Development and Results of the German National Strategy for the Promotion of Breastfeeding: a participatory process

Anna-Kristin Brettschneider^1*Jana Steindl¹Beate Matthes-Bolz²Iris Lehmann³Jennifer Hilger-Kolb⁴Elena Roskosch¹Gabriele Strauß¹Mariell Hoffmann¹Regina Ensenauer¹

• ¹Department of Child Nutrition, Max Rubner-Institut (MRI) - Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
• ²Press an Public Relation, Max Rubner-Institut (MRI) - Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
• ³Press and Public Relation, Max Rubner-Institut (MRI) - Federal Research Institute of Nutrition and Food, Karlsruhe, Germany
• ⁴NAKO e.V, Heidelberg, Baden-Württemberg, Germany

Breast milk is the optimal nutrition for infants. However, the proportion of mothers who exclusively breastfeed their children in Germany is low (40 % end of 4th month; 13 % end of 6th month). A recent systematic evaluation of breastfeeding promotion has ranked Germany as moderately breastfeeding-friendly. Therefore, the federal government has commissioned the recently founded Department of Child Nutrition at the Max Rubner-Institut to coordinate the interdisciplinary development and implementation of a German National Strategy for the Promotion of Breastfeeding. In a participatory process, over 150 stakeholders have conceptualized measures to promote breastfeeding in seven strategic fields: 1) "Evidence-based guidelines", 2) "Basic/advanced training and continued professional development", 3) "Prevention and healthcare structures", 4) "Breastfeeding promotion by municipalities", 5) "Breastfeeding in the workplace", 6) "Marketing of breast-milk substitutes", and 7) "Systematic breastfeeding monitoring". Measures include e. g. the development of an evidence-based medical guideline for breastfeeding duration and interventions to promote breastfeeding as a basis for education and training for involved occupational groups. Another measure is to establish At the Department of Child Nutrition, a new research field at the Department of Child Nutrition was established to develop a systematic breastfeeding monitoring system. Other Additional measures concern the development of more breastfeeding-friendly framework conditions in healthcare structures, municipalities, and in the workplace, as well as regulations for the marketing of breast-milk substitutes and the development of communication strategies to promote breastfeeding. Following the adoption by the Federal Cabinet, the strategy serves as the basis for a sustainable improvement of breastfeeding promotion in Germany.