According to its authors, 78 million babies worldwide are missing out on the nutrients and antibodies breast milk and colostrum crucially provide for babies in the first hour of life.
“When it comes to the start of breastfeeding, timing is everything. In many countries, it can even be a matter of life or death,” says Henrietta Fore, UNICEF’s executive director.
“Yet each year, millions of newborns miss out on the benefits of early breastfeeding and the reasons – all too often – are things we can change. Mothers simply don’t receive enough support to breastfeed within those crucial minutes after birth, even from medical personnel at health facilities.”
The release of the report, ‘Capture the Moment’ is timed to coincide with World Breastfeeding Week, celebrated from 1 to 7 August. It provides an insight into the breastfeeding habits of women, collected from data drawn from 76 countries.
It found breastfeeding rates within the first hour after birth are highest in Eastern and Southern Africa (65%) and lowest in East Asia and the Pacific (32%).
Nearly 9 in 10 babies born in Burundi, Sri Lanka and Vanuatu are breastfed within the first hour. By contrast, only two in 10 babies born in Azerbaijan, Chad and Montenegro do so.
‘The best possible start in life’
In discussing these findings, WHO director-general Dr Tedros Adhanom Ghebreyesus said, “Breastfeeding gives children the best possible start in life”.
“We must urgently scale up support to mothers – be it from family members, health care workers, employers and governments, so they can give their children the start they deserve.”
The report found that too many newborns were left waiting too long to be introduced to breastfeeding.
This was due to a number of reasons including giving the newborn a specific liquid, such as sugar, water or infant formula as a substitute, the rise in elective C-sections and gaps in the quality of care provided to mothers and newborns.
Giving newborns foods or drinks in the first days of life is common in many parts of the world and is often linked to cultural norms, family practices and health system policies and procedures that are not based on scientific evidence.
These practices and procedures vary by country and may include discarding colostrum or having an elder family member give the newborn a specific food or liquid, such as honey, or having a health professional routinely give the newborn a specific liquid, such as sugar water or infant formula.
These practices can delay a newborn’s first critical contact with his or her mother, the report highlighted.
Equally, C-sections, which have increased from an average of 13% in 2005 to more than 20 per cent in 2017, were identified as a factor that could reduce the likelihood of immediate skin-to-skin contact and the early initiation of breastfeeding.
“The close contact between mother and baby protects newborns with ‘good’ bacteria from their mother’s body – a critical step in developing the baby’s gut health and immune system,” the report said.
“With a vaginal delivery, this process likely occurs in the birth canal. There is some evidence that immediate or early skin-to-skin contact after a caesarean section can help increase early breastfeeding initiation and decrease the time to the first breastfeed.”
The report goes on to cite a number of studies, in which newborns, who began breastfeeding between two and 23 hours after birth had a 33% greater risk of dying compared with those who began breastfeeding within one hour of birth.
Among newborns who started breastfeeding a day or more after birth, the risk was more than twice as high.
“This is a timely report that should be read and taken notice of by global leaders, politicians and policy makers if they are serious about the health and wellbeing of their population,” said Clare Livingstone, professional policy advisor at the Royal College of Midwives.
“The evidence on the benefits of breastfeeding is incredibly strong and we should all be doing as much as we possibly can to support women to breastfeed.”
“It is without a doubt the best way to give a baby the healthiest possible start in life, and as this report shows, starting it as soon as possible is incredibly important and can even be lifesaving.”