Why breastfeeding is critical for babies

Breastmilk provides all the nutrition that a newborn needs. UNICEF explains why breastfeeding, not formula,
provides the best start to life.

UNICEF/UNI554914/Herwig

Reading time: 8 minutes

What is exclusive breastfeeding?

The practice of feeding an infant only breast milk for the first six months of life, without any additional food or
drink, not even water.

Why is exclusive breastfeeding important?

Breastmilk is the perfect food for babies, providing complete nutrition while being naturally safe, clean, and
ready to feed without any preparation, even in areas with poor water quality or sanitation. Starting
breastfeeding right after birth through skin-to-skin contact helps babies stay warm, builds their immune
system, strengthens the bond between mother and baby, and helps mothers produce more milk for longer
periods.

More than just nutrition, breastmilk acts as powerful medicine that's specially designed for each baby's needs,
with the first milk (colostrum) packed with antibodies that protect against disease and death. Breastfed babies
are naturally protected from dangerous bacteria and contaminated foods that can cause diarrhea and poor
nutrition, making breastfeeding especially important in emergency situations where these risks are higher.
Studies show that breastfed babies get fewer ear infections, experience less diarrhea, and are less likely to
develop pneumonia and other common childhood illnesses. When mothers get sick, their bodies
automatically create antibodies in their breastmilk to fight the infection, which then protects their babies
from the same illness, creating what experts call “the most personalized form of medicine” that adapts
uniquely to each baby’s health needs and environment.

Breastfeeding is also cost-effective and reduces the financial burden on families and health systems while also
having a minimal environmental footprint compared to formula production, which involves industrial
processing, packaging, and transportation.

What are the risks of using formula?

Formula producers and distributors have invested enormous resources, including using aggressive marketing,
to change the perception of infant formula from a specialized food vital for infants who are not breastfed into
an appropriate substitute for any baby. However, formula carries significant risks that breastmilk does not.

Infant formula lacks the living cells, hormones, and antibodies found in breastmilk. Formula, along with other
liquids or foods, can alter the profile of good bacteria in a child’s gut. There is also the risk of contamination
from non-breastmilk feedings, particularly those containing water or honey, which can expose vulnerable
newborns to life-threatening pathogens, for example through improper preparation or the use of unsafe
water.

In contrast, breastmilk is naturally safe and contains a multitude of vitamins, minerals and enzymes to
promote growth, as well as antibodies and good bacteria to shield children from disease. Additionally, when
other foods and liquids are provided, they take up valuable space in the newborn’s small stomach, leaving
little room for the more complete nutrition that breastmilk provides.

What if a woman is unable to breastfeed or feels she is not producing enough milk?

When a woman is unable to breastfeed or is concerned about insufficient milk production, there are several
important considerations and support strategies to consider:

Understanding early milk production: Many mothers worry about milk supply in the first few days after birth.
Colostrum, the first milk, is extremely beneficial for newborn babies, and what may seem like a small amount
is perfectly adequate for a newborn’s needs. Newborn babies have small stomachs and have stored up
adequate nutrients that completely meet their limited needs at this very early stage of life. No water, juice, or
formula milk is needed.

Supporting successful breastfeeding: The key to establishing breastfeeding is early and frequent contact:

● Early contact, early suckling and early initiation of the flow of breast milk can be aided by the support
of health care professionals, midwives, or community workers.
● Infants should be put to the mother’s breast shortly after birth to keep skin-to-skin contact as this is
when they have the strongest instinct to suckle the mother’s nipples.

Avoiding common pitfalls: Introducing a milk bottle or baby formula early can adversely impact the child's
natural sucking reflex and is one of reasons that infants can fail to breastfeed properly. Additionally, anything
other than colostrum (mother’s first milk) can have a negative impact on the baby’s health. A lack of
colostrum may cause diarrhea in the baby and the mother’s lactation can be interrupted because the baby
loses its instinct to breastfeed.

When women are unable to breastfeed their infants: Under exceptional circumstances, a mother’s milk may
be considered unsuitable for her infant. In situations where infants cannot, or should not, be breastfed, the
choice of the best alternative will depend on individual circumstances and can include: expressed breast milk
from an infant’s own mother, breast milk from a healthy wet-nurse or a human-milk bank, or a breast-milk
substitute fed with a cup, which is a safer method than a feeding bottle and teat.

The most important step is connecting mothers with skilled lactation counselors and healthcare providers
who can assess the situation properly and provide the right support to establish successful breastfeeding
whenever possible.

Should mothers feel guilty or shamed if they are unable to breastfeed?

Absolutely not. Mothers should never be shamed or feel guilty if they are unable to breastfeed, whether by
choice or necessity. All mothers deserve respect and support for their feeding decisions.
While we advocate for breastfeeding due to its health benefits, we recognize that every family's situation is
unique. What matters most is that babies receive safe, nutritious feeding and that mothers have access to
accurate information and skilled support. All mothers have the right to evidence-based information about
infant feeding options, skilled counseling, and supportive policies – such as workplace accommodations – that
enable them to make the best decisions for their families without judgment or shame.

How does UNICEF support women who cannot breastfeed, whatever the reason?

All women should be supported and counselled during pregnancy – and once their baby is born – on
recommended infant feeding practices so they can make the best decision for them and their baby. We know
from our studies that most women start out wishing to breastfeed their babies, but they can experience
challenges including lack of access to skilled counselling or needing to return to work in contexts that may not
have family-friendly policies in place. For these mothers, we provide support through:

● Skilled counseling to ensure infants receive appropriate nutrition through alternative feeding methods
● Training for healthcare workers to provide non-judgmental, comprehensive feeding support to all
mothers
● Ensuring that mothers who cannot breastfeed receive the same quality of care and support as those
who can
● Advocating for family-friendly policies in the workplace, such as dedicated spaces to express
breastmilk or the ability to take nursing breaks.
● Advocacy for access to clean water and sanitation facilities essential for safe formula feeding

Every mother deserves compassionate, evidence-based support regardless of how she feeds her baby.

What is the International Code of Marketing of Breast-milk Substitutes (BMS Code) and how does it protect
breastfeeding?

The International Code of Marketing of Breastmilk Substitutes is a set of regulations adopted by the World
Health Assembly (WHA) in May 1981, along with subsequent relevant WHA resolutions, to contribute to the
provision of safe and adequate nutrition for infants, by the protection and promotion of breast-feeding, and
by ensuring the proper use of breast-milk substitutes, when these are necessary, on the basis of adequate
information and through appropriate marketing and distribution.

The Code covers infant formula, bottles, teats, follow-up formulas and growing-up milks marketed for feeding
infants and young children up to the age of 3 years. By integrating the Code’s provisions into national
legislation, governments can help protect mothers and health-care workers from commercial pressures that
seek to undermine breastfeeding. The Code is necessary because the breastmilk substitutes industry uses
aggressive marketing tactics to target pregnant women, new mothers and health workers, often making false
claims that formula is equal or superior to breastfeeding, can improve digestive problems, or will ensure that
babies sleep through the night – all of which erode women's confidence in breastfeeding.

What is the Baby-Friendly Hospital Initiative?

The Baby-Friendly Hospital Initiative (BFHI) is a global programme launched in 1991 by the World Health
Organization (WHO) and UNICEF to help motivate facilities providing maternity and newborn services
worldwide to better support breastfeeding. The initiative is based on the “Ten Steps to Successful
Breastfeeding” and focuses on providing optimal clinical care for new mothers and their infants during the
critical first hours and days after birth when establishing lactation and providing mothers with the support
they need to breastfeed successfully is most important.

The Ten Steps are divided into critical management procedures (ensuring written infant feeding policies,
ensuring staff competency, complying with the International Code of Marketing of Breast-milk Substitutes,
and establishing monitoring systems) and key clinical practices (providing antenatal breastfeeding
information, facilitating immediate skin-to-skin contact and early breastfeeding initiation, supporting mothers
with breastfeeding techniques, avoiding unnecessary supplementation, enabling rooming-in 24 hours a day,
supporting responsive feeding, counseling on bottles and pacifiers, and coordinating discharge with ongoing
community support).

What if a woman is malnourished or unable to eat enough while breastfeeding?

Remarkably, even when mothers are malnourished, they can still produce nutritionally adequate breastmilk
for their babies. Breastfeeding typically remains the safest option for babies, especially in settings with limited
access to clean water or risk of contamination and infection. For this reason, the priority should be supporting
both the mother’s nutritional recovery and continued breastfeeding, rather than switching to alternatives that
may pose greater risks to the infant’s health and survival.

What is UNICEF’s recommendation for breastfeeding in emergencies?

UNICEF’s recommendations for breastfeeding in emergencies build upon standard infant feeding guidelines:
Babies should be put to the breast within 1 hour of birth, followed by exclusive breastfeeding for the first six
months with no other food or liquid, not even water. Breastfeeding should continue for two years or more,
with safe, age-appropriate complementary foods introduced at six months.

During emergencies, these practices become critical and must be actively protected, promoted and
supported. Breastfeeding saves lives in emergencies and provides immunity that artificial feeding cannot
match. The younger the infant, the more vulnerable they are during emergencies. Children under 2 are most
vulnerable during emergencies, making proper feeding practices essential for survival.

If a woman in a humanitarian setting is unable to breastfeed, UNICEF follows its standard recommendation (as
detailed above), depending on individual circumstances. When formula – the last infant feeding resort – is the
only option, it should be procured by UNICEF, as we strongly oppose donations of infant formula due to its
unverifiable quality and safety. In all cases, UNICEF advocates for supporting mothers with adequate food,
safe drinking water, and skilled breastfeeding support.