EVERY year in August, Breastfeeding Week arrives with the same kind of messaging all over the media: ‘breastfeeding is best’. That is where the conversation begins and ends. This year, the World Alliance for Breastfeeding Action, alongside Unicef and the WHO, has deliberately questioned the math behind it all, instead of general awareness. The 2026 theme is ‘Breastfeeding for a sustainable start in life: strengthen what works’. This signifies that the world does not lack knowledge of the subject; however, it has an issue putting the money where the mouth is. Pakistan’s experience is no different.

The interventions that move exclusive breastfeeding rates are well tested and documented. The question is why we are not making use of them. The biggest issue in Pakistan in this regard is the gap in counselling and access to accurate information regarding breastfeeding. A systematic analysis across 16 studies found that skilled counselling on infant feeding raises exclusive breastfeeding rates by 58 per cent.

Pakistan already has a delivery mechanism for such counselling in place. It is not new or untested, and it has a wide enough net to address the challenge of low breastfeeding rates across the nation. The numbers presented publicly are unreliable and badly skewed (‘ever breastfed in any form or quantity’ shown as ‘breastfeeding rates’ etc, and almost no consistent or reliable year-on-year data tracking the journey the country is taking in this regard). This delivery system is our Lady Health Workers’ network. While it is a system with fantastic bones it is terribly understaffed and underfunded. As a result, it is not even monitored effectively. LHWs don’t need a pilot programme; in order to deliver, we need to pay for more workers and train the ones already active in the field.

Unicef’s Baby Friendly Hospital Initiative (BFHI) is supported by an evidence base, which shows that, once implemented effectively, breastfeeding rates at six months rise by around 45pc, while continued breastfeeding increases by 26pc. We can use those numbers. There was some work back in the 1990s in Sindh, led by Dr Noorjahan Samad, and verified hospitals saw improvement in breastfeeding rates. However, over time, those certifications stopped being renewed.

Breastfeeding support should be a part of NDMA’s response protocol.

Pakistan’s 2022 floods displaced millions of people and disrupted clean water access across acres. These are precisely the conditions in which formula feeding becomes exceptionally dangerous, as it requires clean water and frequent sterilisation — something that camps for the displaced cannot actually provide. Breastfeeding, on the other hand, does not need a supply chain or an external infrastructure like clean water or electricity. It remains in the most literal sense the absolute resilient infrastructure. Yet, breastfeeding support is rarely built into Pakistan’s disaster-response planning as a formal component — it is more of an afterthought voiced by a few activist circles.

With climate volatility now a regular feature of Pakistani summers, formalising accurate and useful lactation support should be an integral part of the National Disaster Management Authority’s standard response protocol. It must specifically include placing trained and accessible counsellors across the floodplains, creating safe spaces for mothers to discuss and find solutions to breastfeeding issues instead of jumping to formula at the first hurdle or the perception of one, and ensuring protection from needless formula-pushing by healthcare providers and the market.

Most of these actions should be taken before a calamity as we cannot possibly establish or initiate breastfeeding journeys in the midst of disaster — the cost and logistics of which aren’t supported by the cir­­­-

cumstances of that moment. In the years betw­een floods and climate calamities, we need to work tirelessly to build breastfeeding capacity in populations most susceptible to displacement on account of climate change, so that when disaster does strike, we only need to ensure that the general health of the mother and child is taken care of.

None of these suggestions require new groundwork. LHWs, BFHI, disaster response planning — we have the bones for all these areas. What is missing is the unphotogenic, unglamorous backend work of funding, monitoring, evaluation and implementation of each of these areas that will actually ‘strengthen what works’. That’s a harder story to tell than ‘breastfeeding is best for babies’ as part of the photo ops this week, but it is one that this year’s theme truly demands.

The writer works as a finance professional. Motivated by personal breastfeeding challenges, she transitioned to healthcare. She is an IBCLC and trains healthcare professionals, provides global telehealth support and runs a lactation clinic.

Published in Dawn, August 5th, 2026