From: Food security for infants and young children: an opportunity for breastfeeding policy?
Food security term | Infant feeding system | ||
---|---|---|---|
Breastfeeding and wet-nursing 1 | Expressed breast milk | Breast milk substitutes (BMS) | |
Appropriateness | WHO/UNICEF Global Strategy for Infant and Young Child Feeding (2003) –breastfeeding most preferred of 4 options. Suitability of wet-nursing depends on circumstances. Health of mother/wet-nurse. | WHO/UNICEF Global Strategy for Infant and Young Child Feeding (2003) –suitability of milk from mother or donor depends on circumstances. Health of donor. | WHO/UNICEF Global Strategy for Infant and Young Child Feeding (2003) –suitability of BMS depends on circumstances. Compliance with composition, food safety and labelling standards for infant food3. |
Availability | Rate of exclusive breastfeeding at 6Â months. Continued breastfeeding for up to two years of age or beyond. Prevalence of wet nursing. | Location and support of breast milk banks and milk sharing. Transport and handling cold chain. | Retail outlets, including pharmacies, or rarely on prescription-only4. Local or imported brands. |
 |  | Feeding equipment and sterilization. | Clean water, feeding equipment and sterilization. |
Accessibility | Economic and social policies that facilitate proximity between breastfeeding dyad: BFHI2; Maternity leave; Breastfeeding-friendly childcare; Breastfeeding-friendly work place. Acceptance of wet-nursing. | Donor and recipient must meet eligibility criteria for breast milk banks, milk sharing sites and social networks. Access to some milk banks may be on prescription only. | Retail outlets, including pharmacies, or on prescription-only4. Policies that separate mother and child. Regulation of marketing of BMS. |
Affordability | Economic and social support for time, labour and opportunity cost to breastfeed. Financial, gift or social remuneration of wet-nurse. | Costs may include shipping, compensation or payment to milk bank or donor. Breast pump, feeding equipment and sterilization, storage and transport costs. | Requires financial payment. Retail cost of powdered or liquid infant formula varies with location and whether domestic or imported product used. Feeding equipment and sterilization costs. |
Utilization | 100% if milk production and intake regulated by breastfeeding dyad. | Wastage in handling, storage, distribution and feeding. Diversion from food chain. | Reduces consumption of breast milk. Wastage in BMS supply chain, manufacturing, distribution and feeding. |
Stability | High rates of exclusive breastfeeding and proximity of breastfeeding dyad required. Stable in emergencies, unless relief disrupts breastfeeding. e.g. by supply of BMS. | Variation in supply not investigated. Expressing milk may increase supply of breast milk. Unstable in emergencies. | Feeding breast milk substitutes decreases supply of breast milk. Market access, including free trade agreements. Unstable supply and added risks in emergencies. May be oversupply of BMS as emergency relief. |