Breastfeeding and Beyond: The Overlooked SDG Strategy for Child Health and Nutrition

While pondering the key intention of the Sustainable Development Goals (SDGs),
breastfeeding may not be the first thought that springs to mind. Nonetheless, it has numerous
health benefits, including natural recourse, cost-effectiveness, and, above all, highly impactful
intervention that possesses the power to hit universal targets on hunger, health, and gender
equality. Despite the crucial role of breastfeeding, it customarily remains underrepresented in
sustainable development agendas (Souza et al., 2023) . To shape a sustainable future, it is
essential to recognize breastfeeding as a keystone in accomplishing SDG 2 (zero hunger), SDG 3
(good health and well-being), and SDG 5 (gender equality).

Breastfeeding is known to be a life-saving intervention for both healthy and unhealthy
children. A breastfed baby receives the most nutritious, luxurious, and appropriate food ever
known. A millionaire’s baby fed with commercial baby milk has a poorer diet than the poorest
family’s baby who is breastfed (Gbagbo & Nkrumah, 2022) . The World Health Organization
(WHO) Strategic and Technical Advisory Group of Experts (STAGE) has proclaimed exclusive
breastfeeding for six months, followed by supplementary food along with complete two years.

An infant’s nutritional requirements are biologically fulfilled by breast milk, as it is a
complete package that provides all vital nutrients, antibodies, and hormones helpful for healthy
growth and development. However, according to the WHO, over 820,000 lives could be
prevented yearly among children under 5 years if all children 0–23 months were optimally
breastfed. To achieve SDG2 to overcome hunger and increase nutrition, breastfeeding can be a
major contribution. This can merely reduce the number of malnutrition, obesity, and chronic
diseases.

Besides many advantages to breastfeeding for an infant, there are several health benefits
to mothers as well. According to Modak et al. (2023), maternal attachment hormones are
released during the time of the breastfeeding process, which helps control postpartum depression
and bleeding. Concerning a clinical perspective, breastfeeding probably lowers the rate of
developing type 2 diabetes mellitus, breast and ovarian cancers, osteoporosis, and cardiovascular
conditions.

It also helps mothers recover more quickly after childbirth by promoting uterine
contractions (Masi & Stewart, 2024) . This is one of the natural contraceptive methods for birth
spacing as well, which also facilitates post-delivery weight loss. Furthermore, there are various
benefits to maternal mental health. It can also lower the stress level and enhance emotional well-
being through mother and child bonding. Moreover, breastfeeding is both time- and cost-
efficient, as it eliminates the need for putting an extra effort into purchasing formula milk,
feeding bottles, and necessary sterilization resources. The variety of these advantages shows that
breastfeeding significantly improves maternal health, provides physical and psychological well-
being, and provides economic assistance.

Despite knowing its valuable impact on both mother and child, breastfeeding practices
are suboptimal, especially in low- and middle-income countries (LMICs). UNICEF shares an
eye-opening report that only 44% of infants globally are exclusively breastfed for the first six
months. A couple of factors contribute to these findings. The foremost reason is that at many
public and private workplaces, designated breastfeeding rooms or childcare facilities remain
largely inaccessible (Nguyen et al., 2023). Therefore, working mothers find it difficult to
continue breastfeeding.

Secondly, there are several cultural taboos and misrepresentations. Mothers are
discouraged from breastfeeding and are encouraged to opt for formula feeding (De Souza et al.,
2021) . Many studies highlight that some formula companies frequently mislead mothers with
exaggerated health claims, portraying formula as equivalent or superior to breast milk. Some
formula companies claim that formula feeding offers convenience to the mother.
Lastly, the lack of availability of trained health care workers may also result in missing a
golden opportunity to guide new mothers at their crucial stage (Souza et al., 2023) .

While a new mother transitions to motherhood, availing the provision of that critical window and supporting them may bring healthy outcomes. These challenges are overstated for marginalized populations, including rural women, refugees, and those living in extreme poverty. These factors contribute to health inequalities and hinder progress towards SDG 10 (reduced inequalities).

Various interventions are being implemented to promote breastfeeding as a core in
achieving the SDGs target at the policy and system level. First is the Baby-Friendly Hospital
Initiative (BFHI). This project aims to support early initiation and exclusive breastfeeding (De
Souza et al., 2021) . Moreover, the community-based education programs cater to antenatal and
postnatal mothers. They guide families to teach the value of breastfeeding (Nguyen et al., 2023).

In addition, several steps are taken at the workplace level to ensure support for working
mothers. Such as maternity leaves and nursing rooms to provide an opportunity for mothers to
breastfeed without compromising their work. Lastly, the International Code of Marketing of
Breast Milk Substitutes aims to stop the aggressive and inappropriate marketing of breast milk
substitutes. The Code also aims to contribute “to the provision of safe and adequate nutrition for
infants by the protection and promotion of breastfeeding. These measures require coordinated
efforts to achieve the goal.

Breastfeeding is not just a personal choice; it is a global public health and development
priority. Knowing the fact that it is a low-cost and high-impact intervention towards child
survival, improving maternal health, overcoming poverty, and ensuring gender equality. Yet, it
remains overshadowed in various national and global strategies. If we aim to achieve the SDGs
by 2030, we must consider this basic strategy as a priority. This step is not just feeding an infant;
it can result in a healthier and more sustainable world for all.

References

De Souza, C. B., Venancio, S. I., & da Silva, R. (2021). Breastfeeding Support Rooms and Their
Contribution to Sustainable Development Goals: A Qualitative Study. Front Public
Health, 9, 732061. https://doi.org/10.3389/fpubh.2021.732061

Gbagbo, F. Y., & Nkrumah, J. (2022). Breastfeeding-friendly policies and programs in three
public Universities in Ghana. Int Breastfeed J, 17(1), 29. https://doi.org/10.1186/s13006-
022-00468-7

Masi, A. C., & Stewart, C. J. (2024). Role of breastfeeding in disease prevention. Microb
Biotechnol, 17(7), e14520. https://doi.org/10.1111/1751-7915.14520

Souza, C. B., Melo, D. S., Relvas, G. R. B., Venancio, S. I., & Silva, R. (2023). Promotion,
protection, and support of breastfeeding at work, and achieving sustainable development:
a scoping review. Cien Saude Colet, 28(4), 1059-1072. https://doi.org/10.1590/1413-
81232023284.14242022 (Promoção, proteção e apoio à amamentação no trabalho e o
alcance do desenvolvimento sustentável: uma revisão de escopo.)

Neelam Suleman

Nurse Educator in Nursing Education Services Department, Aga Khan University Hospital, Karachi, Pakistan

Currently pursuing MSc Nursing (in progress), Post RN BScN, Diploma in Midwifery.

Research interest: Maternal and Child health, digital health in antenatal care, nursing education, and public health awareness.

Professional Experience: Over 16 years of clinical and academic experience in Obstetrics and Gynecology, Oncology, Clinical Nurse Instructor, and Clinical Preceptor.

Neelam Suleman

Nurse Educator in Nursing Education Services Department, Aga Khan University Hospital, Karachi, Pakistan

Currently pursuing MSc Nursing (in progress), Post RN BScN, Diploma in Midwifery.

Research interest: Maternal and Child health, digital health in antenatal care, nursing education, and public health awareness.

Professional Experience: Over 16 years of clinical and academic experience in Obstetrics and Gynecology, Oncology, Clinical Nurse Instructor, and Clinical Preceptor.