'World needs to invest US $15.5 billion a year on breastfeeding'

World Bank estimate for investment on breastfeeding is less than 20 per cent of what is required, according to international non-profit, IBFAN

 
By Jyotsna Singh
Last Updated: Saturday 04 July 2015

Counselling on infant feeding has improved health of children under 2 in Lalitpur district of Uttar Pradesh in India (photo by Sayantoni  Palchoudhuri

A global investment of US $15.5 billion each year will be needed to ensure optimal breastfeeding for all children in the world. The cost will cover measures suggested jointly by UNICEF and WHO to improve breastfeeding practices. Improper breastfeeding causes nearly 800,000 deaths annually of children under five years. Apart from this, it is responsible for impaired development, as well as risk of diabetes, hypertension, cancer and cardiac diseases in adult life.

The calculations were released on Tuesday by International Baby Food Action Network (IBFAN), an international NGO for the World Breastfeeding Costing Initiative (WBCi). The report—The Need to Invest in Babies—challenges the current estimate of US $2.9 billion given by  World Bank in 2010. The World Bank report estimated only for promotion or awareness for breastfeeding. The IBFAN report, on the other hand, has estimated costs for protection, promotion and support of breastfeeding, as outlined in WHO's Global Strategy for Infant and Young Child Feeding.

Arun Gupta, co-author and regional coordinator of IBFAN-Asia, says, “The costs involve many dimensions like policy development, coordination and media outreach. Unless you invest in all the interventions required it would be foolish to expect that breastfeeding rates will rise."

The report has calculated the amount that will be needed to fund measures and interventions in 214 countries as suggested in WHO's global strategy. The report says the world needs to invest US $15.45 billion every year. In addition, a sum of US $2.05 billion will have to be invested one time to develop policies and legislation, and provide training to health workers and community workers.

The recurring cost includes coordination, refresher trainings, monitoring of WHO's International Code of Marketing of Breastmilk Substitutes, and implementation of UNICEF's Baby Friendly Hospital Initiative (BFHI). It will also include updating policies and legislation, and data management. The estimate also incorporates maternity benefits at US $2.00 per day for 180 days for women living below the poverty line to enable them to exclusively breastfeed their babies. The amount is being given in lieu of the wage that women stand to lose by not going to work in the first few weeks after delivery.

According to UNICEF, out of the 135 million babies born every year globally, almost 83 million are not optimally breastfed. The data further shows that only 42 per cent (56.7 million) babies get breastfed in the first hour of life, 39 per cent (52.6 million) are exclusively breastfed during the first six months of life, and only 58 per cent (73.5 million) continue to be breastfed till the age of two.

Cause for concern
 
  • 800,000 children under 5 die annually because of improper breastfeeding
  • 83 million of the 135 million babies born each year are not optimally breastfed
  • Only 56.7 million babies (42%) are breastfed in the first hour after birth
  • Only 52.5 million (39%) babies are exclusively breastfed during the first six months of life
  • Only 73.5 million (58%) continue to be breastfed till the age of two


What India needs to spend

According to the report, the projected cost for India is a total of Rs 10,600 crores annually. It includes Rs 8,500 crore for provision of maternity entitlements to women below poverty line. The rest Rs 2,100 crore is needed for implementing other recommendations of WHO's Global Strategy and UNICEF's BFHI.

Interventions needed to keep kids healthy
 
The interventions suggested by the WHO and UNICEF and selected by the report for estimating the financial resources are:

  • Development of policies and plans, coordination
  • Health and nutrition care system: This has two components - BFHI and training of health workers
  • Community services and mother support
  • Media promotion
  • Maternity protection
  • Implementing the International Code of Marketing of Breastmilk Substitutes
  • Monitoring and research

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