Breastfeeding rates

How many mothers breastfeed?

Breastfeeding rates vary greatly from country to country, within the same country, and among different cultures and income groups. Generally, babies in low- or middle-income countries are more likely to breastfeed than babies in high-income countries. In some societies, breastfeeding is widely accepted, while in others, mothers who want to breastfeed may find little support from family or health-care providers, may have to return to work early, and may face persistent marketing from the makers of infant formula.

A) Breastfeeding rates

Breastfeeding rates vary greatly:

  • From country to country.
  • Among different cultural and ethnic groups (Yourkavitch 2018).
  • Among different socio-economic groups (Bentley 2016).

1) Differences between low- and high- income countries

In low- and middle-income countries, 96% of babies have ever received breast milk but this falls to 79% of babies in high-income countries (UNICEF 2018). Ireland has the lowest breastfeeding rate worldwide with only 55% of babies ever receiving breast milk (UNICEF 2018).

2) Differences between countries

Worldwide, only about 43% of children younger than six months are breastfed exclusively, and this rate varies greatly by country (CDC 2018; Lancet 2016; Theurich 2019; WHO 2017):

  • U.K.:0.5%
  • Germany: 23%
  • USA: 25%
  • New Zealand: 44%
  • Brazil: 56%
  • India: 92%
  • Senegal: 99%

3) Differences within countries

Differences also exist within the same country between individuals and groups with different cultures and income levels.

Wealthy people in high-income countries have higher breastfeeding rates than lower-income people and families, who would have the most to gain from the benefits of breastfeeding, are least likely to do so (Neves 2020; Orr 2018; Venu 2017). This is called the breastfeeding paradox.

This contrasts with low- and middle-income countries, where mothers who do not breastfeed mostly come from wealthier households (UNICEF 2018). Those mothers who breastfeed may do so because they have no other milk or food for their babies (Wong 2019).

B) Decreasing rates of breastfeeding over time

Worldwide breastfeeding rates have mostly decreased over time (Thorvaldson 2008; WHO/UNICEF 2017; Wolf 2003). More recently, exclusive breastfeeding has increased globally from 34.0% in 1990 to 43% in 2019 (Gardner 2020).

In some societies, breastfeeding remains a regular and accepted practice. In others, breastfeeding is not valued and mothers face many challenges, including (Fang 2019; Stevens 2009):

Given the relatively low rate of breastfeeding in many societies, it can be difficult for mothers to find support among friends and family. It is important to identify the people who will support you on your journey and to remember that breastfeeding is normal and will benefit you, your child, and your family.

References

Bentley JP, Bond D, de Vroome M, et al. Factors Associated with Recurrent Infant Feeding Practices in Subsequent Births. J Hum Lact. 2016 Nov;32(4):721-729
 
Fang Z, Liu Y, Wang H, et al. The Patterns and Social Determinants of Breastfeeding in 12 Selected Regions in China: A Population-Based Cross-Sectional Study. J Hum Lact. 2019 Sep 12:890334419868156

Centers for Disease Control and Prevention (CDC). Breastfeeding Report Card. Atlanta: Centers for Disease Control and Prevention; 2018 [cited 2018 Sep 15] 

Gardner W, Kassebaum N. Global, Regional, and National Prevalence and Trends in Infant Breastfeeding Status in 204 Countries and Territories 1990–2019. Current Developments in Nutrition 2020: 4(2); 992

Lancet (Editorial). Breastfeeding: achieving the new normal. Lancet 2016 Jan 30;387(10017):404
 
Neves PAR, Gatica-Domínguez G, Rollins NC, et al. Infant Formula Consumption Is Positively Correlated with Wealth, Within and Between Countries: A Multi-Country Study. J Nutr. 2020 Apr 1;150(4):910-917

Orr SK, Dachner N, Frank L, et al. Relation between household food insecurity and breastfeeding in Canada. CMAJ. 2018 Mar 19;190(11):E312-E319.
 
Stevens S, Patrick TE, Pickler R. A history of infant feeding. J Perinat Educ. 2009. 18(2): 32–39

Theurich MA, Davanzo R, Busck-Rasmussen M, et al. Breastfeeding Rates and Programs in Europe: A Survey of 11 National Breastfeeding Committees and Representatives. J Pediatr Gastroenterol Nutr. 2019;68(3):400‐407

Thorvaldson G. Was there a European breastfeeding pattern? The History of the Family 2008;13(3): 283

United Nations Children’s Fund (UNICEF). BREASTFEEDING; A Mother’s Gift, for Every Child. New York: UNICEF; 2018 [cited October 2019]
 
Venu I, van den Heuvel M, Wong JP, et al. The breastfeeding paradox: Relevance for household food insecurity. Paediatr Child Health. 2017 Jul;22(4):180-183

Wolf J. Low Breastfeeding Rates and Public Health in the United States. Am J Public Health. 2003 December; 93(12): 2000–2010
 
Wong PD, Thadani SH, Brown LL, et al. Consider the full spectrum of household food insecurity. CMAJ. 2019 Jan 7;191(1):E20
 
World Health Organization, United Nations Children’s Fund (WHO/UNICEF) Global Breastfeeding Collective. Global breastfeeding scorecard; tracking breastfeeding policies and programmes. Geneva: World Health Organization; 2017
 
Yourkavitch J, Kane JB, Miles G. Neighborhood Disadvantage and Neighborhood Affluence: Associations with Breastfeeding Practices in Urban Areas. Matern Child Health J. 2018 Jan 2