Protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services


World Health Organization

breastfeeding guideline cover page

Publication details

Number of pages: 120
Publication date: 2017
Languages: English
ISBN: 978 92 4 155008 6



This guideline provides global, evidence-informed recommendations on protection, promotion and support of optimal breastfeeding in facilities providing maternity and newborn services, as a public health intervention. It is intended to contribute to discussions among stakeholders when selecting or prioritizing appropriate actions in their efforts to achieve the Sustainable Development Goals and the global targets for 2025 as put forward in the Comprehensive implementation plan on maternal, infant and young child nutrition, endorsed by the Sixty-fifth World Health Assembly in 2012, in resolution WHA65.6, the Global strategy for women’s, children’s, and adolescents’ health (2016–2030), and the Global Strategy for infant and young child feeding.

The document presents the key recommendations, a summary of the supporting evidence and a description of the considerations that contributed to the deliberations and consensus decision-making.


A. Immediate support to initiate and establish breastfeeding

Early skin-to-skin contact
  • Moore ER, Bergman N, Anderson GC, Medley N.
    Early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database Syst Rev. 2016;(11):CD003519. doi:10.1002/14651858.CD003519.pub4.
  • Conde-Agudelo A, Díaz-Rossello JL.
    Kangaroo mother care to reduce morbidity and mortality in low birth weight infants. Cochrane Database Syst Rev. 2016;(8):CD002771. doi:10.1002/14651858.CD002771.pub4.
Early initiation of breastfeeding
Showing mothers how to breastfeed
  • Jaafar SH, Ho JJ, Lee KS.
    Rooming-in for new mother and infant versus separate care for increasing the duration of breastfeeding. Cochrane Database Syst Rev. 2016;(8):CD006641. doi:10.1002/14651858.CD006641.pub3.
Demand feeding

B. Feeding practices and additional needs of infants

Early additional foods or fluids
  • Smith HA, Becker GE.
    Early additional food and fluids for healthy breastfed full-term infants. Cochrane Database Syst Rev. 2016;(8);CD006462. doi:10.1002/14651858.CD006462.pub4.
Avoidance of pacifiers or dummies
  • Jaafar SH, Ho JJ, Jahanfar S, Angolkar M.
    Effect of restricted pacifier use in breastfeeding term infants for increasing duration of breastfeeding. Cochrane Database Syst Rev. 2016;(8):CD007202. doi:10.1002/14651858.CD007202.pub4.
  • Foster JP, Psaila K, Patterson T.
    Non-nutritive sucking for increasing physiologic stability and nutrition in preterm infants. Cochrane Database Syst Rev. 2016;(10):CD001071. doi:10.1002/14651858.CD001071.pub3.
  • Greene Z, O’Donnell CPF, Walshe M.
    Oral stimulation for promoting oral feeding in preterm infants. Cochrane Database Syst Rev. 2016;(9):CD009720. doi:10.1002/14651858.CD009720.pub2.
Avoidance of feeding bottles and teats
  • Ganchimeg T, Sugimoto K, Fukazawa KR, Rayco-Solon P, Ota E.
    Avoidance of bottles and artificial teats during the establishment of breastfeeds in healthy term infants: a systematic review of randomized controlled trials [protocol]. PROSPERO. 2016:CRD42016041370 ( 2017).
  • Flint A, New K, Davies MW.
    Cup feeding versus other forms of supplemental enteral feeding for newborn infants unable to fully breastfeed. Cochrane Database Syst Rev. 2016;(8):CD005092. Doi:10.1002/14651858.CD005092.pub3.
  • Collins CT, Gillis J, McPhee AJ, Suganuma H, Makrides M.
    Avoidance of bottles during the establishment of breast feeds in preterm infants. Cochrane Database Syst Rev. 2016;(10):CD005252. doi:10.1002/14651858.CD005252.pub4.

C. Creating an enabling environment

Breastfeeding policy of facilities providing maternity and newborn services
Training of health workers
Antenatal breastfeeding education for mothers
Discharge planning and linkage to continuing support

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