Infant and young child feeding

In 2021, maternal and child malnutrition was estimated to be associated with 2.4 million child deaths annually or more than 50% of all child deaths (1). Early, exclusive and continued breastfeeding can prevent pneumonia and diarrhoea, which are amongst the leading causes of child death. Infant and young child feeding is a key area to improve child survival and promote healthy growth and development. The first two years of a child’s life are particularly important, as optimal nutrition during this period lowers morbidity and mortality, reduces the risk of chronic disease, and fosters better development overall.

However, many infants and children do not receive optimal feeding. For example, only about 47% of infants aged 0–6 months worldwide were exclusively breastfed over the period of 2018–2025 (2).

Infants born to mothers receiving lifelong antiretroviral therapy (ART) can safely initiate breastfeeding in the first hour after birth, breastfeed exclusively for six months and continue breastfeeding until at least 12 months of age with very little risk of acquiring HIV (8). Mothers living with HIV should breastfeed for at least 12 months and may continue breastfeeding for up to 24 months or longer (similar to the general population) while being fully supported for ART adherence. In settings where national health authorities recommend breastfeeding for HIV-infected mothers, visit the e-library of evidence for nutrition actions (eLENA) for guidelines and interventions to optimize adherence.

Early, exclusive and continued breastfeeding protect infants and children from infectious diseases. Infants who are mixed fed (partially breastfed) or not breastfed are much more likely to die from diarrhoea, pneumonia and other infectious diseases. While the effect is greater in low- and middle- income countries, infants in high-income countries who are not breastfed are also more likely to die in childhood (9).

Breast milk is also an important source of energy and nutrients for children aged 6–23 months. It can provide half or more of a child’s energy needs between the ages of 6 and 12 months, and one third of energy needs between 12 and 24 months. Breast milk is also a critical source of energy and nutrients during illness, and it reduces mortality among children who are malnourished.

Children and adolescents who were breastfed as babies are less likely to be overweight or obese. Additionally, they perform better on intelligence tests and have higher school attendance. Breastfeeding is associated with higher income in adult life.

Failure to invest in breastfeeding comes at a high cost. The cost of underfunding breastfeeding programmes is estimated to result in global economic losses of US$ 339 billion each year, equivalent to 0.32% of global gross national income. Scaling up evidence-based health system support for breastfeeding, including facility- and community-based IYCF counselling and implementation of the Ten Steps to Successful Breastfeeding would generate returns of $59 for every $1 invested, with impacts driven largely by improvements in cognitive development, education outcomes and lifetime productivity (3).

Longer durations of breastfeeding also contribute to the health and well-being of mothers. It reduces the risk of ovarian and breast cancer, increases the duration between pregnancies (breastfeeding an infant under six months exclusively causes hormonal changes that can delay the return of fertility) and reduces all-cause mortality.

Mothers and families need to be supported to breastfeed. Actions that help protect, promote and support breastfeeding include:

Breastfeeding practices are highly responsive to supportive interventions, and the prevalence of exclusive and continued breastfeeding can be improved over the course of a few years.

Around the age of 6 months, an infant’s need for energy and nutrients starts to exceed what is provided by breast milk, and additional (complementary) foods are necessary to meet those needs. If complementary foods are not introduced around the age of 6 months, or if they are given before this age, growth may falter. Guiding principles for appropriate complementary feeding are:

Feeding in exceptionally difficult circumstances

Families and children in difficult circumstances require special attention and practical support. Wherever possible, mothers and babies should remain together and get the support they need to exercise the most appropriate feeding option available. Breastfeeding remains the preferred mode of infant feeding in almost all difficult situations, for instance:

WHO is committed to supporting countries with implementation and monitoring of the Comprehensive implementation plan on maternal, infant and young child nutrition, endorsed by Member States 2012 and reaffirmed in 2025. The plan includes 6 targets, one of which is to increase the rate of exclusive breastfeeding for the first 6 months of life to at least 60% by 2030. Activities that will help to achieve this include the multisectoral actions outlined in the Topical briefs on maternal, infant, young child nutrition.

WHO provides guidance and technical assistance to countries on the implementation of the International Code of Marketing of Breast-milk Substitutes, the Baby-Friendly Hospital Initiative, breastfeeding counselling and support services, and breastfeeding monitoring.

UNICEF and WHO created the Global Breastfeeding Collective to rally political, legal, financial and public support for breastfeeding. The Collective brings together implementers and donors from governments, philanthropies, international organizations, and civil society. The Collective’s vision is a world in which all mothers have the technical, financial, emotional, and public support they need to breastfeed.

UNICEF and WHO created the Global Complementary Feeding Collective to accelerate efforts and systems-level change to improve complementary feeding. The Collective brings together global agencies dedicated to improving nutrition for children aged 6 to 23 months through improved programmes, policies and advocacy.

In addition, WHO and UNICEFInfant and young child feeding counselling: an integrated course: trainer’s guide, 2nd ed have developed courses for training health workers to provide skilled support to breastfeeding mothers, counsel on complementary feeding, help them overcome problems, and monitor the growth of children, so they can identify early the risk of undernutrition or overweight/obesity.