The WHO Ten Steps to Successful Breastfeeding
How Successful Are They?
There are essential elements to ensuring a birthing parent is successful in breastfeeding their baby for as long as mutually desired. For instance, teaching a parent how to breastfeed is critical to successful breastfeeding.
Almost all parents are taught that all ten steps of the WHO/UNICF Ten Steps to Successful Breastfeeding are essential to getting breastfeeding off to a good start.[1] While the Ten Steps overall were effective in promoting breastfeeding in a large multi-center clinical trial done in Belarus, it was unclear which steps actually had an effect on breastfeeding.[2]
The research on the efficacy of each step to promote breastfeeding has been systematically reviewed by a 2017 WHO expert panel.[3] While a few steps improved breastfeeding rates, the rest had little to no effect; for some, there was no data to know if there was an effect. One part of step 6: “Give no food [or formula] other than breast milk unless medically indicated,” was actually counterproductive to promoting breastfeeding as the data showed judicious supplementation improved both any and exclusive breastfeeding rates at three months.[4] Despite this data, the WHO decided to retain the recommendation.
The following table is a summary of the findings of that 2017 WHO expert panel so that you can decide which steps are more important than others when initiating breastfeeding after birth.
To learn more about this topic, read the Fed Is Best book available on paperback, e-book, and audiobook.
References
- “Ten Steps to Successful Breastfeeding,” accessed August 9, 2021, https://www.who.int/teams/nutrition-and-food-safety/food-and-nutrition-actions-in-health-systems/ten-steps-to-successful-breastfeeding.
- M. S. Kramer et al., “Promotion of Breastfeeding Intervention Trial (PROBIT): A Cluster-Randomized Trial in the Republic of Belarus. Design, Follow-up, and Data Validation,” Advances in Experimental Medicine and Biology 478 (2000): 327–45. https://jamanetwork.com/journals/jama/fullarticle/193490
- “WHO | Protecting, Promoting and Supporting Breastfeeding in Facilities Providing Maternity and Newborn Services,” WHO, accessed April 11, 2019, https://www.who.int/publications/i/item/9789241550086.
- Genevieve E. Becker and Tracey Remmington, “Early Additional Food and Fluids for Healthy Breastfed Full-Term Infants,” The Cochrane Database of Systematic Reviews 11 (2014): CD006462, https://doi.org/10.1002/14651858.CD006462.pub3.