Despite looks, Switzerland does not provide a very suitable environment for breastfeeding, with very limited implementation of the International Code and societal support that needs to be improved for breastfeeding mothers.
Therefore, she offers a low level of protection for younger consumers and their parents against the strong promotion of breastmilk substitutes, bottles and teats. It also guarantees maternity protection (in French), which is certainly available but low compared to northern European countries showing higher breastfeeding rates. There is considerable risk of conflicts of interest and the training of health professionals remains inadequate.
Switzerland, contrarily to other European countries, and to the recommendations of the Global Strategy for Infant and Young Child Feeding adopted by the World Health Assembly in 2002, has not developed a coherent strategy for the protection, promotion, and support of breastfeeding. Few resources (Fr.) are available to finance projects for the protection, promotion and support of breastfeeding at the national and cantonal levels.
Although breastfeeding rates have increased in Switzerland over the past 20 years, Switzerland can do a better job of protecting its youngest consumers and enabling them, according to Article 24 of the Convention on the Rights of the Child, General Comments 15 and 16, to reach the highest possible level of health.
According to UNICEF Switzerland (in German), which is responsible for the Baby-Friendly Hospital Initiative (BFHI), Switzerland is a leader in Europe for the promotion of breastfeeding, since nearly half of all babies born in Switzerland nowadays are born in certified facilities. However, World Health Organization (WHO) guidelines are far from being satisfactorily applied since only 14% of infants are exclusively breastfed until the end of the 6th month and the average duration of breastfeeding is only 31 weeks according to the SWIFS Swiss Infant Feeding Study of 2003. The SWIFS of 2014 is similar.
The Swiss Health Survey 2012 breastfeeding indicator (link unavailable today) showed that almost 90% of women breastfed their latest child, and more than half of them breastfed for more than three months; however, between 2002 and 2007, the proportion of mothers who did not breastfeed hardly changed. In contrast, the number of mothers who breastfed for more than three months was higher in 2007.
More recent data on the implementation of WHO recommendations (introduction of breastfeeding within one hour of birth, exclusive breastfeeding for 6 months, and continued breastfeeding for 2 years or more) are unfortunately not available for Switzerland (link unavailable today) (UNICEF State of the World’s Children Report). Moreover, national breastfeeding recommendations are not always aligned with WHO recommendations.
While the Swiss Foundation for the Promotion of Breastfeeding and the Federal Office of Public Health (in French) clearly refer to the WHO recommendations, the position of the Swiss Paediatric Society (Fr.) is confusing, since it recommends the introduction of breastfeeding within 2 or 3 hours after birth, which contradicts the WHO standards. The Nutrition Commission of the same Swiss Paediatrics Society, however, stipulates that « the WHO recommendations may also apply in Switzerland (Fr.), but with the restriction that the introduction of complementary foods is possible at the individual level and, in certain situations, reasonable from the fifth month of life at the earliest ». The introduction of solids at 4 months (or from the 5th month), also recommended by the Swiss Society of Nutrition, is however also contrary to WHO public health recommendations (at 6 months, or from the 7th month).
Finally, in Switzerland, it is rarely mentioned that breastfeeding should be supported beyond the age of 2 years (a WHO recommendation). The recommendation to continue breastfeeding after introduction of complementary foods and until and beyond the child is 2 years old, is still controversial.
With regard to the protection of non-breastfed children, Switzerland has not adopted the 2007 WHO and FAO Guidelines on the safe preparation, storage and handling of powdered infant formula. On the contrary, the Swiss Paediatric Society, while referring to the WHO, advises to « heat the water to >70 degrees C, let it cool down before preparing the artificial milk bottle, and give it to the baby at body temperature (Paediatrica 2013) ». This differs completely from the actual WHO recommendations, which instead require that the preparation (mixing powder – water) be carried out at a temperature above 70 degrees C, then allowed to cool before consumption – this to protect against infections due to the presence of bacteria in the milk powder, which is not sterile (Fr.).
It must be noted that the protection, promotion and support of optimal breastfeeding practices is not yet a reality in Switzerland today (Fr.). For mothers and the general public, messages remain contradictory, and Switzerland is not among the countries offering a supportive environment for optimal breastfeeding practices. For mothers, and parents, who always do their best for their children, the feeling of guilt often prevails, and yet, who is responsible?
The WBTi (World Breastfeeding Trends Initiative) approach, which audits breastfeeding programmes and policies in each country, was launched in September 2018 in Switzerland. Since 2005, more than 100 countries are in the WBTi process, European countries started in 2015. The WBTi Reports have been published for Germany, Belgium, France, the United Kingdom, Switzerland and many more.
- List of publications related to Switzerland (Fr.)
- Recommendations on nutrition during pregnancy and breastfeeding: good foundations for the lives of the very young ones (link unavailable), FOPH 2008
- Nutrition during pregnancy and breastfeeding, (Fr.) FOPH 2008
- Recommendations for infant feeding 2017, (Fr.) Swiss Paediatric Society SSP 2017
- IBFAN-GIFA Analysis of SSP 2017 Recommendations (Document on request)
- Why is it important to exclusively breastfeed for 6 months, even in Europe and even in 2020? (GIFA Document on request)