Global, Regional, and National Prevalence and Trends in Infant Breastfeeding Status in 204 Countries and Territories, 1990–2019

Abstract

Abstract Objectives To estimate prevalence of breastfeeding (exclusive, predominant, partial, and none) and trends for infants under six months of age for 204 countries and territories from 1990 to 2019. Methods We conducted a systematic review for data on breastfeeding status for children under six months of age. We used survey and food diary data to categorize breastfeeding status into exclusive, predominant, partial, and none. Using a 3-step spatio-temporal Gaussian process regression, we modeled the prevalence of each breastfeeding category in 204 countries and territories, 1990 to 2019. Results Global prevalence of exclusive breastfeeding in infants less than six months of age was 43.5% (95% CI 42.7–44.3) in 2019, up from 34.0% (32.7–35.3) in 1990. Globally, non-exclusive breastfeeding was distributed 30.5% (29.8–31.1) predominant, 16.6% (16.2–17.0) partial, and 9.4% (8.9–10.0) no breastfeeding in 2019. Each of these categories experienced a decline in prevalence since 1990, when non-exclusive breastfeeding was 37.0% (36.0–38.1) predominant, 18.7% (18.1–19.4) partial, and 10.2% (9.5–11.0%) no breastfeeding. Exclusive breastfeeding was highest in Andean Latin America (59.7% [57.4–61.9]), Oceania (56.8% [53.2–60.0]), and South Asia (53.9% [53.2–60.0]). There was marked geographic variation in the distribution of non-exclusive breastfeeding types. Predominant breastfeeding was highest in Western Sub-Saharan Africa (51.5% [49.8–53.2]) and Central Asia (47.2% [45.3–49.0), partial breastfeeding was highest in Southern Latin America (31.1% [28.4–34.0]) and the Caribbean (29.3% [27.6–31.1]), and no breastfeeding was highest in High-income North America (36.7% [31.0–42.5]) and Australasia (32.4% [26.3–36.4]). Conclusions Since 1990, global prevalence of exclusive breastfeeding has increased nearly 10 percentage points. Nonetheless, many countries are not on track to meet the WHO Global Nutrition Target of at least 50% of infants under 6 months exclusively breastfeeding. These cross-nationally comparable estimates of current levels and trends in breastfeeding status provide useful data for targeting interventions to improve breastfeeding practices and to help alleviate the associated global burden of infant malnutrition. Funding Sources Funding for this research was provided by the Bill and Melinda Gates Foundation.