August 26, 2025
ISLAMABAD – For Pakistan, the stakes are high. Failing to support breastfeeding not only compromises child health and development but also limits women’s economic participation and perpetuates gender inequality.
“During my shift, there is nowhere to breastfeed and no extra time during breaks,“ said a lactating mother employed in the retail sector. “By the time I get home, my baby is crying with hunger. I have no choice but to leave her with a milk bottle, which breaks my heart.”
Her words echo in factories, offices, and classrooms across Pakistan, where mothers are often forced to choose between their newborn’s nutrition — crucial in the early months — and maintaining a livelihood.
The reality is stark: only 48 per cent of infants under six months in the country are exclusively breastfed, far below the global target of at least 70pc. According to Unicef, this shortfall is directly linked to high rates of stunting (low height for their age, resulting from chronic poor nutrition, repeated infections, and inadequate care, particularly during the first 1,000 days of life), 37pc, and wasting (a severe form of malnutrition where a child is dangerously thin for their height, indicating recent and severe weight loss), 7pc, among Pakistani children under the age of five.
While the benefits of breastfeeding — from protecting children against infections to lowering mothers’ risk of cancer and diabetes — are well-documented, it seems that Pakistan’s workplace culture is either unaware of them or has turned a blind eye toward them.
The tough choice
Many women, struggling to balance motherhood and a career, return to work within weeks of childbirth. Maternity leave — up to 180 days under the Maternity and Paternity Leave Act, 2023 — is often too short or unpaid. The situation only gets worse; lactation rooms are rare, and daycare facilities are barely functional.
“There is no clean space to feed or pump, and if I ask for extra time, they cut my wages,” said a mother who works at a garment factory in Karachi.
For those in leadership roles, the struggle takes a different shape.
“I wanted to set up a breastfeeding space for one of my female team members, but when I raised the idea before management, it wasn’t supported,“ shared a Karachi-based woman, employed at a non-profit organisation. “I didn’t push further due to the fear of losing my position.”
In these circumstances, some mothers are even forced to simply quit the labour force altogether because it fails to accommodate them.
“When my baby was born, I had to choose between going back to work or staying home to breastfeed him. I chose my baby, and I am not sure if I will ever return — but I know this choice gives me peace,” said another new mother.
A missed opportunity
These choices, as personal as they may look from afar, have significant economic implications for Pakistan, the key amongst them being the declining female labour force participation (FLPR) in the country, which currently stands at a meagre 24pc — the lowest in South Asia. The FLPR in Bangladesh stands at 44pc, while in India it is 33pc.
Among women who continue to work, only 16pc are formally employed; the rest, in the informal sector, have no maternity protection.
According to data compiled by the World Bank, industry employs 15pc of women, while 19pc work in services of the employed women; the remaining 66pc are employed in the agriculture sector.
This gap between women’s participation in the workforce and the growth of industries and services is a missed opportunity for economic expansion.
What is vs what should be
Over the past two decades, Pakistan has made legislative strides when it comes to breastfeeding rights. Case in point: The Protection of Breast-feeding and Child Nutrition Ordinance, 2002, which set the foundation for protecting breastfeeding mothers and regulating the marketing of breast milk substitutes.
Legislation at the provincial level — the Khyber Pakhtunkhwa Protection of Breast-Feeding and Child Nutrition Act (2015), the Balochistan Protection and Promotion of Breastfeeding and Child Nutrition Bill (2014), and the most recent Sindh Protection and Promotion of Breast-Feeding and Young Child Nutrition Act (2023) — has also expanded these protections.
The law in Sindh mandates the establishment of an Infant and Young Child Nutrition Board, bans aggressive marketing of breast milk substitutes, restricts their sale to pharmacies with a doctor’s prescription, and prohibits public advertising for children up to 36 months. It is aligned with recommendations by the World Health Organisation and Unicef.
Yet, business councils have challenged the restrictions, and enforcement remains uncertain.
Maternity leave is now enshrined in the Maternity and Paternity Leave Act (2023), which grants maternity and paternity leave to working parents. However, the reality is that many private employers either ignore the law or circumvent it by keeping women on short-term contracts.
Even in regulated urban sectors like banks and financial institutions, such arrangements for women employees are often absent. On the other hand, for women employed in the informal sector, these legal protections are almost meaningless without efficient enforcement mechanisms.
While initiatives such as the Baby-Friendly Hospital Initiative (BFHI) are proven to improve breastfeeding outcomes worldwide, Pakistan has yet to integrate these standards into its hospital accreditation system. Some facilities have partially implemented these standards, but nationwide scaling — and embedding compliance into hospital licensing — would ensure early initiation of breastfeeding, rooming-in, and elimination of pre-lacteal feeds.
Bridging the gap
What is equally critical is community-level support.
Lady health workers (LHWs), midwives, and peer counsellors are trusted channels for providing breastfeeding counselling. Yet, no structured, nationwide home-based breastfeeding support programme has been documented.
Flexible clinic hours and mobile health teams could bridge the gap for breastfeeding mothers.
The Mamta programme in Sindh is one such initiative that offers a promising model. Designed to provide conditional cash transfers to over 1.3 million pregnant and lactating women over five years, it links financial incentives to antenatal visits, institutional deliveries, and breastfeeding practices.
By addressing both economic and health barriers, such programmes can improve outcomes, but only if coupled with nutrition education, micronutrient supplements, and consistent supply chains.
But beyond policy gaps, it is the cultural attitudes toward breastfeeding that pose a big challenge. Taboos against breastfeeding in public or at work discourage women from continuing their jobs once they return to employment.
“I attend classes with my newborn at home,“ said a PhD student. “I can barely concentrate during the lectures because my mind is on whether my baby has been fed or not. I feel like I am compromising her health for my education.”
The stakes are high
Moreover, during emergencies such as floods, ensuring safe breastfeeding is critical to child survival, yet disaster response plans often fail to include infant and young child feeding (IYCF) protocols. Shelters in flood-affected areas often breach women’s privacy, forcing them to breastfeed in crowded, exposed spaces, which causes mental strain and, for some, leads to early cessation.
Mother-baby friendly spaces in shelters, staffed by trained responders, are therefore essential for protecting breastfeeding moms during disasters.
National nutrition assessments often lump women and children into broad categories, overlooking the specific barriers faced by women in paid employment. This lack of disaggregated data means that nutrition policies rarely address structural constraints such as workplace inflexibility, lack of childcare, and mobility restrictions.
Collecting and analysing breastfeeding data by employment status, maternal education, and service access could enable more targeted interventions. Budget allocations for infant and young child feeding programmes remain insufficient, particularly in high-burden provinces such as Sindh and Balochistan. Protecting and increasing these budgets through child-responsive budgeting could ensure sustained investment in early childhood nutrition.
There is a need for realisation that breastfeeding must be treated as a workplace right, not a privilege. This means enforcing maternity leave in line with standards outlined by the International Labour Organisation, mandating functional breastfeeding spaces, integrating maternal and child health into labour inspections, and educating employers on the economic returns of supporting working mothers.
For Pakistan, the stakes are high. Failing to support breastfeeding not only compromises child health and development but also limits women’s economic participation and perpetuates gender inequality.
The author teaches economics and is the Director of the Center for Business and Economic Research at the Institute of Business Administration, Karachi.