key: cord-1049309-5v94098v authors: Hernández‐Cordero, Sonia; Pérez‐Escamilla, Rafael title: What will it take to increase breastfeeding? date: 2022-05-09 journal: Matern Child Nutr DOI: 10.1111/mcn.13371 sha: 221dc0b7fa6ec5e44456cf5c2b7ef9b96a84d9df doc_id: 1049309 cord_uid: 5v94098v The introduction for the Supplement in Maternal & Child Nutrition: What will it take to increase breastfeeding? describes the contribution of each of the articles included in this Supplement to the current evidence about the major structural challenges in place to overcome to improve breastfeeding practices, as well as the evidence‐based policies and interventions that can be effective at advancing breastfeeding on a large scale to promote, protect and support breastfeeding. essential element of optimal nutrition during the first 2 years of life because it saves lives, improves the short-and long-term health of infants, and enhances their cognitive development across countries, regardless of their level of economic development (Bartick et al., 2017; Horta et al., n.d.; Li et al., 2022; Victora et al., 2016) . Evidence about the constellation of benefits of breastfeeding for women and children and the biological mechanisms explaining them continues to accumulate (Bode et al., 2020; Parul et al., 2021) . With advances in science and technology, more is now known than ever before, about the unique immunological, hormonal, and nutritional properties of breastmilk and how breastmilk composition gets tailored to the unique needs of the infants according to the environments surrounding them ("mother-breastmilk-infant triad") (Bode et al., 2020 ). This complex system developed, over millions of years of evolution, protects the health and stimulates the optimal development of the child and as it turns out it also protects maternal health. In mothers, epidemiological studies have shown that breastfeeding reduces the risk of hypertension, cardiovascular disease, type 2 diabetes, breast, and ovarian cancer and may reduce the risk of depression (Bartick et al., 2017; Tschiderer et al., 2022; Victora et al., 2016) . Hence, optimal breastfeeding practices in the first 2 years is a fundamental component of a healthy diet since birth (i.e., the first food systems , and is considered to be a triple-duty action as it reduces the risk of undernutrition, obesity, and dietary related noncommunicable diseases and fosters child development (Pérez-Escamilla & Segura-Pérez, 2018) . Beyond the individual and family benefits, breastfeeding is also critical for national development and planetary health (Pérez-Escamilla, 2017 • Breastfeeding saves lives, improves the short-and longterm health and cognitive development of infants, and the health of their mothers across the globe. • In most countries, the vast majority of women are choosing to breastfeed but very often cannot do it for as long as they wish because of major structural barriers across layers of the social-ecological model. • Caregivers need to learn the skills to manage normal baby behaviours such as crying and fussiness without placing breastfeeding at risk. • Implementation of well-coordinated evidence-based programmes at the facility and community levels through a highly qualified and motivated workforce, as well as with adequate resources, is needed to improve breastfeeding. • Improving maternity benefits for women working in the formal and informal sectors and enforcing the World Substitutes are key to improving breastfeeding. • Implementation science research is needed to translate While in the other hand, in all four countries, advocacy, multisectoral political will, financing, research and evaluation, and coordination were key to fostering an enabling environment for breastfeeding. In all studied countries, there was an urgent need to improve maternity protection and regulation of BMS marketing to protect women, mothers, parents, and relatives from aggressive BMS promotion that often times violates the WHO Code. In Lastly, a critical issue that the ongoing COVID-19 pandemic has brought to our attention, is the need for countries to be well prepared to protect, support, and promote breastfeeding when public health humanitarian emergencies arise. Sonia Hernández-Cordero and Rafael Pérez-Escamilla conceptualized and drafted the first version of the article They both critically reviewed the manuscript. Both authors read and approved the submitted manuscript and contributed equally to the article. This study was funded by the World Health Organization with a grant from the Bill and Melinda Gates Foundation (Award number: OPP1179886). The authors declare no conflicts of interest. No data were generated as part of this supplement introduction. Sonia Hernández-Cordero http://orcid.org/0000-0002-2209-0962 Rafael Pérez-Escamilla http://orcid.org/0000-0001-9416-8039 First-food systems transformations and the ultra-processing of infant and young child diets: The determinants, dynamics and consequences of the global rise in commercial milk formula consumption. Maternal and Child Nutrition Suboptimal breastfeeding in the United States: Maternal and pediatric health outcomes and costs. Maternal and Child Nutrition Global evidence of persistent violations of the International Code of Marketing of Breastmilk Substitutes: A systematic scoping review. Maternal and Child Nutrition Understanding the mother-breastmilk-infant triad Nurturing care: Promoting early childhood development Doubleduty actions: Seizing programme and policy opportunities to address malnutrition in all its forms Countries experiences scaling up national breastfeeding, protection, promotion and support programs: Comparative case studies analysis. Maternal and Child Nutrition. Advance online publication Long-term consequences of breastfeeding on overweight/obesity: Systematic review and meta-analysis Breastfeeding and post-perinatal infant deaths in the United States, A national prospective cohort analysis. The Lancet Regional Health-Americas Rates and time trends in the consumption of breastmilk, formula, and animal milk by children younger than 2 years from 2000 to 2019: Analysis of 113 countries. The Lancet The need to study human milk as a biological system Food security and the 2015-2030 sustainable development goals: From human to planetary health Breastfeeding in the 21st century: How we can make it work Perspective: Should exclusive breastfeeding still be recommended for 6 months? Scaling up of breastfeeding promotion programs in low-and middleincome countries: The "breastfeeding gear" model Impact of prelacteal feeds and early introduction of breastmilk substitutes on breastfeeding outcomes: Systematic review and meta-analysis. Maternal and Child Nutrition Breastfeeding: A tripleduty action in the context of the double burden of malnutrition. Sight and Life Magazine Why invest, and what it will take to improve breastfeeding practices? The Lancet Risk factors for self-reported insufficient milk during the first 6 months of life: A Systematic review. Maternal and Child Nutrition Violations of International Code of Breast-milk Substitutes (BMS) in commercial settings and media in Bangladesh. Maternal and Child Nutrition What Works to protect, promote and support breastfeeding on a large scale Breastfeeding is associated with a reduced maternal cardiovascular risk: Systematic review and meta-analysis involving data from 8 studies and 1 192 700 parous women Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect Follow-up and growing-up formula promotion among Mexican pregnant women and mothers of children under 18 months old. Maternal and Child Nutrition Impact of baby behavior on caregiver's infant feeding decisions during the first 6 months of life: Systematic review. Maternal and Child Nutrition, 1, e13345 The international code of marketing of breast-milk substitutes: Frequently asked questions on the roles and responsibilities of health workers The extension of the 2025 maternal, infant and young child nutrition targets to 2030 How the marketing of formula milk influences our decisions on infant feeding What will it take to increase breastfeeding? Maternal & Child Nutrition