Overview
- For term, healthy infants, the guideline advises exclusive or predominant breastfeeding until the completed sixth month and a total duration of at least 12 months, with WHO also supporting continuation up to two years or beyond.
- The S3 classification denotes Germany’s highest guideline tier and the country’s first on breastfeeding duration, intended to standardize advice across maternity and pediatric care.
- Recommendations are based on observational studies linking longer breastfeeding with lower risks of middle‑ear and gastrointestinal infections, asthma, and possibly some inflammatory bowel diseases, while evidence on overweight and obesity remains inconsistent.
- Authors stress that the evidence shows associations rather than causation and that counseling should avoid stigma or pressure regarding breastfeeding, weaning, or timing of complementary foods.
- Recent data highlight an implementation gap: only 13% of infants were exclusively breastfed to six months in KiGGS 2014–2017, 69% were exclusively fed with breast milk at discharge in 2023 perinatal data, and breastfeeding duration varies by maternal education.