Skip to main content
    • Aa
    • Aa
  • Access
  • Cited by 24
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Arnold, Melina Karim-Kos, Henrike E. Coebergh, Jan Willem Byrnes, Graham Antilla, Ahti Ferlay, Jacques Renehan, Andrew G. Forman, David and Soerjomataram, Isabelle 2015. Recent trends in incidence of five common cancers in 26 European countries since 1988: Analysis of the European Cancer Observatory. European Journal of Cancer, Vol. 51, Issue. 9, p. 1164.

    2015. Nutrition, health and disease.

    Groleau, Danielle Sigouin, Catherine and D'souza, Nicole Anne 2013. Power to negotiate spatial barriers to breastfeeding in a western context: When motherhood meets poverty. Health & Place, Vol. 24, p. 250.

    Sanders, Thomas A. B. 2013. Nutrition and Development.

    2013. Nutrition and Development.

    Cassidy, Tanya M Giglia, Roslyn C and Cassidy, Tanya M 2012. Cochrane Database of Systematic Reviews.

    Fredriksen, Anne Mari Lyberg, Anne and Severinsson, Elisabeth 2012. Health supervision of young women during pregnancy and early motherhood: A Norwegian qualitative study. Nursing & Health Sciences, Vol. 14, Issue. 3, p. 325.

    Ibanez, G. Martin, N. Denantes, M. Saurel-Cubizolles, M.-J. Ringa, V. and Magnier, A.-M. 2012. Prevalence of breastfeeding in industrialized countries. Revue d'Épidémiologie et de Santé Publique, Vol. 60, Issue. 4, p. 305.

    García-de-León-González, Ricardo Oliver-Roig, Antoni Hernández-Martínez, Mónica Mercader-Rodríguez, Beatriz Muñoz-Soler, Verónica Maestre-Martínez, Maria Isabel and Monreal-Tomás, Ana Belén 2011. Becoming baby-friendly in Spain: a quality-improvement process. Acta Paediatrica, Vol. 100, Issue. 3, p. 445.

    Krawinkel, Michael B. 2011. Benefits from Longer Breastfeeding: Do We Need to Revise the Recommendations?. Current Problems in Pediatric and Adolescent Health Care, Vol. 41, Issue. 9, p. 240.

    Pannu, PK Giglia, RC Binns, CW Scott, JA and Oddy, WH 2011. The effectiveness of health promotion materials and activities on breastfeeding outcomes. Acta Paediatrica, Vol. 100, Issue. 4, p. 534.

    Łoś-Rycharska, Ewa and Niecławska, Agnieszka 2010. Odżywianie dzieci w wieku poniemowlęcym i przedszkolnym w ocenie ich matek. Pediatria Polska, Vol. 85, Issue. 6, p. 588.

    Duijts, Liesbeth Ramadhani, Made K. and Moll, Henriëtte A. 2009. Breastfeeding protects against infectious diseases during infancy in industrialized countries. A systematic review. Maternal & Child Nutrition, Vol. 5, Issue. 3, p. 199.

    Noirhomme-Renard, F. and Noirhomme, Q. 2009. Les facteurs associés à un allaitement maternel prolongé au-delà de trois mois : une revue de la littérature. Journal de Pédiatrie et de Puériculture, Vol. 22, Issue. 3, p. 112.

    Bitsori, Maria and Kafatos, Anthony 2007. Dysmetabolic syndrome in childhood and adolescence. Acta Paediatrica, Vol. 94, Issue. 8, p. 995.

    Furber, Christine M. and Thomson, Ann M. 2007. Breastfeeding practice in the UK: midwives’ perspectives. Maternal & Child Nutrition, Vol. 4, Issue. 1, p. 44.

    Gudnadottir, Maria Sigurdur Gunnarsson, Björn and Thorsdottir, Inga 2007. Effects of sociodemographic factors on adherence to breastfeeding and other important infant dietary recommendations. Acta Paediatrica, Vol. 95, Issue. 4, p. 419.

    Marshall, Joyce L. Godfrey, Mary and Renfrew, Mary J. 2007. Being a ‘good mother’: Managing breastfeeding and merging identities. Social Science & Medicine, Vol. 65, Issue. 10, p. 2147.

    Pechlivani, Fani Vassilakou, Tonia Sarafidou, Jasmin Zachou, Themis Anastasiou, Costas A and Sidossis, Labros S 2007. Prevalence and determinants of exclusive breastfeeding during hospital stay in the area of Athens, Greece. Acta Paediatrica, Vol. 94, Issue. 7, p. 928.

    Rovers, Maroeska M. de Kok, Inge M.C.M. and Schilder, Anne G.M. 2006. Risk factors for otitis media: An international perspective. International Journal of Pediatric Otorhinolaryngology, Vol. 70, Issue. 7, p. 1251.


Breastfeeding in countries of the European Union and EFTA: current and proposed recommendations, rationale, prevalence, duration and trends

  • Agneta Yngve (a1) and Michael Sjöström (a1)
  • DOI:
  • Published online: 01 April 2001

Recommendations suggest exclusive breastfeeding for at least the first 4 to 6 months after birth. Paradoxically, an overwhelming proportion of breastfeeding (BF) data in Europe refers to all BF, i.e. not only exclusive but also partial BF (including formula, juices, water, sweetened water etc). This makes it difficult to estimate to what extent the recommendations are met. There is currently strong evidence for recommending exclusive breastfeeding for at least 6 months.

Exclusive BF has progressively gained scientific support. Prevention of infections, allergies and chronic diseases and a favourable cognitive development are highlighted in the recent scientific literature. Further long-term studies on the effects of BF on prevention of chronic disease in the adult are needed.

Great differences exist in BF prevalence and duration both within and between European countries. Trends point towards higher prevalence and duration, with some exceptions. Young mothers breastfeed less than older mothers; single and/or less educated mothers breastfeed less than married mothers with more education. However, inefficient and unreliable monitoring systems prevail, and the data are scarce, not only on exclusive BF but also on demographic, socio-economic, psychosocial and medical determinants of BF patterns. National BF co-ordinators have not been appointed in many countries, and only every second country has promotion of BF incorporated into their national plan of action for nutrition.


Efficient surveillance systems, comparable across Europe and using common definitions and methodology, need to be developed. These should include determinants of breastfeeding. A European consensus conference should urgently be determinants of breastfeeding. A European consensus conference should urgently be organised, in which strategies for successful promotion of exclusive BF should be particularly considered. There is now strong evidence for a recommendation to breastfeed exclusively for about 6 months, which is more than the duration recommended previously.

    • Send article to Kindle

      To send this article to your Kindle, first ensure is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle.

      Note you can select to send to either the or variations. ‘’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Breastfeeding in countries of the European Union and EFTA: current and proposed recommendations, rationale, prevalence, duration and trends
      Your Kindle email address
      Available formats
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Dropbox account. Find out more about sending content to Dropbox.

      Breastfeeding in countries of the European Union and EFTA: current and proposed recommendations, rationale, prevalence, duration and trends
      Available formats
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your Google Drive account. Find out more about sending content to Google Drive.

      Breastfeeding in countries of the European Union and EFTA: current and proposed recommendations, rationale, prevalence, duration and trends
      Available formats
Corresponding author
*Corresponding author: Email
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

6A Ferriman . WHO accused of stifling debate about infant feeding. BMJ 2000; 320: 1362.

9Position of the American Dietetic Association: promotion of breast-feeding. J. Am. Diet. Assoc. 1997; 97: 662–6.

10American Academy of Pediatrics. Policy Statement; Breastfeeding and the use of human milk. Pedicatrics 1997; 100(6): 1035–9.

11KG Dewey , MJ Heinig , LA Nommsen-Rivers . Differences in morbidity between breast-fed and formula-fed infants. J. Pediatr. 1995; 126: 696702.

12PW Howie , JS Forsyth , SA Ogston , Protective effect of breast feeding against infection. BMJ 1990; 300: 11–6.

15M Beaudry , R Dufour , S Marcoux . Relation between infant feeding and infections during the first 6 months of life. J. Pediatr. 1995; 126: 191–7.

17UM Saarinen . Prolonged breast feeding as prophylaxis for recurrent otitis media. Acta. Paediatr. Scand. 1982; 71: 567–71.

20D Montgomery , P Splett . Economic benefit of breast-feeding infants enrolled in WIC. J. Amer. Diet. Ass. 1997; 97: 379–85.

22RP Ford , HM Taylor , EA Mitchell , Breast feeding and the risk of sudden infant death syndrome. Int. J. Epidemiol. 1993; 22: 51–9.

25AE Gordon , AT Saadi , DA Mackenzie , N Molony , VS James DM Weir , A Busuttil , CC Blackwell The protective effect of breast feeding in relation to sudden infant death syndrome (SIDS): III. Detection of IgA antibodies in human milk that bind to bacterial toxins implicated in SIDS. FEMS Immunol. Med. Microbiol. 1999; 25: 175–82.

26PA Newcomb , BE Storer , MP Longnecker , Lactation and a reduced risk of premenopausal breast cancer. N. Engl. J. Med. 1994; 330: 81–7.

27PM Marcus , DD Baird , RC Millikan , PG Moorman , B Qaqish , B Newman . Adolescent reproductive events and subsequent breast cancer risk. Am. J. Public Health 1999; 89(8): 1244–7.

28MO Bernier , G Plu-Bureau , N Bossard , L Ayzac , JC Thalabard . Breastfeeding and the risk of breast cancer: a metaanalysis of published studies. Human Reproduction Update 2000; 6(4): 374.

31HP David . Abortion in Europe 1920–91: a public health perspective. Stud. Fam. Plann. 1992; 0102; 23(1): 122.

32L Kovacs . Abortion and contraceptive practices in eastern Europe. Int. J. Gynaecol. Obstet. 1997; 07; 58(1): 6975.

35R Kries , B Koletzko , T Sauerwald , E Mutius , D Barnert , V Grunert , H Voss . Breast feeding and obesity: cross sectional study. BMJ 1999; 319: 147–50.

36HC Gerstein . Cow's milk exposure and type I diabetes mellitus. A critical overview of the clinical literature. Diabetes Care 1994; 01; 17(1): 13–9.

37LC Harrison , MC Honeyman . Cow's milk and type 1 diabetes: the real debate is about mucosal immune function. Diabetes 1999; 08; 48(8): 1501–7.

38PA McKinney , R Parslow , KA Gurney , GR Law , HJ Bodansky , R Williams . Perinatal and neonatal determinants of childhood type 1 diabetes. A case-control study in Yorkshire, U.K. Diabetes Care 1999; 06; 22(6): 928–32.

39TY Tai , CY Wang , LL Lin , LT Lee , ST Tsai , CJ Chen . A casecontrol study on risk factors for Type 1 diabetes in Taipei city. Diabetes Res. Clin. Pract. 1998; 12; 42(3): 197203.

40GG Dahlquist , C Patterson , G Soltesz . Perinatal risk factors for childhood type I diabetes in Europe: The EURODIAB substudy 2 study group. Diabetes Care 1999; 22(10): 1698–702.

41DJ Pettitt , MR Forman , RL Hanson , WC Knowler , PH Bennett . Breastfeeding and incidence of non-insulin-dependent diabetes mellitus in Pima Indians. Lancet 1997; 07 19; 350(9072): 166–8.

42CG Grulee , HN Sanford . The influence of breast and artificial feeding on infantile eczema. J. Pediatr. 1980; 9: 223–6.

44Y Vandenplas . Myths and facts about breastfeeding: does it prevent later atopic disease? Acta Paediatr. 1997; 86: 1283–7.

46UM Saarinen , M Kajosaari . Breastfeeding as prophylaxis agains atopic disease: prospective follow-up study until 17 years old. Lancet 1995; 346: 1065–9.

47S Halken , A Hoest , LG Hansen , O Østerballe . Effects of an allergy prevention programme on incidence of atopic symptoms in infancy. A prospective study of 159 high-risk infants. Allergy 1992; 47: 545–53.

48S Plancoulaine , MA Charles , L Lafay , M Tauber , N Thibult JM Borys , E Eschwège . Fleurbaix Laventie Ville Santé Study group. Infant-feeding patterns are related to blood cholesterol concentration in prepubertal children aged 5–11 y: The Fleurbaix-Laventie Ville Santé study. Eur. J. Clin. Nutr. 2000; 54: 114–9.

49AJ Ravelli , JHP van der Meulen , C Osmond , DJP Barker , OP Bleker . Infant feeding and adult glucose tolerance, lipid profile, blood pressure and obesity. Arch. Dis. Child 2000; 82: 248–52.

51JA Mennella , GK Beauchamp . Early Flavor Experiences: Research Update. Nutr. Rev. 1998; 07; 56(7): 205–11.

53K Christensson , T Cabrera , E Christensson , K Uvnäs-Moberg , J Winberg . Separation distress call in the human neonate in the absence of maternal body contact. Acta Paediatr. 1995; 84: 468–73.

54AM Widström , V Wahlberg , AS Mathiesen , P Eneroth , K Uvnäs-Moberg , S Werner , J Winberg . Short-term effects of early suckling and touch of the nipple on maternal behaviour. Early Human Develop. 1990; 21: 153–63.

56H Pohl , B Hibbs . Breastfeeding exposure of infants to environmental contaminants – a public health risk assessment viewpoint: chlorinated dibenzo-p-dioxins and chlorinated dibenzofurans Toxicol. Ind. Health 1996; 12(5): 593611.

57H Abadin , B Hibbs , H Pohl . Breastfeeding exposure of infants to environmental contaminants – a public health risk assessment viewpoint: II. Cadmium, lead, mercury. Toxicol. Ind. Health 1997; 13(4): 495517.

58HR Pohl , CA Tylenda . Breastfeeding exposure of infants to selected pesticides: a public health viewpoint. Toxicol. Ind. Health 2000; 16: 6577.

65KF Michaelsen , PS Larsen , BL Thomsen , G Samuelson . The Copenhagen cohort study on infant nutrition and growth: duration of breast feeding and influencing factors. Acta Paediatr. 1994; 83: 565–71.

75A Cattaneo , R Davanzo , L Ronfani . Are data prevalence and duration of breastfeeding reliable? The case of Italy. Acta Paediatr. 2000; 89: 8893.

79AE Ferguson , DM Tappin , RWA Girdwood , R Kennedy , F Cockburn . Breastfeeding in Scotland. BMJ 1994; 308: 824–5

92F Perez-Escamilla , E Pollitt , B Lonnerdal , KG Dewey . Infant feeding policies in maternity wards and their effect on breastfeeding success: An analytical overview. Am. J. Publ. Health 1994; 84: 8997.

93R Saadeh , J Akré . Ten steps to successful breastfeeding: Summary of the Rationale and Scientific Evidence. BIRTH 1996; 23: 154–60.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Public Health Nutrition
  • ISSN: 1368-9800
  • EISSN: 1475-2727
  • URL: /core/journals/public-health-nutrition
Please enter your name
Please enter a valid email address
Who would you like to send this to? *