poorer households and disadvantaged backgrounds, said Dr. Laura Kair, medical director of the Well Newborn Nursery at University of California, Davis Medical Center, who was not involved in the UNICEF report.

"Because of all the benefits of human milk that we know of, lack of breastfeeding could worsen health disparities among those populations," she said. "So I think it’s good that these statistics exist, because it sort of gives a framework, and it highlights the importance of promoting breastfeeding to improve maternal-child health."

Joanne Silbert-Flagg, assistant professor and clinical coordinator for the MSN Entry into Nursing Program at Johns Hopkins University School of Nursing, and Deborah Busch, also an assistant professor at the university, pointed out the importance of clarifying what rates of "ever" being breastfed really mean. They were not involved in the UNICEF report.

" ‘Ever breastfed’ is if you ever gave some breast milk. If they say, ‘Have you breastfed in the first six months? Have you provided any breast milk?’ It could just be they breastfeed once or twice a day, and the rest of the time they give formula, but that would be included in ‘ever breastfed,’ as opposed to exclusively breastfeeding, meaning you’re not giving anything other than breast milk. Whether it’s pumped milk, breast milk or breastfeeding at the breast, they’ve received no formula whatsoever," Silbert-Flagg said.

"There’s very few that exclusively breastfeed," she said. "So it’s very interesting to look at research studies or how they’re collecting the data, because you could skew the results to look like there’s a higher breastfeeding rate if you included ‘ever breastfed.’ "

UNICEF and the World Health Organization also recommend exclusive breastfeeding from within an hour after a baby is born until the baby is 6 months old, but thereafter, nutritious complementary foods should be added to a child’s diet while continuing to breastfeed for up to 2 years or beyond.

"In the US, it’s not really stressed to breastfeed after a year, and a lot of moms will feel like they need to wean at a year, even though that’s not always necessary," Silbert-Flagg said. "Of course, you’re only doing it maybe twice a day after a year, but still continuing to breastfeed has the health benefits."

Some mothers are unable to breastfeed for medical reasons, such as being infected with the human immunodeficiency virus, HIV, or not producing enough milk. The University of Iowa’s Mulder said that those mothers should consult with a trained health care professional for support and guidance.

"Additionally, mothers can try breastfeeding in the hospital after birth and infant formula is available if breastfeeding is not working for them or their infants," she said. "They can also combine breast milk and infant formula feedings, and they can breastfeed for the time they choose, whether that be two weeks or six months."

"Any allergic disorders like asthma or allergies are less in breastfed babies," she said. "Then, cancers in mom — uterine and breast cancer — actually are dose related to breastfeeding. So the more months a mom breastfeeds, it lessens her risk of getting breast cancer."

A study published last year in the journal Pediatrics found limited positive impacts of breastfeeding for children’s cognitive development and behavior later in life. That study involved about 8,000 families in Ireland and included information on children’s behaviors and cognitive activities at ages 3 and 5. Breastfeeding data were collected from their moms.

"Human milk has immune cells as well as commensal bacteria, or good bacteria, that help us establish our microbiota. It has highly specialized sugars and proteins that help fight infections, as well," she said. "Human milk is alive, and it’s medicine that’s prepared specifically for an individual baby."