Breastfeeding against climate change: linking infant nutrition and environmental sustainability – a narrative review

BackgroundClimate change is a growing threat to human health, yet infant feeding is rarely included in sustainability discussions. Breastfeeding (BF) and commercial milk formula (CMF) have very different environmental and health impacts. Since infant nutrition is linked to planetary health, paediatricians can help promote feeding practices that support both child health and environmental goals.MethodsWe conducted a narrative review of scientific literature and international reports to summarize evidence on the environmental impacts of CMF production and consumption, the sustainability advantages of BF, and the barriers that influence feeding choices.ResultsBF is the most sustainable first-food system, requiring no industrial processing, packaging, or transport and producing minimal waste, whereas CMF is resource-intensive. Life cycle assessments show that CMF has higher environmental impacts than BF in areas such as global warming potential, land use, and water eutrophication, mainly due to dairy production. CMF manufacture also contributes to antimicrobial resistance and biodiversity loss. Social and workplace barriers, including limited parental leave, inadequate lactation support, and CMF marketing, reduce BF rates.ConclusionsSupporting BF within climate and health policies can not only improve maternal and child outcomes but also contribute to planetary health.Impact QuestionsThe article shows that breastfeeding, beyond its clinical benefits, represents a substantially more sustainable first-food system than commercial milk formula and should be regarded as a meaningful climate-mitigation strategy.The review integrates and updates life-cycle evidence on the environmental footprint of commercial milk formula (carbon, water, land, and waste) highlighting the persistent exclusion of breastfeeding from climate-policy frameworks.By reframing breastfeeding as a climate-relevant intervention, the article supports its incorporation into environmental and public health strategies with the potential for significant resource conservation and emission reduction.