It is widely recognized that breastfeeding carries huge health benefits, but countries' failure to crack down on the marketing of substitutes means far too many children are still being reared on formula, said the Geneva-based World Health Organization (WHO), the UN children's agency Unicef and the International Baby Food Action Network (IBFAN).
“There are still far too many places where mothers are inundated with incorrect and biased information through advertising and unsubstantiated health claims,” warned Francesco Branca, head of WHO's Nutrition for Health and Development department.
“This can distort parents' perceptions and undermine their confidence in breastfeeding, with the result that far too many children miss out on its many benefits,” he said in a statement.
Experts have long extolled the health benefits of breastfeeding, pointing out that breastfed children are healthier, perform better on intelligence tests and are less likely to be overweight or suffer from diabetes later in life.
Women who breastfeed also have a reduced risk of breast and ovarian cancer, research shows.
A study in the Lancet medical journal earlier this year estimated that more than 800,000 child deaths and 20,000 breast cancer deaths could be averted every year if more babies were breastfed for longer.
WHO and Unicef recommend babies have nothing but breast milk for the first six months, after which they should continue to breastfeed alongside other safe and nutritionally-adequate foods until they are at least two.
But in spite of the clear advantages, only about one child in three is exclusively breastfed for the first half year of life, a rate that has not improved in two decades.
Countries have agreed to try to push that number up to at least 50 percent by 2025, but pressure from a growing breast-milk substitute industry is complicating those efforts.
The industry today rakes in sales of nearly $45 billion annually, a figure which is projected to grow to $70 billion by 2019.
Of the 194 countries studied, 135 had some form of legal measures linked to the WHO's International Code of Marketing of Breast-Milk Substitutes.
That was a clear improvement from 103 countries in 2011, but the report showed only 39 of them covered all the Code's recommendations, including banning all advertising and sample hand-outs of breast-milk substitutes, bans on labels making nutritional or health claims and requiring products to inform consumers of the superiority of breastfeeding over formula.
'Fudging the truth'
And the world's wealthiest countries, which are often the most business-friendly, tend to have the weakest legislation.
Only six percent of European countries provide comprehensive legislation and most have just a few laws.
The United States, Australia and New Zealand meanwhile had no legal measures at all, the report said.
At the other end of the scale, a full 36 percent of countries in Southeast Asia had laws covering all the recommendations in the Code, followed by Africa at 30 percent and the Eastern Mediterranean region at 29 percent, the report showed.
“Clever marketing should not be allowed to fudge the truth that there is no equal substitute for a mother's own milk,” Unicef nutrition chief Werner Schultink said in the statement.