Availability of national-level provision for breastfeeding counselling services in public health and/or nutrition programmes 

What does this indicator tell us?

Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process with important implications for the health of mothers. Optimal practices include early initiation of breastfeeding within 1 hour and exclusive breastfeeding for 6 months, followed by appropriate complementary with continued breastfeeding for 2 years or beyond. Although it is a natural act, breastfeeding is also a learnt behaviour. Almost all mothers can breastfeed provided they have accurate information, and have support within their families and communities, and from the health care system. Mothers should also have access to skilled practical help from, for example, trained health workers, lay and peer counsellors, and certified lactation consultants. These professionals can help to build a mother's confidence, improve feeding technique, and prevent or resolve breastfeeding problems.

This indicator has been established as an interim indicator, while the WHO-UNICEF Technical Expert Advisory group for nutrition Monitoring (TEAM) is further developing and validating the indicator "proportion of mothers receiving breastfeeding counselling, support or messages" - a process indicator in the core set of indicators for the Global Nutrition Monitoring Framework.

How is it defined?

This indicator is defined as availability of a national programme that includes provision for delivering breastfeeding counselling services to mothers of infants aged 0-23 months, through health systems or other community-based platforms.

What are the consequences and implications?

Counselling and informational support on optimal breastfeeding practices for mothers improves initiation and duration of breastfeeding, which has many health benefits for both the mother and infant. Breast milk contains all the nutrients an infant needs in the first 6 months of life. Also, breastfeeding protects against diarrhoea and common childhood illnesses such as pneumonia, and it may have longer term health benefits for the mother and child, such as reducing the risk of overweight and obesity in childhood and adolescence. Breastfeeding has also been associated with higher IQ in children. Improved breastfeeding practices worldwide could save the lives of more than 800 000 children every year.

Source of data

WHO. Global nutrition policy review. What does it take to scale-up nutrition action? Geneva: World Health Organization; 2013 (www.who.int/nutrition/publications/policies/global_nut_policyreview/en/).

WHO. Global nutrition policy review 2016-2017. Country progress in creating enabling policy environments for promoting healthy diets and nutrition. Geneva: World Health Organization; 2018 (https://www.who.int/nutrition/publications/policies/global_nut_policyreview_2016-2017/en/). 

WHO. Global database on the implementation of nutrition action (GINA) (https://extranet.who.int/nutrition/gina/).

International Baby Food Action Network (IBFAN). World breastfeeding trends initiative. (http://worldbreastfeedingtrends.org).

WHO, UNICEF. Global Nutrition Monitoring Framework: operational guidance for tracking progress in meeting targets for 2025. Geneva: World Health Organization; 2017 (http://www.who.int/nutrition/publications/operational-guidance-GNMF-indicators/en/ ).

Further reading

WHO, UNICEF. Global strategy for infant and young child feeding. Geneva: World Health Organization; 2003 (http://www.who.int/nutrition/publications/infantfeeding/9241562218/en/).

WHO, UNICEF. Global nutrition targets 2025: Breastfeeding policy brief. Geneva: World Health Organization; 2014 (http://who.int/nutrition/publications/globaltargets2025_policybrief_breastfeeding/en/).

Internet resources

WHO. e-Library of Evidence for Nutrition Actions (eLENA)

• Breastfeeding education for increased breastfeeding duration (http://www.who.int/elena/titles/breastfeeding_education/en/).
• Implementation of the Baby-friendly Hospital Initiative (http://www.who.int/elena/titles/implementation_bfhi/en/).