WORLD Breastfeeding Week is observed globally from 1 to 7 August each year, and Pakistan too joins in echoing the message that breastfeeding saves lives.
Health experts, nutritionists, government departments and NGOs highlight the irreplaceable benefits of mother’s milk: it boosts immunity, prevents malnutrition and enhances the cognitive development of infants. Yet, beyond these campaigns lies a deeper, more troubling reality—one that remains largely unaddressed. In the narrow lanes of urban slums and the neglected corners of rural Pakistan, poor mothers often find themselves unable to breastfeed their newborns. Not by choice, but by circumstance. This failure isn’t natural—it is systemic. It is shaped by poverty, influenced by market forces and made worse by a lack of regulatory enforcement.
Across Pakistan, particularly in underprivileged communities, it’s not uncommon to see newborns being fed powdered milk from plastic bottles within hours of birth. At first glance, it might seem like convenience or modern practice. But in reality, many of these mothers either fail to produce breastmilk or are misled into believing formula is better. The question is—why? One key factor is maternal undernutrition. Chronic poverty forces women into cycles of physical exhaustion and inadequate diets throughout pregnancy. A mother who cannot access enough iron, protein, calcium and essential vitamins is likely to face health complications, including difficulties in lactation. In fact, studies have shown that food insecurity during pregnancy directly impacts milk production after childbirth. For many of these women, skipping meals is more common than prenatal supplements.
Then there’s the role of institutional failure. In numerous low-cost hospitals and maternity homes, especially those catering to the urban poor, there is little to no emphasis on breastfeeding education. In some cases, mothers are immediately handed tin-packed formula—either by hospital staff, nurses, or medical representatives—under the pretext that the mother is too weak to nurse. There are disturbing accounts of healthcare providers encouraging formula without assessing the mother’s actual capacity to produce milk. This isn’t mere negligence; some believe it reflects a planned preference driven by pharmaceutical marketing.
The formula milk industry in Pakistan is vast and largely unregulated. Despite the existence of the Pakistan Infant Feeding Board and the adoption of the International Code of Marketing of Breastmilk Substitutes, enforcement remains weak. There are reports of formula milk being actively promoted in private clinics, maternity wards and even pharmacies—with little to no consequence. Promotional materials are often handed out, sometimes even free samples and sales agents indirectly incentivize healthcare workers to push certain brands.
The most vulnerable suffer the most. For low-income families, once they switch to formula, they’re forced into a costly cycle. A tin of powdered milk costs far more than what many can afford, especially when clean water, sterilization and feeding bottles are added to the mix. Often, the milk is diluted to make it last longer, increasing the risk of malnutrition and infection in infants. The tragic irony is that breastfeeding—a free, life-saving and naturally available option—is sidelined in favour of a commercial product that can be dangerous when misused.
So, what can be done?
Firstly, the Government of Pakistan must strictly regulate and monitor the marketing of breastmilk substitutes. Hospitals and clinics must be held accountable if they are found recommending formula without medical necessity. The Health Services Academy, provincial health departments and regulatory bodies like DRAP (Drug Regulatory Authority of Pakistan) must jointly ensure that no institution promotes or distributes infant formula in violation of international and national guidelines.
Secondly, the government must invest in mass awareness and behavior change campaigns in marginalized communities. Midwives, lady health workers and birth attendants must be trained to counsel mothers on the benefits of breastfeeding and provide support, especially in the critical first 48 hours after birth. Thirdly, there is a dire need to address maternal poverty and malnutrition. Programs like Ehsaas Nashonuma that target stunting and child growth must also integrate breastfeeding support and maternal nutrition into their core strategy. A healthy mother is the foundation of a healthy child.
Lastly, community support systems—such as peer mother groups and trained lactation consultants—must be introduced in public health settings to ensure that mothers are not isolated or misled during the critical early weeks. Breastfeeding should not be a privilege of the wealthy or informed. It is a basic human right—for the child and the mother. As Pakistan continues to battle high infant mortality and malnutrition rates, safeguarding breastfeeding practices is not just a maternal health issue—it is a national priority. If Pakistan truly wants to celebrate World Breastfeeding Week with meaning, it must look beyond slogans and posters. It must begin by asking: why are so many mothers unable to breastfeed—and who benefits from that silence?
—The writer is a human rights activist, based in Karachi.
