Why Sustainable Support Matters
Breastfeeding is more than a personal choice, it is a public health investment.The World Health Organization recommends early initiation within the first hour of birth, exclusive breastfeeding for six months, and continued breastfeeding for two years or more alongside complementary feeding. The evidence is clear; breastfeeding protects against infections, improves cognitive development, and lowers the risk of obesity and chronic diseases even later in life. For mothers, it reduces the risk of postpartum hemorrhage, breast and ovarian cancers, and supports birth spacing.
Yet despite these benefits, structural and cultural barriers persist. In Pakistan for instance, only 20% of newborns are breastfed within the first hour, far below the WHO target of 60% by 2030—reflecting systemic gaps in awareness, healthcare support, and workplace protection.
Dr. Shabina Raza on the Ground Realities
Dr. Shabina Raza, a public health pediatrician and long-time breastfeeding advocate, has spent over four decades working to improve maternal and child health systems. As she explains, breastfeeding support must be embedded in law, reinforced by health systems, and sustained through community networks.
She highlights four urgent priorities for sustainable support in Pakistan:
- Legal Protection and Enforcement :Laws like the Protection of Breastfeeding and Child Nutrition Ordinance (2002) exist at the federal level, and all provinces have also enacted related legislation. However, stronger enforcement is required. Infant Feeding Boards should be empowered to penalize violations and safeguard policymaking from corporate influence. Moreover, both federal and provincial laws should be revised to align with the International Code of Marketing of Breast-Milk Substitutes and the relevant World Health Assembly (WHA) resolutions 2016.
- Health System Strengthening :Scale up Baby-Friendly Hospital Initiatives, integrate skilled breastfeeding counselling into antenatal and postnatal care, and train health workers in practical lactation management.
- Culturally Sensitive Awareness Campaigns : Address myths, especially the fear of “milk insufficiency,” a major driver of early formula use.
- Workplace and Social Protection Measures :Ensure paid maternity leave, breastfeeding breaks, daycare facilities, and targeted support for women in the informal sector, who make up nearly 73% of Pakistan’s female workforce.
Recent Policy Wins
There are encouraging reforms as well in Pakistan. Sindh Province enacted the Protection, Promotion and Support of Breastfeeding and Child Nutrition Act (2023), aligning with WHO guidance and setting a national example. Federally, the Maternity and Paternity Leave Act (2023) extended paid maternity leave to six months and introduced one month of paid paternity leave, creating a more enabling environment for continued breastfeeding.
These measures, if fully implemented and enforced, could transform breastfeeding outcomes, and indeed resulting health and socio-economic benefits for countries propelled by a healthier population and workforce. But, as Dr. Raza notes, “Having laws is one thing, making them work for every mother is the real challenge.”
The Cost of Inaction
According to Nutrition International’s Cost of Inaction tool, Pakistan loses an estimated USD 2.8 billion annually due to suboptimal breastfeeding, and spends around USD 888 million on breast milk substitutes. The economic case is clear: investing in breastfeeding saves lives and resources.
Communities as the Missing Link
Beyond hospitals and policies, community-led approaches remain critical. Peer-to-peer mother support groups, trained community health workers, and local influencers, especially fathers and grandmothers, can challenge harmful norms, discourage early bottle feeding, and build confidence in mothers’ ability to breastfeed.
Dr. Raza’s philosophy is simple: “A mother’s ability to breastfeed must be protected by law, supported by the system, and sustained by society.”
A Shared Responsibility
Sustainable breastfeeding support is not the sole responsibility of mothers, it is a shared responsibility across sectors:
- Governments must legislate, fund, and enforce protections.
- Health systems must train and equip providers to offer hands-on support.
- Employers must create family-friendly workplaces.
- Communities must nurture positive norms and offer everyday encouragement.
By aligning these systems, we can move from isolated initiatives to an integrated support network that ensures every child has the healthiest possible start.
Call to Action for World Breastfeeding Week 2025:
“Prioritising breastfeeding is both a public health imperative and a moral commitment to the next generation. Let’s make it the norm, not the exception."
