Commentary: Why We All Need to Work Together to Prioritize Breastfeeding

As of April 2025, 48% of infants under six months are exclusively breastfed worldwide, approaching the World Health Assembly’s target of 50% by 2025. However, reaching the more ambitious global target of 60% by 2030 will require sustained investment in evidence-based programs and policies, strong political commitment, robust accountability mechanisms, and strengthened health systems to protect, promote, and support breastfeeding practices.

China has undertaken measures to promote breastfeeding nationwide. In 2021, fifteen government ministries issued the National Action Plan for Promoting Breastfeeding (2021–2025). Concurrently, China has implemented concrete national-level actions, including nationwide promotion of infant and young child feeding counseling services, improvements in family-friendly workplace policies, and strengthening of Baby-Friendly Hospital Initiatives.

Achieving breastfeeding targets requires sustained, multisectoral efforts across all levels of society. Key recommendations for action include enacting and enforcing a legally binding Code of Marketing of Breastmilk Substitutes, implementing comprehensive family-friendly workplace policies, strengthening community support networks, integrating breastfeeding counseling and support into routine maternal and child health services, implementing the Ten Steps to Successful Breastfeeding in all maternity facilities, and establishing routine monitoring and evaluation systems. Through these coordinated measures, mothers will receive the comprehensive support they need to breastfeed exclusively, providing their babies with the healthiest possible foundation for life.

Breastfeeding extends far beyond nutrition — it establishes the foundation for lifelong health. Rather than simply providing essential nutrients, breast milk is a living, complex fluid rich in antibodies, enzymes, and hormones that protect infants and young children from infections such as diarrhea and respiratory illnesses while reducing the risk of chronic diseases later in life, including obesity and diabetes. Breastfeeding also fosters emotional security and strengthens the maternal-infant bond. For mothers, breastfeeding provides protection against certain cancers and facilitates postpartum recovery. In China, these benefits are particularly significant for advancing national health objectives. National strategies, including the Healthy China Initiative (2019−2030), National Nutrition Plan (2017−2030), and the China Children Development Plan (2012−2030), have established a target of achieving exclusive breastfeeding for at least 50% of children under six months of age.

The first week of August marks World Breastfeeding Week, providing a valuable opportunity to assess progress in breastfeeding initiatives, evaluate the enabling environment for breastfeeding support, and propose strategic actions to protect, promote, and support breastfeeding practices. World Breastfeeding Week (WBW) was established in 1992 by the World Alliance for Breastfeeding Action, with support from the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF), calling for global commitment to breastfeeding promotion. Each year, WBW mobilizes stakeholders around specific themes, including healthcare integration, women in the workforce, marketing restrictions, and community engagement (1). This year’s theme, “Prioritize Breastfeeding: Create Sustainable Support Systems,” emphasizes the critical need for robust policy and workplace support for breastfeeding — a key demand of the 2025 WBW — while highlighting breastfeeding’s minimal carbon footprint and contribution to climate resilience.

As of April 2025, 48% of infants under six months worldwide are exclusively breastfed, representing an increase from 38% a decade ago and approaching the World Health Assembly’s target of 50% by 2025. However, achieving the more ambitious global target of 60% by 2030 (2) will require sustained investment in evidence-based programs and policies, continued political commitment, strengthened accountability mechanisms, and enhanced health systems to effectively protect, promote, and support breastfeeding.

To track progress and drive evidence-based policy action, the Global Breastfeeding Collective, led by the WHO and UNICEF, launched the Global Breastfeeding Scorecard in 2017. This comprehensive monitoring tool evaluates a country’s performance across critical domains including maternity protection, health system support, implementation of the International Code of Marketing of Breastmilk Substitutes, and community engagement. The Scorecard has emerged as a cornerstone accountability mechanism for countries to benchmark their progress and prioritize strategic interventions (3). The 2024 Global Breastfeeding Scorecard reveals that only 30% of countries have successfully implemented all four of the Collective’s recommended policy actions, highlighting the urgent need for accelerated implementation of maternity protection, Code enforcement, Baby Friendly Hospital Initiative (BFHI) coverage, and community support (4).

A comprehensive Lancet Breastfeeding series from 2023 demonstrated that the marketing of Breastmilk Substitutes profoundly influences societal beliefs, values, and practices surrounding infant feeding, creating an ecosystem that systematically undermines breastfeeding (5). Furthermore, mothers’ decisions to breastfeed are shaped by multiple interconnected factors — biological, cultural, social, and commercial — and must be supported through coordinated actions across households, communities, workplaces, health systems, and national regulatory frameworks.

China has implemented measures to promote breastfeeding nationwide. In 2021, fifteen government ministries jointly issued the National Action Plan for Promoting Breastfeeding (2021–2025), establishing a comprehensive breastfeeding promotion mechanism led by the government, coordinated across departments, and supported by society as a whole to advance breastfeeding practices (6). While more recent estimates are not yet available, UNICEF anticipates that these measures will result in substantial national progress in exclusive breastfeeding rates, which according to the most recent National Nutrition and Health Surveillance of 2017 stood at 34% (7).

China has implemented concrete national-level actions to promote breastfeeding practices. Since 2019, the National Health Commission and UNICEF have jointly implemented the Infant and Young Child Feeding (IYCF) program, training more than 290,000 health workers from townships and villages across 1,212 counties in all thirty-one provincial-level administrative divisions to deliver skilled IYCF counseling as part of routine primary health care (8). Progress in family-friendly workplace policies is also evident, with institutional support for breastfeeding, parental leave, childcare services, and flexible work arrangements (9). Additionally, China’s Baby-Friendly Hospital Initiative has expanded substantially: 7,036 hospitals had achieved “Baby-Friendly” accreditation by 2015, representing the highest number globally (10).

Achieving breastfeeding targets demands sustained, multi-sectoral commitment and coordinated implementation efforts. The following evidence-based recommendations provide a framework for creating sustainable support systems that prioritize breastfeeding (4):

1) Enact and enforce a legally binding Code of Marketing of Breastmilk Substitutes to protect breastfeeding from aggressive marketing practices of breast milk substitutes.

2) Enforce family-friendly workplace policies by ensuring employers fully implement maternity leave and lactation break legislation while providing safe, designated breastfeeding spaces in workplace environments.

3) Strengthen community support networks by providing both emotional and practical assistance throughout mothers’ breastfeeding journeys.

4) Integrate breastfeeding counseling and support into routine maternal and child health services, encompassing antenatal, delivery, and postnatal care. This integration should ensure systematic assessment of breastfeeding practices and provision of individualized counseling tailored to each mother’s needs.

5) Implement the Ten Steps to Successful Breastfeeding across all maternity facilities to establish comprehensive support systems that motivate healthcare providers delivering maternity and newborn services (11).

6) Establish robust monitoring and evaluation systems to systematically assess breastfeeding outcomes and policy implementation effectiveness. These systems should utilize standardized questionnaires and the global breastfeeding scorecard framework to guide evidence-based nationwide interventions.

Through implementing these comprehensive measures, mothers will receive the essential support necessary for successful exclusive breastfeeding, thereby providing their infants with the optimal foundation for lifelong health and development.