On a global basis, WHO and UNICEF recommend exclusive breastfeeding for the first six months of babies’ lives, and in combination with other food and drinks for up to two years and beyond. In Europe, introduction of complementary feeding at the age of about 4-6 months is recommended along with breastfeeding, because this was shown to reduce the risk of developing food allergies (1) while there is no appreciable risk increase of infectious disease morbidity in Europe associated with introducing complementary feeding prior to the age of 6 months. Breastfeeding has shown to have huge public health benefits for both children and mothers. However, the WHO European region has some of the lowest breastfeeding rates when compared to other parts of the world [2].

Protecting and promoting breastfeeding is a public health priority. Increasing breastfeeding rates to a near universal level may prevent 823 000 annual deaths in children younger than 5 years in low- and medium income countries with a high burden of infant diarrhoea and respiratory infections, and 20 000 annual deaths from breast cancer [3]. Paediatricians and healthcare professionals working with mothers and babies have an important role and responsibility in promoting, protecting and supporting breastfeeding.

Breastfeeding is not always the norm in many countries. This is due to many reasons at different levels, which include cultural attitudes and values, different healthcare policies, women working conditions and parental leave. The best breastfeeding outcomes are achieved when many interventions are implemented through multiple channels [4,5]. Even if improving staff training and knowledge on its own might not sufficiently improve breastfeeding rates [6], education and training of healthcare professionals is one crucial component in breastfeeding support strategies. Implementation of the 10 Ten Steps to Successful Breastfeeding in maternity wards was been shown to effectively improve breastfeeding outcomes [7]. The Baby-Friendly Hospital Initiative (BFHI) promotes implementation of the Ten Steps in maternity and newborn services [8]. Step 2 states: ‘Ensure that staff have sufficient knowledge, competence and skills to support breastfeeding’ while Step 5 states: ‘Support mothers to initiate and maintain breastfeeding and manage common difficulties.’ This will include checking position, latch and suckling, giving practical breastfeeding support and help mothers with breastfeeding problems [8]. BFHI certification are scattered across Europe. Only around 35% of births in the WHO European Region occur in BFHI-certified services; however, there are large differences between countries, with one third of countries in the WHO European region having no BFHI-certified facilities [2].

It is commonly reported by mothers that doctors may give contradictory advice about breastfeeding which creates confusion and undermines mothers’ confidence in persevering when they face difficulties[9,10]. Various studies have revealed inadequacies in breastfeeding education during paediatric training and have shown the efficacy of breastfeeding training in improving physician knowledge and confidence in providing care for breastfed babies and their mothers [9–13]. Interestingly, a targeted breastfeeding curriculum for paediatric, family medicine and obs&gynae trainees in US also improved rates of infants exclusively breastfeeding in the institutions where the intervention was implemented[11].