Breastfeeding and maternal–infant health: benefits, barriers, commercial influences and strategies for sustainable support

Abstract

Breastfeeding is a fundamental component of maternal and infant health, providing nutritional, immunological, developmental, psychological, and long-term health benefits for both mother and child. Despite strong international recommendations supporting exclusive breastfeeding during the first six months of life and continued breastfeeding with complementary feeding thereafter, optimal breastfeeding practices remain inadequate across many populations. This review examines the multifaceted contribution of breastfeeding to infant survival, immune protection, neurodevelopment, maternal recovery, chronic disease prevention, and mother–infant bonding. It further explores the social, economic, cultural, and structural factors that influence breastfeeding initiation and continuation. Particular attention is given to the growing commercialization of infant feeding, including marketing of breast-milk substitutes, digital promotion, and industry influence on parental decision-making. Workplace constraints, inadequate maternity protection, limited lactation support, sociocultural stigma, gender-related responsibilities, and socioeconomic inequalities are also examined as important determinants of breastfeeding outcomes. The review additionally considers the environmental implications of infant feeding, highlighting the resource use, packaging, waste, and carbon footprint associated with formula production and distribution. Evidence from global health initiatives indicates that effective breastfeeding promotion requires coordinated action involving healthcare systems, governments, workplaces, communities, and regulatory bodies. Strengthening lactation counseling, implementing breastfeeding-friendly workplace policies, protecting families from inappropriate marketing, and promoting culturally sensitive community support are essential to creating enabling environments for breastfeeding. Overall, breastfeeding should be recognized not merely as an individual feeding decision but as a major public health, social equity, and sustainability priority requiring supportive policies and multisectoral commitment.