In the developing world, breastfeeding is nearly univeral, with most children being breastfed for some time. Even after 6 months of age when food supplementation becomes necessary many mothers continue to breastfeed, often until their child is two years old.

However, evidence indicates that in these countries exclusive breastfeeding during the first 6 months is rare and early supplementation with water, or other fluids, is the norm. According to UNICEF’s statistics, less than 40 per cent of infants under 6 months old are exclusively breastfed. This rate is particularly low in Africa.

In developing countries, most children who are not exclusively breastfed do not receive infant formula, but rather dangerous substitutes, including water, water-based liquids, or unadapted whole cow’s milk. These are inappropriate substitutes because they lack the required nutritional content and balance to satisfy a baby’s development and growth. In addition, food supplementation often starts very early.

The use of inadequate breast-milk substitutes may lead to stunting, underweight or wasting and increases infant mortality. Infant feeding practices account to a large extent for the high rates of malnutrition among children in developing countries.

Although exclusive breastfeeding rates have been increasing in Africa and Asia over the past 10 to 15 years, UNICEF’s statistics show the necessity to continue to educate mothers about the importance of exclusive breastfeeding during the 6 first months of age and the introduction of appropriate and nutritious complementary food thereafter.