Breastfeeding and malnutrition: A global perspective

Breastfeeding is universally recognized as a cornerstone of infant health and a critical intervention for addressing malnutrition. The World Health Organization (WHO) and UNICEF emphasize its unparalleled role in providing optimal nutrition, boosting immunity, and fostering long-term health outcomes for both infants and mothers. As we reflect on global health efforts, the intersection of breastfeeding practices and malnutrition remains a focal point for achieving sustainable development goals, particularly those related to child survival and maternal well-being. The 2025 World Breastfeeding Week theme, "Invest in Breastfeeding, Invest in the Future," also emphasizes supporting mothers to breastfeed, recognizing it as a vital foundation for lifelong health, development, and equity.

The importance of breastfeeding

Breastfeeding provides infants with a safe, nutrient-rich food source tailored to their developmental needs. Exclusive breastfeeding-“that the infant receives only breast milk. No other liquids or solids are given – not even water – with the exception of oral rehydration solution, or drops/syrups of vitamins, minerals or medicines,”offers protection against common childhood illnesses like diarrhea and pneumonia, which are significant contributors to under-five mortality. World Health Organization (WHO) estimates that optimal breastfeeding could save over 820,000 children’s lives annually. Beyond infancy, continued breastfeeding alongside complementary foods up to two years or beyond supports sustained growth and cognitive development. For mothers, breastfeeding reduces the risk of breast and ovarian cancers, type 2 diabetes, and postpartum complications.

The WHO and UNICEF have set ambitious targets to increase exclusive breastfeeding rates to at least 50% by 2025, with an extended goal of 70% by 2030. These targets are part of the Comprehensive Implementation Plan on Maternal, Infant, and Young Child Nutrition, endorsed by the World Health Assembly in 2012. Breastfeeding is also a key pillar of food security, as it requires no external resources, leaves no carbon footprint, and is resilient to supply chain disruptions.

Progress on breastfeeding targets in 2025

The Global Breastfeeding Scorecard, published by UNICEF and WHO, indicates significant progress toward the 2025 target. By 2023, global exclusive breastfeeding rates for infants under six months had reached 48%, a 10-percentage-point increase over the past decade. This upward trend suggests that the 50% target is within reach by 2025, with 23 countries across Africa, Asia, Europe, and Oceania reporting increases of over 10 percentage points since 2017. Notable success stories include China, Timoe Leste, Nigeria, and Uganda where policy and programmatic advances-such as baby-friendly hospital initiatives and workplace breastfeeding policies-have driven improvements.

However, regional disparities persist. South Asia leads with 60% of infants exclusively breastfed, while East Asia and the Pacific (42%) and West and Central Africa (38%) lag behind. Early initiation of breastfeeding, ideally within the first hour of birth, remains suboptimal globally, with only 46% of newborns achieving this critical milestone. Delays in initiation increase mortality risks, particularly in low-resource settings where access to clean water and formula is limited.

Malnutrition: A persistent challenge

Malnutrition, encompassing undernutrition (stunting, wasting, and underweight), micronutrient deficiencies, and overnutrition (overweight and obesity), continues to pose a significant threat to global health. According to the latest estimates, 150.2 million children under five are stunted, 42.8 million are wasted, and 35.53 million are overweight or obese. Undernutrition alone is linked to 2.7 million child deaths annually, accounting for 45% of under-five mortality. The double burden of malnutrition-where undernutrition and overnutrition coexist-is particularly pronounced in low- and middle-income countries.

Pregnant and breastfeeding women are increasingly vulnerable to malnutrition. A 2023 UNICEF report highlighted a 25% surge in acute malnutrition among pregnant and breastfeeding adolescent girls and women in 12 crisis-affected countries, rising from 5.5 million to 6.9 million since 2020. In Gaza, over 40% of pregnant and breastfeeding women were severely malnourished  with malnutrition-related deaths spiking in July 2025.

The interplay between breastfeeding and malnutrition

Breastfeeding is a critical intervention for mitigating malnutrition, particularly in the first 1,000 days from conception to a child’s second birthday. Malnutrition during this period can lead to irreversible developmental setbacks. For instance, stunting, often rooted in maternal malnutrition during pregnancy and inadequate infant feeding, affects 51 million children under two, with half becoming stunted before six months. Exclusive breastfeeding can prevent this by ensuring optimal nutrition and reducing exposure to contaminated water or inappropriate foods.

However, challenges to breastfeeding exacerbate malnutrition risks. Inappropriate marketing of breast-milk substitutes undermines breastfeeding rates, particularly in low-income settings where formula use increases the risk of diarrhea and pneumonia. WHO’s International Code of Marketing of Breast-milk Substitutes and subsequent World Health Assembly resolutions  aims to curb such practices, but enforcement remains inconsistent. As of 2024, of the 146 countries with legal measures in place, only 33 countries have measures in place aligned to the Code. Additionally, maternal malnutrition-especially in conflict zones like Yemen, Syria and South Sudan contributes to intergenerational cycles of undernutrition.

A 2022 study in Brazil highlighted a complex relationship between breastfeeding duration and malnutrition leading to development outcomes in children. Study from South Asia reaffirm that maternal malnutrition significantly impairs breastfeeding outcomes and calls for coordinated approach across maternal nutrition, health and social protection. A review shows how nutrition education significantly enhances mother’s knowledge leading to improved nutritional status in children.

Barriers and opportunities

Several barriers hinder breastfeeding and malnutrition reduction efforts. Inadequate lactation support in healthcare facilities, limited maternity leave, and lack of workplace breastfeeding policies discourage sustained breastfeeding. Conflict, climate change, and economic instability further exacerbate food insecurity, limiting maternal access to nutritious diets. Like the war in Ukraine left more than 7 million food insecure, in need of food and livelihood support. Globally, the conflict has disrupted Ukraine’s agricultural exports, causing a sharp surge in food prices, straining food production and supply chain disruptions. 

Opportunities for progress lie in evidence-based interventions. The Global Breastfeeding Collective advocates for seven key actions: increased funding to imporve breastfeeding rates, full implementation of the International Code of Marketing of Breast-milk Substitutes, paid family leave, baby-friendly hospital initiatives, skilled lactation counseling, community support, and strengthened monitoring systems to track progress of policies and programmes. Successful case studies across nations have proven the impact of above interventions in scaling breastfeeding rates to benefit mothers, children and society.

Conclusion

As 2025 marks a critical milestone for global nutrition targets, breastfeeding remains a powerful tool for combating malnutrition. The near-achievement of the 50% exclusive breastfeeding target reflects progress, but regional disparities and persistent malnutrition highlight the need for intensified efforts. Addressing maternal malnutrition, strengthening health systems, and enforcing policies to protect breastfeeding are essential to breaking the cycle of undernutrition and ensuring a healthier future for children and mothers worldwide. Continued investment in breastfeeding advocacy, coupled with targeted interventions in crisis-affected regions, will be crucial to meeting the 2030 goal of 70% exclusive breastfeeding prevalence and reducing the global burden of malnutrition.

illuminem Voices is a democratic space presenting the thoughts and opinions of leading Sustainability & Energy writers, their opinions do not necessarily represent those of illuminem.

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