Strengthen what works: Why breastfeeding is the best investment we are still failing to make

At this moment, parents are holding their newborn for the first time. They will not be thinking about global nutrition targets or international summits. They will simply hope to give their child the healthiest possible start in life.

Whether they succeed should not depend on where they live, access to skilled counselling, workplace protection, or freedom from aggressive marketing of breast-milk substitutes. Yet for millions of families, it does.

This year’s World Breastfeeding Week, themed “Strengthen What Works,” is not asking the world to discover a new solution. It is asking us to fully deliver one we already have.

The evidence is clear; the progress is not

Breastfeeding is a baby’s first food, first vaccine and one of the world’s best investments in human capital. It protects against infection, supports brain development, lowers maternal cancer risks, strengthens the bond between mother and child and prevents an estimated 600,000 child deaths a year—no factories, packaging or refrigeration required. It is one of the planet’s most sustainable parts of the food system, simultaneously advancing seven Sustainable Development Goals (SDGs): No poverty (SDG 1), Zero hunger (SDG 2), Good health and well-being (SDG 3), Quality education (SDG 4), Gender equality (SDG 5), Reduced inequalities (SDG 10) and Responsible production and consumption (SDG 12).

To achieve the World Health Assembly’s new target of 60% of children under six months being exclusively breastfed, we need to pick up the pace. Per the Global Breastfeeding Scorecard 2025, over the last 13 years, exclusive breastfeeding moved 10 points (from 37 percent in 2012 to 47 percent in 2025). We are moving forward, but to hit the 2030 milestone, we will need to achieve even more than that (13 points) in less than five years. Progress that still leaves millions of children behind cannot be our finish line.

According to the Global Breastfeeding Collective, despite this progress, there’s been a decline in early initiation in the last five years, which is critical for providing immune protection, reducing infection risk, and setting the stage for exclusive breastfeeding to continue. Only 48 percent of newborns are put to the breast within the first hour, falling short of the 70 percent target. Most countries lack the systems needed to protect breastfeeding during crises; only 17 percent have legislation aligned with the International Code of Marketing of Breast-milk Substitutes, and just 10 percent meet International Labour Organisation maternity-leave standards. We are under-resourcing both the intervention and the data needed to track it, the scorecard finds.

The return on investment we need to achieve

The World Bank’s Investment Framework for Nutrition puts the benefit-cost ratio of breastfeeding investment at 44 to 1. Closing the global gap would cost an estimated US$7.2 billion over ten years, most of it for nutrition counselling. Where political will exists, results follow fast: the scorecard reports 15 countries gained more than five percentage points in exclusive breastfeeding within five years (much faster than the average), and six now exceed 60 percent, meeting the 2030 target early.

Actors keep pledging. The Tokyo Nutrition for Growth (N4G) Summit 2021 mobilised over US$27 billion in nutrition commitments; N4G Paris 2025 Summit added US$30.5 billion more. Of the 1,545 active commitments in the Nutrition Accountability Framework (NAF), 826 commitments—more than half of all active commitments—target breastfeeding. Yet the scorecard finds only 24 of 61 countries have actually made clear commitments that would bring change in this area.

Strengthen what works

True change means enforcing Code legislation, not just adopting it. It means skilled counselling in every health facility, instead of the only 14 percent of countries now reaching that standard. It means paid maternity leave and breastfeeding-friendly workplaces, so mothers need not choose between feeding their child and earning a living. And it means transparent, independent monitoring, so promises made to mothers are honoured, not filed away.

The evidence exists. The solutions are known. The commitments have been made. What remains is the political courage to act on them. Every family deserves support so that their baby can breastfeed. Every child deserves the healthiest possible start in life. That is an investment no one can afford to keep deferring.

The author is Co-Chair of the Global Nutrition Report Stakeholder Group and Chair of the SUN Civil Society Network Steering Group. The views expressed are personal.