Abstract:
The promotion of exclusive breastfeeding (EBF) during the first six months of life is a central component of child survival and development strategies due to the indisputable nutritional and immunological benefits of breastmilk (Betran et al., 2001; Black et al., 2008; Jones et al., 2003; Lu and Costello, 2000; Victora et al., 1987, 2008, 2016). Compared to providing infants with breastmilk substitutes in addition to breastmilk (referred to as mixed feeding), EBF is associated with reduced infectious morbidity, diarrhea- and pneumonia-related mortality, and all-cause mortality (Betran et al., 2001; Black et al., 2008). EBF has also been associated with improvements in early cognitive development and intelligence scores during adolescence, demonstrating a dose-response effect of improved cognition with greater breastfeeding duration (Eickmann et al., 2007; Horta et al., 2015; Koh, 2017; Kramer et al., 2008). Given that intelligence is associated with economic productivity in adulthood, early introduction of infant formula may jeopardize both child health in the short term as well as economic well-being over the long term (Rollins et al., 2016)...