Epidemiologic research has clearly demonstrated that breastfeeding provides health and development advantages to infants while significantly decreasing the risk for a large number of acute and chronic diseases. Exclusively breastfed infants are at a much lower risk of diarrhea and acute respiratory infections, two leading causes of infant death, than are infants who receive other liquids and foods in addition to breast milk during their first months of life (UNICEF, 2009). Breast milk stimulates infants’ immune systems and response to vaccinations, and it contains hundreds of health-enhancing antibodies and enzymes. An additional benefit of exclusive breastfeeding is that it protects the mother from pregnancy during the early postpartum period and can be used intentionally for family planning if she meets the three lactational amenorrhea method (LAM) criteria: (1) the mother’s period has not returned; (2) the infant is fully or nearly fully breastfed and is fed often, day and night; and (3) the infant is less than six months old (USAID, 2008). 

Early initiation of breastfeeding shortly after birth improves the likelihood that mothers will be able to successfully initiate lactation, will encounter fewer problems breastfeeding, and will be able to maintain optimal breastfeeding behaviors. Breastfeeding should begin no later than one hour after the delivery of the infant. Skin-to-skin contact between mother and infant is important for bonding, maintaining infant body warmth, and may stimulate mother and infant, thereby facilitating suckling (Sheau-Huey and Anderson, 2009). Early use of water and substitute feeds postpartum can interfere with the initiation and success of breastfeeding.   

In contrast to the benefits of breastfeeding, breast milk substitutes and feeding bottles have high risks for contamination that can lead to life threatening infections. Infant formula is not sterile, can be mixed with contaminated water, and/or improperly diluted. In 1981, the World Health Assembly (WHA) adopted the International Code of Marketing of Breast-milk Substitutes as the minimum international standard for the proper use of breast milk substitutes (WHO, 1981). The WHA has adopted subsequent resolutions and in 2002, WHO Member States endorsed the Global Strategy for Infant and Young Child Feeding that includes the Code and further resolutions, the Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding, as well as the, Baby-Friendly Hospital Initiative (WHO, 2008; WHO, 2009).