“The evidence published so far only comes from a few countries. In order to make firmer conclusions that could aid policy and practice, we need more data,” said Victor Ochieng Owino, a nutrition specialist at the IAEA. “The available evidence is mainly from the Global South, so going forward, it would be important to see data from the Global North as well.”
The IAEA helps countries use a non-radioactive or stable isotope technique to measure breast milk intake and determine if the infant is being exclusively breastfed. This noninvasive technique (DTM) is more accurate for measuring exclusivity of breastfeeding than the most commonly used approach of self-reporting by mothers on what kind of foods and liquids they feed their children. The DTM technique traces the flow of deuterium, a naturally occurring stable isotope of hydrogen as it is transferred via breast milk from the mother to her infant during breastfeeding. The IAEA encourages countries to use this technique to monitor progress towards achieving exclusive breastfeeding targets. However, not many high-income countries have used this method to date to measure breast milk intake and exclusivity of breastfeeding.
Read more: What are Isotopes? | IAEA
“We compiled the Database on Human Milk with the aim of creating a distinctive and expanding global repository of DTM data. Typically, individual studies of breast milk intake are hard to generalize due to their small sample sizes. Our goals are to bring together these studies in one place to facilitate innovative data analyses that enhances our understanding of breastfeeding behaviour and its determinants, allowing the design of more effective interventions that promote breastfeeding,” said Cornelia Loechl, Head of the Nutritional and Health-Related Environmental Studies Section at the IAEA.
Data from the DTM technique is already informing public health policies in countries around the world. In a recent study, the DTM technique was used to determine how promotional activities impact exclusive breastfeeding. A collaborative study carried out with the support of the IAEA's technical cooperation programme in Mauritania by its Ministry of Health, the IAEA and UNICEF found that awareness-raising campaigns almost doubled the rate of exclusive breastfeeding in intervention areas compared to those areas yet to benefit from such promotional efforts.
A study carried out in South Africa, where exclusive breastfeeding rates were historically very low, found that mentoring and counseling programmes significantly improved exclusive breastfeeding rates, as assessed using the DTM technique.
This nuclear method has also facilitated breakthrough studies on the link between food security and breast milk output. An IAEA-supported research project in Western Kenya found that food insecurity is associated with lower breast milk intake, potentially resulting from a lack of nutrient intake by the mother. Prior to this study, the effects of food insecurity on breastfeeding had not been assessed with an objective measurement of exclusive breastfeeding or the amount of breast milk consumed.
The IAEA’s human milk intake database was launched in 2022, and is currently compiling information from studies around the world that used the DTM technique previously in diverse contexts. Although it is still in development, this database will enable researchers to explore relationships between breastfeeding practices and related driving factors, for example socio-economic status across the globe.
For example, a first data analysis was recently conducted using the DTM database to find links between maternal education and infant breast milk intake. It was inferred from the study that there was not a significant difference in breast milk intake based on maternal education level. While this analysis did not find a conclusive link between breastfeeding and maternal education, comparisons by country Human Development Index (HDI) showed a trend towards higher breast milk intake in settings with lower HDI, further re-enforcing the need for more data to objectively evaluate breastfeeding practices in higher income settings. More data is needed on a global scale from various contexts to provide more conclusive results. As a practical step towards protecting the survival and health of babies and women, breastfeeding is a central part of the 2030 Agenda for Sustainable Development and is linked to many of the Sustainable Development Goals (SDGs).
Breastfeeding plays an important role in preventing malnutrition and protecting infants against infection, reducing mortality. Children who are breastfed may also be less likely to become overweight or obese, supporting nutrition goals. Additionally, women who breastfeed have a lower risk of developing cancer and type II diabetes, enhancing maternal health. Breastfeeding supports gender equality by addressing workplace rights and birth spacing issues.
Obtaining more data is essential, from both high- and low-income countries, to close the evidence gap and inform action for improved breastfeeding and health for future generations.
