Hi Daniel,

It's complicated and it is always a battle to advocate for the rights of women and children in relation to breastfeeding. As outlined in the article you share, policy makers often do not understand breastfeeding and so it is not appropriately accounted for. The situation in the US is particularly bad as they have no requirement that women have paid maternity leave (the only OECD country) and they have not ratified the UN Convention on the Rights of the Child. Other countries also do poorly in many respects, and breastfeeding in public remains a barrier in many places alongside cultural expectation to formula feed partially or fully from early in an infant's life. Strong legislation protecting women and infants from predatory marketing is also absent in virtually all wealthy countries (in fact I can't think of a single high income country that has adequate legislation in this regard). There are some things that are being done to try to make things better. The WBTi policy assessment program is putting pressure on governments to implement better policies- in Australia where I live, it has been very helpful. We need to be careful though about export of poor policy or practices that undermine breastfeeding advocacy or support for breastfeeding women being exported from high income countries to elsewhere. This was a big problem during the COVID-19 pandemic- some colleagues and myself conducted some research that documented how guidance from the US undermined international efforts to support breastfeeding during COVID-19. This research can be read here https://nutrition.bmj.com/content/3/2/339
More recently, myself and others have been concerned about cultural exporting of desexing language around maternity (avoiding using the words 'women' 'mothers'  'maternity' etc) from places like the US and other high income countries will reduce capacity to advocate for breastfeeding. Just recently I saw a style guide from a UN organisation which said that we should no longer refer to 'maternity leave' but 'parental leave'. I question how we can advocate for workplace maternity protections if we cannot clearly specify what we are advocating for. A paper that I wrote with some others on this can be read here https://www.frontiersin.org/articles/10.3389/fgwh.2022.818856/full

I think that we need to ensure that people who are outside of wealthy countries are able to be more influential in policy and advocacy. Part of that would mean providing avenues for involvement in languages other than English. It would also mean moving more meetings outside of the time zones that suit Europe and the US and having more meetings outside of the US and Europe. And influential organisations based in wealthy counrties need to more carefully consider how they operate in the international sphere.

Karleen