The contribution of breastfeeding to a healthy, secure and sustainable food system for infants and young children: monitoring mothers' milk production in the food surveillance system of Norway.

OBJECTIVE: The mother-child breastfeeding dyad is a powerful force for achieving healthy, secure and sustainable food systems. However, food system reports exclude breastfeeding and mother's milk. To help correct this omission and give breastfeeding women greater visibility in food systems dialogue and action, we illustrate how to estimate mother's milk production and incorporate this into food surveillance systems, drawing on the pioneering experience of Norway to show the potential value of such analysis. DESIGN: The estimates use data on the proportion of children who are breastfed at each month of age (0-24 months), annual number of live births and assumptions on daily human milk intake at each month. New indicators for temporal and cross-country comparisons are considered. SETTING: It is assumed that a breastfeeding mother on average produces 306 l of milk during 24 months of lactation. PARTICIPANTS: The annual number of live births is from Statistics Norway. Data for any breastfeeding at each month of age, between 0 and 24 months, are from official surveys in 1993, 1998-1999, 2006-2007, 2013 and 2018-2019. RESULTS: Estimated total milk production by Norwegian mothers increased from 8·2 to 10·1 million l per year between 1993 and 2018-2019. Annual per capita production increased from 69 to 91 l per child aged 0-24 months. CONCLUSIONS: This study shows it is feasible and useful to include human milk production in food surveillance systems as an indicator of infant and young child food security and dietary quality. It also demonstrates significant potential for greater milk production.

Wet nursing and donor human milk sharing in emergencies and disasters: A review

During emergencies and disasters infant survival can depend on their access to breastfeeding or human milk. Wet nursing and donor human milk sharing are options endorsed by the World Health Assembly (wha). This study looks at regulatory environments for wet nursing and donor human milk sharing and considers the wider food security and resilience implications.Legislation and policies relating to wet nursing, donor human milk sharing and milk banking can support appropriate infant and young child feeding in emergencies responses (IYCF-E). However, in many countries there is a lack of legislative and regulatory clarity on protecting and supporting breastfeeding practices in these situations. This is true for all income country settings and geographic regions.High breastfeeding prevalence in a country can reduce exposure to food insecurity and risk for mothers and their children during emergencies. Regulatory clarity is also needed to protect safe wet nursing and donor human milk sharing, being an important step in developing protocols and plans for emergency preparedness and response. With human milk products becoming more available, there is also an urgent need to ensure full implementation of the IYCF-E Operational Guidance and the World Health Organization (who) International Code of Marketing of Breast-milk Substitutes and subsequent relevant WHA Resolutions.