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Breastfeeding Rates in Iran: Why Is There Such a Large Gap Between Iran and Other Countries?

Breastfeeding has been recognized worldwide as being beneficial for both mother and child. According to the World Health Organization guidelines, the recommended feeding practice for infants is exclusive breastfeeding for 6 months. Breastfeeding rates in the Islamic Republic of Iran are among the highest in the world. In Iran, 86% and 83% of the infants are fully breastfed at 3 and 6 months, respectively. In the last 25 years, the increase in breastfeeding rates in Iran was attributable to Iranian government’s strategy to strongly combat bottle-feeding. The government had limited the import of formula into the country and it was not available for sale to the public. Although health care practitioners were providing more support for breastfeeding and the provision of flexible work hours and paid maternity leave increased the ability of employed mothers to feed their infants, formula was rather expensive and was only prescribed by physicians and could be purchased by formula coupons in pharmacies or on the black market! Indeed, there was no mother’s decision or interest in freedom of choice regarding breastfeeding and bottle-feeding in Iran. Currently, infant formula can more readily be purchased by Iranian families and it is prescribed by pediatricians in private clinics. However, health care providers in public health centers do not prescribe formula unless the growing infant experiences at least 2 repeated growth problems judged by their growth monitoring chart. This is especially true for rural areas where infants are visited by public health care providers and formula is distributed by the health system in extreme cases only. It is known that exclusive breastfeeding is not a traditionally recognized practice and is a very complex process and its duration is dependent on many environmental, socioeconomic, and cultural factors. In Islamic countries such as Iran, the legislation is derived from the Quran. The Holy Quran says that the mothers shall suckle their babies for 24 months. However, the Holy Quran explicitly says that mother and father may decide on the feeding method of their infants themselves. In Saudi Arabia, an Islamic country, for example, 48.4% of infants were exclusively bottle-fed at 6 months. So, while the Holy Quran advises on breastfeeding, it respects the parents’ freedom of choice. However, the Iranian government has overtly ignored the mother and father’s right to choose the feeding method of their infants beyond educating them about breastfeeding benefits and establishing breastfeeding facilities. Meanwhile, the Iranian Ministry of Health was appreciated by international organizations for its national programs for promoting breastfeeding. Whether these international organizations advise other countries to adapt such national programs for promotion of breastfeeding remains an unanswered question.