Background

In spite of WHO/UNICEF programs and subsequent measures to promote breastfeeding, breastfeeding still does not represent the norm for infant feeding on a global scale.

Objective

A questionnaire for experts in the field of lactation was designed to assess the international situation of breastfeeding, lactation consulting and breastfeeding promotion including: The experts’ work situation with respect to contentedness, motivation and acceptance, the progress of breastfeeding promotion and the identification of remaining obstacles to derive practice-based policy recommendations towards a breastfeeding culture.

Methods

Quantitative evaluations based on closed question items included mainly descriptive statistics. Qualitative methods based on open question items categorised mutually exclusive response groups by paraphrasing.

Results

Lactation consulting is lacking of payment and career opportunities on an international level and needs a firm position in the health care system with reimbursement to the full extent of work. However, lactation consultants describe themselves as mostly contented and idealistically motivated. Societal and political support is poor and research funds are lacking, NCBFs' should gain political weight and take on additional tasks. Health care providers without education in lactation represent a decisive obstacle to breastfeeding. WHO/UNICEF measures remain priority with overdue implementation.

Conclusions

Health policies to protect and promote breastfeeding including legislation, consumer protection and the integration of lactation consulting in the health care systems represent key measures to achieve progress in the implementation of WHO/UNICEF and subsequent programs to re-establish the breastfeeding culture. A basic education of all health-care providers in the lactation field seems indispensable to promote breastfeeding consistently.

Discussion

Breastfeeding support should be prioritized as promotion of a major health resource on a global scale. Facing a global economic and climate crisis it should be an imperative for health policies to re-build the breastfeeding culture with priority to protect our offspring.