BACKGROUND Despite scientific evidence substantiating the importance of breastfeeding in child survival and development and its economic benefits, assessments show gaps in many countries' implementation of the 2003 WHO and UNICEF Global Strategy for Infant and Young Child Feeding (Global Strategy). Optimal breastfeeding is a particular example: initiation of breastfeeding within the first hour of birth, exclusive breastfeeding for the first six months; and continued breastfeeding for two years or more, together with safe, adequate, appropriate, responsive complementary feeding starting in the sixth month. While the understanding of "optimal" may vary among countries, there is a need for governments to facilitate an enabling environment for women to achieve optimal breastfeeding. Lack of financial resources for key programs is a major impediment, making economic perspectives important for implementation. Globally, while achieving optimal breastfeeding could prevent more than 800,000 under five deaths annually, in 2013, US58billionwasspentoncommercialbabyfoodincludingmilkformula.Supportforimprovedbreastfeedingisinadequatelyprioritizedbypolicyandpracticeinternationally.METHODSTheWorldBreastfeedingCostingInitiative(WBCi)launchedin2013,attemptstodeterminethefinancialinvestmentthatisnecessarytoimplementtheGlobalStrategy,andtointroduceatooltoestimatethecostsforindividualcountries.ThearticlepresentsdetailedcostestimatesforimplementingtheGlobalStrategy,andoutlinestheWBCiFinancialPlanningTool.EstimatesusedemographicdatafromUNICEF′sStateoftheWorld′sChildren2013.RESULTSTheWBCitakesaprogrammaticapproachtoscalingupinterventions,includingpolicyandplanning,healthandnutritioncaresystems,communityservicesandmothersupport,mediapromotion,maternityprotection,WHOInternationalCodeofMarketingofBreastmilkSubstitutesimplementation,monitoringandresearch,foroptimalbreastfeedingpractices.ThefinancialcostofaprogramtoimplementtheGlobalStrategyin214countriesisestimatedatUS17.5 billion ($130 per live birth). The major recurring cost is maternity entitlements. CONCLUSIONS WBCi is a policy advocacy initiative to encourage integrated actions that enable breastfeeding. WBCi will help countries plan and prioritize actions and budget them accurately. International agencies and donors can also use the tool to calculate or track investments in breastfeeding.The project was possible
through financial support from SAFANSI (South Asia Food and Nutrition
Security Initiative) project and a contribution by DFID (Department for
International Development) and AusAID (Australian Agency for International
Development)