Many countries have experienced increases in rates of exclusive breastfeeding at national level, however, the equity gap by levels of maternal education has not been comprehensively accessed in low-and middle-income countries (LMICs). We assessed patterns and trends for six infant and young child feeding indicators (early initiation of breastfeeding, exclusive breastfeeding under 6 months, continued breastfeeding at 1 and 2 years, and consumption of formula under 6 and between 6-23 months) by levels of formal maternal education (none, primary, and secondary or higher) between 2000-2019 for 81 LMICs. Significant increases in early initiation and exclusive breastfeeding across all education categories were observed. Women with no formal education have worsened continuation of breastfeeding at 1 and 2 years. Formula consumption between 6-23 months only dropped among women with primary education at national level, however, in upper-middle income countries there were important gains in the consumption of this type of breast milk substitute among women with primary or secondary or higher education. The Middle East & North Africa was the only region of the world where exclusive breastfeeding decreased across all education levels, while infant formula consumption increased among women with none and primary education. In Latin America & Caribbean countries the consumption of formula by older children  significantly rose among more educated women. In summary, while optimal breastfeeding practices have improved over the years analyzed for all levels of maternal education, the consumption of formula increased among more educated women.

This work is part of the collection “Interventions and policy approaches to promote equity in breastfeeding” published by the International Journal of Equity in Health and it is freely available at https://doi.org/10.1186/s12939-020-01357-3