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July 08, 2021

Rates and time trends in the consumption of breastmilk, formula, and animal milk by children younger than 2 years from 2000 to 2019: analysis of 113 countries

Breastfeeding rates have been increasing over the past three decades in low- and middle-income countries (LMICs). However, analysis including both groups of countries classified as high-income countries (HICs) and LMICs lacks in the scientific literature. Additionally, there’s no evidence of formula and animal milk consumption patterns by children younger than 2 years in LMICs. Therefore, we aimed at producing the first-ever global analysis on trends and rates on the consumption of breastmilk, formula, and animal milk from 2000 to 2019. We used data from nationally representative surveys carried out periodically in LMICs (DHS, MICS, RHS) in combination with data retrieved from a broad literature review searching for national reports and estimates of breastfeeding indicators in HICs, including 113 countries. Seven feeding indicators were estimated: any breastfeeding at 6 months and 1 year (data available for LMICs and HICs), exclusive breastfeeding under six months, formula consumption under six and between 6-23 months, and animal milk consumption under six and between 6-23 months (restricted to LMICs, as no standardized data on these feeding indicators is available for HICs). Significant increases in any breastfeeding in all age ranges were seen in HICs and upper-middle income countries. Exclusive breastfeeding was the only indicator that increased at national level, and all country income groups and regions of the world, except in the Middle East & North Africa that showed downturns over the period. Formula consumption grew substantially in upper-middle income countries in all age ranges during the period of analysis. Animal milk consumption under six months was the only indicator that decreased at national level. Breastfeeding rates are growing globally, especially in HICs and upper middle-income countries; however, the global rates show that the WHO’s global target of at least 70% of children to be exclusively breastfed under six months will not be achieved at the current pace. The alarming increase in formula consumption in upper-middle income countries deserves attention and novel strategies to control the promotion and marketing of such products.

This analysis was published by Lancet Child & Adolescent Health and can be freely downloaded at The Lancet Child & Adolescent Health