Joint statement for World Health Day 2019 – Universal Health Coverage

La Leche League International (LLLI) and the World Alliance for Breastfeeding Action (WABA) celebrate World Health Day 2019 by focusing on universal health coverage (UHC) in the context of breastfeeding. UHC is fundamental to “ensuring all people and communities have access to quality health services where and when they need them” (1) including services that support breastfeeding. Linking actors within primary healthcare systems and the community creates a warm chain of support for breastfeeding and lays the foundation for universal health coverage for all. Breastfeeding is a team effort, and we need to empower mothers, fathers, partners, families, workplaces and communities to enable breastfeeding.

National and local healthcare systems providing strong primary healthcare can help families attain their breastfeeding goals. It is critical that everyone involved in the healthcare system has sufficient knowledge and communication skills to be able to assist families in developing this foundation.

Breastfeeding is the foundation of life. Human milk provides the basic building blocks for optimal growth and development of the child. It contains the right amount of nutrients for growth, is easily digested, and is readily available. Colostrum or first milk is concentrated nutrition for the newborn that contains vital antibodies to defend the baby’s immature immune system against many harmful agents. Mature human milk replaces colostrum to continue meeting the growing needs of the child, providing the needed fats, proteins, carbohydrates, and calories to support optimal growth. (2)

Breastfeeding is also associated with a reduced risk of overweight/obesity and may reduce the risk of type 2 diabetes. Not only do babies thrive on human milk, but it also has lifelong benefits. Infant formula does not provide antibodies or immune system protection, and not breastfeeding increases the risk of many illnesses, such as diarrhea, pneumonia, and infections. (5, 6) The health care system plays an important part in helping families meet their breastfeeding goals, and regardless of the length of the breastfeeding journey, any breastfeeding provides benefits for the baby. A strong primary healthcare system that supports breastfeeding from birth provides the optimal health start with lifelong health benefits for the infant. (2, 3, 4, 7)

There are also maternal health benefits of breastfeeding, such as lowering the risk of breast and ovarian cancers, reducing the risk of type 2 diabetes, cardiovascular disease and protecting against autoimmune diseases. (4, 8-11) Breastfeeding may also help to increase the spacing of pregnancies if done in accordance with the WHO and UNICEF recommendations. (9)

WHO and UNICEF, recommend exclusive breastfeeding for six months of the child’s life with the addition of complementary solid foods at six months and continued breastfeeding for two years or longer to promote the best lifelong health outcomes for the child. (12) Yet, many families lack equitable access to healthcare due to policies and systems or healthcare providers who fail to provide adequate support for breastfeeding. (13) Hence, ensuring such access to all families is critical.

WABA’s Warm Chain of Support for Breastfeeding places the breastfeeding dyad at the core of a continuum of care during the first 1000 days of the baby’s life. (14) With consistent messages and proper referral systems throughout the warm chain, the mother-baby dyad will benefit from ongoing support and skilled assistance. All mothers are then empowered with a more satisfying and effective breastfeeding experience.

Baby-friendly hospitals provide consistent messages through supportive breastfeeding policies that impact the antenatal period and early minutes, hours and days after birth. (15) Additionally, Step 10 of the Ten Steps to Successful Breastfeeding discusses the importance of follow-up for the breastfeeding dyad after discharge from the maternity care facility. In a system that supports breastfeeding as a foundation for lifelong health, this follow-up may be a breastfeeding support group, a community clinic, or a health provider’s practice. Whatever the source of support, it is necessary for the maternity facility to assure that the breastfeeding couple has a knowledgeable source of support when they leave the hospital. LLLI and other peer breastfeeding support organisations offer this support for families and the community. (16)

Breastfeeding benefits babies, mothers and nations. The WHO highlights the need for primary healthcare throughout the life cycle. Breastfeeding, with its lifelong positive health effects requires a warm chain of support that spans primary healthcare and beyond. To empower parents and enable breastfeeding, universal health coverage must be available and accessible for all.

For more information, please contact:
La Leche League International (LLLI): Lee Claassen Executive Director
World Alliance for Breastfeeding Action (WABA):  Chuah Pei Ching Health & Information Coordinator

  1. World Health Organization. (2019). World Health Day 2019.
  2. Mosca, F., & Giannì, M. L. (2017). Human milk: composition and health benefits. La Pediatria Medica E Chirurgica, 39(2). https://doi.org/10.4081/pmc.2017.155
  3. Horta BL, et al. Long-term consequences of breastfeeding on cholesterol, obesity, systolic blood pressure and type 2 diabetes: a systematic review and meta-analysis. Acta Paediatr. 104:30-7,2015.
  4. Victora, C.G., Bahl R., Barros, A. J. D., França, G.V.A., Horton, S., Krasevec, J., Murch, S., Sankar, M. J., Walker, N., Rollins, N. C. for The Lancet Breastfeeding Series Group. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 387:475-90. doi: https://doi.org/10.1016/S0140-6736(15)01024-7
  5. Hengstermann, S., Mantaring, J.B., 3rd, Sobel, H.L., Borja, V.E., Basilio, J., Iellamo, A.D., Nyunt-U, S. (2010). Formula feeding is associated with increased hospital admissions due to infections among infants younger than 6 months in Manila, Philippines. Journal of Human Lactation,26(1), 19-25. doi: 1177/0890334409344078.
  6. Stuebe, A. (2009). The risks of not breastfeeding for mothers and infants. Rev Obstet Gynecol, 2(4), 222-31.
  7. Victora, C.G., Horta, B.L., de Mola, C.L., Quevedo, L., Pinheiro, R.T., Gigante, D.P., Goncalves, H., & Barros, F.C. (2015). Association between breastfeeding and intelligence, educational attainment, and income at 30 years of age: A prospective birth cohort study from Brazil. Lancet Glob. Health, 3:e199-205. thelancet.com/lancetgh
  8. Blincoe, A.J. (2005). The health benefits of breastfeeding for mothers. British Journal of Midwifery, 13 (6), 398-401. doi: 10.12968/bjom.2005.13.6.18361
  9. World Health Organization. (2019). Breastfeeding.
  10. Langer-Gould, A. , Smith, J. B. , Hellwig, K. , Gonzales, E. , Haraszti, S. , Koebnick, C. & Xiang, A. (2017). Breastfeeding, ovulatory years, and risk of multiple sclerosis. Neurology, 89(6), 563–569. doi: 10.1212/WNL.0000000000004207.
  11. Stuebe AM, Michels KB, Willett WC, Manson JE, Rexrode K, Rich-Edwards JW. Duration of lactation and incidence of myocardial infarction in middle to late adulthood. Am J Obstet Gynecol 2009;200:e131–e138. doi: 10.1016/j.ajog.2008.10.001
  12. World Health Organization. (2019). The World Health Organization’s infant feeding recommendation.
  13. Reis-Reilly, H., Fuller-Sankofa, N., & Tibbs, C. (2018). Breastfeeding in the Community: Addressing disparities through policy, systems, and environmental changes systems. Journal of Human Lactation, 34(2), 262-271. doi: 10.1177/0890334418759055
  14. World Alliance for Breastfeeding Action (WABA) (2019). Warm Chain of Support for Breastfeeding.
  15. World Health Organization (WHO). (2019). Nutrition. Infographics: The TEN STEPS to successful breastfeeding.
  16. La Leche League International (LLLI). (2019). Get Help.

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