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New Research Highlights Critical Need for Strong Policies to Leverage the Value of Breastfeeding

February 9, 2023

Dear Members of the 118th Congress,

As leaders advocating for healthy families and children, 1,000 Days and the U.S. Breastfeeding Committee invite you to join us in creating a landscape of breastfeeding support across the United States.

Breast milk is recognized as the optimal food for babies and plays a critical role in their growth and development.[i] Numerous studies have shown that breastfeeding promotes healthy cognitive and social-emotional development.[ii] It also saves lives by helping to protect babies from infections and conditions such as sudden infant death syndrome (SIDS).[iii] Breastfeeding even lowers a child’s risk of obesity and type 2 diabetes later in life. In addition, women who breastfed reduce their risk of specific chronic diseases, including type 2 diabetes, cardiovascular disease, and breast and ovarian cancers.[iv]

Unfortunately, the U.S. has many barriers to establishing and maintaining breastfeeding. While four out of five babies born in the United States start out being breastfed, about half are still doing so at six months.[v] This is not due to capacity or wishes of the parent, but rather because environments in the U.S. do not support breastfeeding.

Our country’s policies, systems, and environments must be improved to make breastfeeding a realistic option for all families. New research released this week highlights the critical need for strong policies to fully leverage the value of breastfeeding.

  • Breastfeeding rates can be rapidly improved by scaling up known interventions, policies, and programs in the workplace and health system.
  • Infant formula companies utilize intrusive marketing strategies to families, health care providers, and policy makers to portray these products as solutions to common infant health issues in ways that systematically undermine breastfeeding and prey on parental concerns.
  • Policy changes are needed to address the power imbalances and political and economic structures that influence feeding practices and health outcomes.

As we approach the one-year anniversary of the infant formula crisis, it is critical that you and your colleagues in the House and Senate take action to address infant nutrition security, including through support for breastfeeding.

As you know, changing environments and systems requires everyone do their part – parents, policymakers, health facilities, communities, and employers. As a Member of Congress, you have an incredible opportunity to create the policy changes families need. Together, we can build on the momentum from recent advancements like the Providing Urgent Maternal Protections (PUMP) for Nursing Mothers Act to build a robust infrastructure for infant nutrition security.

Breastfeeding has such a profound impact on population health outcomes that increasing breastfeeding rates and creating lactation-friendly environments have been identified as critical public health priorities in the U.S. as well as across the world. Breastfeeding is included in a variety of national initiatives, including the Dietary Guidelines for Americans, Healthy People 2030, The Surgeon General’s Call to Action to Support Breastfeeding, and more.

It is time to move from reports and vision statements, to taking action on the policy priorities that families deserve. We hope you will take the time to explore the new Lancet series on breastfeeding and join us as we work to build a country where infant nutrition security and breastfeeding is valued, protected, promoted, and supported.

Sincerely,

Amelia Psmythe Seger,
U.S. Breastfeeding Committee		 Blythe Thomas,
1,000 Days

 

About 1,000 Days

An Initiative of FHI Solutions, 1,000 Days is the leading non-profit organization working in the U.S. and around the world to ensure women and children have the healthiest first 1,000 days. Our mission is to make the well-being of women and children in the first 1,000 days a policy and funding priority. We are passionate about turning evidence into action and use our deep understanding of the science and the issues to help shape policies that improve the lives of moms and babies in the U.S. and throughout the world.

About the U.S. Breastfeeding Committee

The mission of the U.S. Breastfeeding Committee (USBC) is to drive collaborative efforts for policy and practices that create a landscape of breastfeeding support across the United States. USBC functions as a national coalition of 100+ organizational members representing nonprofits, breastfeeding coalitions, federal agencies, and businesses working at national, state/territorial, tribal, local, and community levels to protect, promote, and support human milk feeding. The USBC uses an equity-centered collective impact approach to facilitate multisectoral collaborations.

 

[i] Breastfeeding. World Health Organization. https://apps.who.int/nutrition/topics/exclusive_breastfeeding/en/index.html.  Published Aug. 2018. Accessed February 6, 2023.

[ii] Nutrition in the First 1,000 Days: A Foundation for Brain Development and Learning, 1,000 Days and Think Babies. https://thousanddays.org/wp-content/uploads/1000Days-Nutrition_Brief_Brain-Think_Babies_FINAL.pdf. Accessed February 4, 2023.

[iii] Breastfeeding Benefits Both Baby and Mom. Centers for Disease Control and Prevention, https://www.cdc.gov/nccdphp/dnpao/features/breastfeeding-benefits/index.html. Published July 27, 2021. Accessed February 6, 2023.

[iv] Making the decision to breastfeed | womenshealth.gov. womenshealth.gov. https://www.womenshealth.gov/breastfeeding/making-decision-breastfeed/#1. Published 2020. Accessed December 20, 2022.

[v] Breastfeeding Report Card, United States 2022. Centers for Disease Control and Prevention. https://www.cdc.gov/breastfeeding/data/reportcard.htm. Published August 31, 2022. Accessed February 8, 2023.

The Nutrition Year of Action in Review: 5 Things that Give Us Hope

It’s easy to be pessimistic about the current state of global nutrition. Malnutrition still kills more kids in an average year than the population of Chicago, and leaves millions more with permanently stunted brain development and life-long health problems. COVID-related disruptions to food and health systems have exacerbated these numbers, with experts predicting that by the end of 2022 we’ll see an additional 13.6 million cases of wasting, the most deadly type of malnutrition. To top it all off, experts are now saying that we’ve been underestimating how much it will cost to reach our global nutrition targets, and that with the additional demand from the pandemic we now need to mobilize at least $10.8 billion every year just to stay on track.

On December 8, the 3rd Nutrition for Growth Summit wrapped up the 2021 Nutrition Year of Action, a pledging event that could not have come at a more urgent time. And despite all the challenges ahead, we want to take a moment to celebrate some of the things that give us hope as we conclude the Nutrition Year of Action and move into 2022. Here are our top five:

  1. Breadth and depth of high-burden country commitments

As N4G hosts, the Government of Japan created an inclusive environment that helped encourage and support governments to prepare bold commitments to accelerate progress on the nutritional issues in their countries. This support helped facilitate new commitments from 70 countries with a high burden of malnutrition. Commitments ranged from financial, policy, programmatic, and impact to cut across the five themes of the Summit: Health, Food, Resiliency, Financing, Data/Accountability. This is great news, in part because steadily increasing domestic resource mobilization is a key component of nutrition financing models toward the WHA targets. We are hopeful that the large number of new commitments from high-burden countries will help offset the rising cost of these interventions.

  1. New vehicles for innovative financing

Donors are increasingly turning to innovative financing mechanisms to fill funding gaps and leverage new funding streams. One great example is the Nutrition Match Fund launched this year by the Children’s Investment Fund Foundation (CIFF), UNICEF, and the Bill & Melinda Gates Foundation. The fund helps to mobilize domestic resources for nutrition by providing a 1-to-1 match for any money governments spend on essential tools to combat undernutrition such as purchasing ready-to-use therapeutic foods to treat wasting. The fund has unlocked nearly $4 million of incremental domestic resources, and is already attracting additional donor investment. We are hopeful that advancements like this one in nutrition supply financing will help prevent supply chain disruptions and offer one solution for the low coverage rates of many nutrition interventions.

  1. Progress on UN wasting treatment reform

An update to the UN’s wasting management protocols has been a long time coming. The reform process began in 2020 with the launch of the Global Action Plan (GAP) on Child Wasting. Though the GAP fell short of expectations in many ways, we are heartened by the steps the UN has taken to advance this work in 2021, including releasing operational country roadmaps for the GAP. Another step forward is the WHO and UNICEF’s ongoing evidence review to update global and national guidelines on wasting treatment. This review will reflect the growing evidence that there are simpler, cheaper, and more efficient ways to detect and treat wasting to open the door for reaching more children.

  1. Nutrition accountability at the forefront

One of the major outcomes from the 2021 Nutrition Year of Action is the launch of the Global Nutrition Report’s (GNR) Nutrition Accountability Framework (NAF). The NAF is the world’s first comprehensive accountability platform for nutrition, helping to ensure all commitment-makers put their promises into tangible action. Commitments must be SMART and align with national nutrition plans. The platform inspires bold and measurable commitments that drive progress on nutrition. At 1,000 Days, we believe holding ourselves and our leaders accountable is a crucial component of scaling evidence-based nutrition interventions.

  1. Renewed US leadership in the global nutrition space

In 2019 – the lead-up to the original 2020 N4G dates – the US was pulling back from international obligations and seemed unlikely to make any sort of substantial commitment at N4G. By December 2021, the US has not only publicly committed up to $11 billion over three years to combat global malnutrition, but sent USAID Administrator Power to make the announcement. The commitment builds on the Biden Administration’s repeated nods to the importance of good nutrition, especially in the wake of the pandemic. Though it is still unclear how the US will fulfill its financial commitment and how much (if any) of the $11 billion is new money, US commitments throughout the Nutrition Year of Action signal its plans to remain at the forefront of the fight against global malnutrition. As the sector’s largest donor, and in the face of a notable lack of commitment from the UK, US leadership will be a key component of any successful nutrition effort. As advocates continue to socialize the Nourish the Future proposal in 2022, the Administration’s demonstrated commitment to global nutrition is a welcome signal for more to come.

On top of these successes, we saw a host of other positive developments for nutrition, such as the addition of multiple micronutrients to the WHO Essential Medicines List, a growing adoption of the new OECD DAC nutrition policy marker, and the recent release of the Global Financing Facility’s Nutrition Roadmap. Ultimately, Summit participants from around the world pledged over $27 billion toward global nutrition at a time when donor fatigue is high and every country in the world is facing outsized domestic challenges. 2021 was a year of setbacks in our fight against malnutrition, but the new tools and resources coming out of the Nutrition Year of Action give us hope that the state of global nutrition will look better in 2022 and beyond.

The Looming Threat of Malnutrition in the COVID-19 Pandemic

Co-hosted by 1,000 Days, Bread for the World and InterAction, The Looming Threat of Malnutrition in the COVID-19 Pandemic, brought together five speakers from different fields including government, the nutrition community and documentary film, to share their perspectives on how COVID-19 has impacted health and nutrition for women, children, and families globally. The overwhelming consensus: the time to act on addressing dramatically increasing rates of severe malnutrition around the world is now.

The picture is staggering. In many parts of the world, malnutrition related to the pandemic is projected to kill more people, especially children, than the pandemic itself because of COVID-19-related disruptions to food and health systems. Recent estimates show that by 2022, these disruptions could leave an additional 12 million children severely malnourished.

Investing in nutrition can’t wait.

Highlights from the virtual briefing moderated by Jenny Marron, Director of Public Policy and Government Relations at InterAction:

Congressman Jim McGovern, co-chair of the House Hunger Caucus, spoke to the importance of investing in nutrition now not later so that we do not lose progress. A strong nutrition advocate, McGovern laid out in urgent terms what is at stake: “We know that each day we fail to focus on the threat of malnutrition, that means another child will grow up stunted, a mother will give birth to a malnourished baby…and a family and a community will have a diminished future.” He followed by explaining we know what needs to be done to combat malnutrition and food security and that investments in the health of women and children are in the best interest of us all. View his remarks here.

Skye Fitzgerald, Emmy and Oscar nominated documentary filmmaker, discussed his film Hunger Ward which chronicles the famine in Yemen. He provided a view of what severe malnutrition looks like in the world right now. Watch a clip from his film here.

Karin Lapping, Nutrition Technical Director at FHI Solutions, outlined the causes of malnutrition and the proven solutions we have to save women and children. She explained that poor nutrition affects every aspect of a person’s life, especially in three main areas: education, health, and economics. But we have the solutions, like the protection and promotion of breastfeeding, which is an extremely successful intervention that saves lives, and is easily scalable. Her concluding remarks were straight to the point: “Bottom line, we have to act now. Children are dying and this will continue to happen. It is an ethical, economic, and human remit. We must reinvigorate efforts towards nutrition. The cost is too high not to.”

Asma Lateef, Director at Bread for the World Institute, highlighted the history of U.S. leadership on nutrition and the need for that to continue by saying: “We know that when the U.S. leads, other donors and partners follow. That is crucial.”

Shawn K Baker, Chief Nutritionist at USAID, provided closing remarks, emphasizing that, while malnutrition is a major threat to the health and wellbeing of many children around the world, it is a problem for which there are numerous, cost-effective solutions. Additionally, if mothers, infants and young children have access to quality nutrition in the 1,000-day window, he emphasized, “we have locked in their ability to survive and to thrive, and that is irreversible.” The United States has demonstrated consistent commitment to ending the crisis of maternal and child malnutrition, even amidst the challenges posed by the coronavirus pandemic, and this leadership is crucial in ensuring the U.S., other partner governments, civil society and the private sector can work together and mobilize resources to have the greatest possible impact. Continued U.S. leadership is critical in improving the nutrition of mothers, infants, and young children— “we know it’s possible, we know it saves lives, and we know it ensures their future.”

Urgent investment in proven, cost-effective, and scalable nutrition solutions is necessary to address the crisis of maternal and child malnutrition and end preventable child deaths. The time to act is now.

Find a recording of the full event here. And for more, read our brief on severe malnutrition and COVID here.