The World Health Organization breastfeeding recommendations are created based on the global population. Their recommendations are evidenced-based with a focus on overall public health. You will see variations between countries’ recommendations and the World Health Organization (WHO) because specific demographics and socio-economic differences.

However, the World Health Organization breastfeeding recommendations remain the standard. This is because they provide accurate information for the global population. As a Certified Breastfeeding Counselor (CBC), it is important to remain up to date with current recommendations.

Current World Health Organization Breastfeeding Recommendations

As of December 2023, WHO has several ‘best practice’ guidelines to help improve breastfeeding initiation and duration rates. Best practice means guidelines which will help the most people reach their breastfeeding goals.

Best practice does not mean the only way to breastfeed. Neither does best practice account for specific circumstances, such as mother baby separation for health. Nonetheless, these guidelines are important and work best for most of the population.

• Current World Health Organization breastfeeding recommendations are:
• early initiation of breastfeeding within 1 hour of birth;
• exclusive breastfeeding for the first 6 months of life; and
• introduction of nutritionally-adequate and safe complementary (solid) foods at 6 months together with continued breastfeeding up to 2 years of age or beyond.

These guidelines were also developed with UNICEF. The WHO and UNICEF breastfeeding recommendations are evidenced based to help the most babies have access to breastmilk.

Why Do Breastfeeding Guidelines Matter?

For those of us who are CBCs and doulas, a big component of our training is providing non-judgmental support to our clients. Knowing how difficult breastfeeding can be, especially within hospital policies and lack of parental leave in the US, many of us walk a fine line of not wanting clients to feel pressured.

However, breastfeeding remains one of the best things to help the most infants in both the short and the long term. The WHO wrote:

“Undernutrition is estimated to be associated with 2.7 million child deaths annually or 45% of all child deaths. Infant and young child feeding is a key area to improve child survival and promote healthy growth and development.”

It is important to note that the WHO and UNICEF guidelines are actually meant to influence policies and practice within systems. They are not meant purely to tell parents how to feed their baby.

As a CBC, you know that many of the barriers to meeting personal breastfeeding goals can be outside the control of parents. Out of date hospital policies, predatory formula advertisements, short parental leave, etc., can all influence breastfeeding duration.

These guidelines can be used in advocating for evidence-based practices within a hospital. They can also be used to educate parents, so they know what questions to ask and how to communicate with their child’s doctor if recommendations differ from WHO ones.

These guidelines matter because access to breastmilk can reduce infant mortality and morbidity. Breastfeeding is also associated with improved short- and long-term health in some areas for the person lactating, including a reduced risk of breast cancer.

Yet, we do not see optimal breastfeeding rates among the global population. The WHO wrote:

“However, many infants and children do not receive optimal feeding. For example, only about 44% of infants aged 0–6 months worldwide were exclusively breastfed over the period of 2015-2020.”

Are WHO Breastfeeding Recommendations Applicable in The US?

As WHO and UNICEF are global organizations, making recommendations for the global population, are their suggestions applicable in the US?

In short, absolutely. While many in the US do have access to clean water, formula, and healthcare, not everyone does. In fact, in 2022, 17.3% of US households with children faced food insecurity.

According to the Department of Health and Human Services, “A study published last year in the journal Pediatrics estimated that if 90% of U.S. families followed guidelines to breastfeed exclusively for six months, the U.S. would annually save $13 billion from reduced medical and other costs.”

While for individual families cost may not be a concern, that large number shows the reduced overall healthcare costs. That means that infants who are breastfed may require less healthcare related to illness and other issues.

There have also been incidents of lack of access to clean water, such as Flint, Michigan. Natural disasters also occur within the US which can create temporary access issues.

For parents able to breastfeed, following the WHO guidelines can reduce costs, likelihood of severe illness, and reduce concerns about access to water and formula.

What Do These Guidelines Mean For Professionals?

As a Certified Breastfeeding Counselor, these guidelines reiterate the importance of your role. If you are a nurse, PA, midwife, etc., as well, these guidelines can be used to help you implement appropriate policies within your health system.

Not already a CBC but want to help more people follow the WHO breastfeeding guidelines? Register today and get started with your training!