Dr Zahid Anwar
BREASTFEEDING is a cornerstone of public health, delivering benefits for both maternal and child well-being while advancing national development goals.
It fosters infant immunity, cognitive growth, and maternal-child bonding. Yet, despite its recognized value, breastfeeding, particularly in public, faces social resistance. This reflects the gap between medical evidence and cultural perceptions, especially in Pakistan, where weak infrastructure and policies hinder normalization and support.
Biologically, breastfeeding uniquely nourishes and protects infants in their most vulnerable stage. Human milk adapts to changing infant needs and contains antibodies, enzymes, hormones, and bioactive components that prevent infections and diseases, lowering child mortality. According to UNICEF and WHO, optimal breastfeeding could save over 800,000 children under five each year by preventing diarrhea, pneumonia, and neonatal infections.
Breastfeeding also promotes long-term cognitive development. Children who are breastfed for longer periods tend to have higher IQs, better academic results, and a higher income potential. Mothers benefit too; exclusive and sustained breastfeeding reduces risks of breast and ovarian cancers, type 2 diabetes, and postpartum depression, while aiding natural child spacing in low-resource settings.
Economically, breastfeeding reduces family costs compared to formula feeding, which can be a burden on households.
Nationally, it lowers healthcare spending by reducing disease and hospital admissions. A 2016 Lancet series estimated global losses from inadequate breastfeeding at $300 billion annually, due to reduced productivity and higher medical costs. In Pakistan, although 90% of children are breastfed, only 48% are exclusively breastfed during the WHO-recommended first six months. Barriers include weak maternity leave enforcement, lack of workplace support, misinformation, aggressive formula marketing, and poor healthcare training.
Workplace challenges are critical. Many women return to work within weeks without facilities for nursing or expressing milk, forcing early discontinuation. While labour laws mandate leave, enforcement is weak, especially in the informal sector. Supporting breastfeeding at work improves employee retention, reduces absenteeism, and ensures healthier children.
Healthcare systems also fall short. Few hospitals meet the WHO’s ‘Baby-Friendly Hospital’ standards, and many professionals lack updated training, sometimes promoting formula. Equipping frontline workers with accurate knowledge is vital, especially for first-time mothers. Mass media and digital campaigns influence public perception, but Pakistan’s breastfeeding messages are sporadic. A national strategy integrating breastfeeding into broader health campaigns, using local languages and community leaders, could expand reach. Regulation of breastmilk substitute marketing is also essential.
Policy links breastfeeding with SDGs Zero Hunger, Good Health, Gender Equality, and Economic Growth. Pakistan’s IYCF Strategy offers a roadmap, but effective implementation needs multisectoral coordination and financing. Research is also crucial. Localized data across regions, socio-economic groups, and rural-urban divides can guide targeted interventions. Monitoring and evaluation should identify gaps and inform policy.
Academic institutions must generate and share evidence. In conclusion, breastfeeding underpins child survival, maternal health, economic savings, and social equity. Its promotion requires medical, structural, and political commitment.
For Pakistan, where malnutrition, gender inequality, and instability persist, reaffirming breastfeeding’s value is both urgent and essential.
—The writer is consultant
paediatrician & neonatologist at Fatima Memorial Hospital, Lahore
