The UK has some of the worst breastfeeding statistics in the world. Just 1% of women are exclusively breastfeeding to 6 months, as recommended by the NHS. (A breakdown of breastfeeding statistics by babies age is a available in my previous post here.)
“The study, led by experts from the World Health Organisation and Unicef, said that child obesity, diabetes and infections could all be significantly reduced if more mothers could be persuaded to breastfeed.”
The study referenced here is The Lancet series paper Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Daily Mail implies mothers choosing not to breastfeed and that more should be done to persuade them to. This is not suggested in the Lancet series. It is, however, suggested that the number of breastfeeding women needs ‘scaling up’ but this requires multiple actions.
Mike Brady of Baby Milk Action states
“I have spent 20 years at Baby Milk Action working to protect all mothers and I think the suggestion that increasing breastfeeding rates is just a matter of persuasion misunderstands why so many mothers stop breastfeeding early.”
“Around nine in ten mothers who breastfed for less than six weeks said that they would have liked to continue longer.”
“Of the mothers who had stopped breastfeeding by Stage 3 [8 to 10 months old], over three in five (63%) said that they would have liked to have breastfed for longer.”
As an advocate for Breastfeeding I look forward to a time when the majority of women can say they breastfed as long as they wanted. Breastfeeding cannot be forced, of course, but there is a lot more that could be done to help women on their journey.
What can be done to improve breastfeeding figures?
Unfortunately it is becoming increasingly difficult to gain good oversight of the UK’s current infant feeding situation since the government cancelled the 2015 National Infant Feeding Survey. This has now been discontinued. The Department of Health (and the health departments in Northern Ireland and Wales) made the decision to discontinue the survey in an effort to focus resources on providing more up to date, high quality information form electronic care records, in line the government’s information strategy for health and care. Statistics are being made available via NHS England and Public Health England but this data only covers Initiation of Breastfeeding and Breastfeeding at 6-8 weeks. You can follow the development of these statistical analysis here.
It’s difficult to evidence the Daily Mails suggestion that the UK’s low breastfeeding rates could simply be overcome by ‘persuading’ new mothers. The infant feeding survey 2010 states:
“The most common reasons for stopping breastfeeding in the first week were problems with the baby rejecting the breast or not latching on properly (27%), having painful breasts or nipples (22%) and feeling that they had ‘insufficient milk’ (22%). The proportion of mothers citing ‘insufficient milk’ as a reason for stopping breastfeeding increased to a peak of 39% at six weeks to four months, then fell to 23% at six to nine months. This was also the most frequently mentioned reason for stopping breastfeeding overall.”
Thankfully I live in an area with fantastic breastfeeding support. I’ve seen Breastfeeding Support Workers, called Infant Feeding Support Helplines and been to my local NCT Baby Latte group. I’d like to give thanks to my fantastic NCT Mummy friends who have all supported me (and each other) on my breastfeeding journey. I know I wouldn’t have gotten this far without them! Surveys find that mothers who had contact with friends who were breastfeeding, and had local support were more likely feed for longer. The issues raised in the Infant Feeding Survey are all problems that breastfeeding counsellors are trained to address.
Cuts affecting funding for breastfeeding peer support groups, as well as cuts to midwife services and the NHS more widely, are limiting help for new mothers.
Further Breastfeeding Education
In order to do more to improve our low breastfeeding rates in the UK we need to employ a range of strategies. Improved local support is one thing, but explaining to new mothers that breastfeeding is more than just nutrition would really make a difference. The authors of the Lancet paper cited here state:
“Human breastmilk is therefore not only a perfectly adapted nutritional supply for the infant, but probably the most specific personalised medicine that he or she is likely to receive, given at a time when gene expression is being fine-tuned for life. This is an opportunity for health imprinting that should not be missed.”
It was found in 2005 that a third of mothers believed that formula is the same or almost the same as breastfeeding (survey by the Department of Health England.) This is wrong. Authors of the Lancet study state:
“There is a widespread misconception that the benefits of breastfeeding only relate to poor countries. Nothing could be further from the truth.”
Breast milk, a living substance, adapts to the baby’s stage of development, it provides protection against infections which mother and baby are exposed to and contributes to development in ways which are still not fully understood. Formula provides nutrition only.
Low breastfeeding figures are not helped by inaccurate information released by formula companies. Mothers who make a choice to use formula require independent, accurate information. Their right to this information must be protected in order to keep products a safe as possible. Independent reports on formula brands and types are published by First Steps Nutrition Trust along with analysis of company claims.
Nestlé is one brand notorious for advertising false truths in their campaigns. They made a huge attack on the breastfeeding culture in developing nations by introducing mothers to their product Farine Lactée. This attack is covered up in their company history with the term ‘expanded abroad’ . Formula companies often state their products are based on breastfeeding research and try to evidence how they replicate breast milk.
Nestlé has used recent European Food Safety Authority Guidelines as a marketing opportunity to sell their ‘new, improved’ product. All those babies who were fed their previous high protein formula are swiftly forgotten.
Nestles product launch press release:
The European Food Safety Authority (EFSA) recognised that protein intake in infants is in excess of requirements, and recommends a reduction of protein quantity in infant formula and follow-on formula.
SMA nutrition launches its new SMA PRO core range in January 2016
SMA PRO First Infant Milk has a high quality, low quantity protein profile and is the only formula clinically proven to achieve a growth rate comparable with a breastfed baby.
No apology was release by Nestlé for implying the old milk was also comparable to breastmilk – they just continue with the same strategy!
The Lancet study authors comment,
“The fact that the reproductive cycle includes breastfeeding and pregnancy has been largely neglected by medical practice, leading to the assumption that breastmilk can be replaced with artificial products without detrimental consequences.”
Remove Breastfeeding Social Stigma
New mothers are under increasing social pressure to enforce routine on their babies, including getting babies to sleep through the night.
Amy Brown of Swansea University spoke at the British Science Festival and said not enough is being done to support new mothers with breastfeeding. Unfortunately the poor advice to impose a feeding routine, where babies don’t feed frequently, contributed to why many women felt they weren’t producing enough milk and ultimately caused them to abandon breastfeeding.
Brown, a GP and member of the department of public health, policy and social sciences at Swansea University, told the Guardian,
“One of the key things about breastfeeding is that you have to feed the baby very regularly… That’s easily every two hours.”
“We are told by so-called experts that you should get your baby in a feeding routine and your baby should not wake up at nights… But that is really incompatible for breastfeeding. If you try and feed them less, you make less milk. You need to feed at night to make enough milk.”
Elizabeth Duff, senior policy adviser at the National Childbirth Trust, also states that feeding frequently is necessary.
“It is obviously easier for everyone if they begin to sleep more during the night, but if you are fully breastfeeding you will have to feed for at least once and probably two or three times during the night. The daily patterns will come, but it won’t be in the first few days or the very first weeks.”
Duff is aware that mothers are not receiving enough breastfeeding support.
“Understanding a bit about the physiology of breastfeeding can be really helpful…Some women who have not been able to find that information think that the baby isn’t getting very much [milk, but] a couple of teaspoons-worth is probably enough at any one time.”
Brown, who is soon to release her book Breastfeeding Uncovered, said
“The vast majority of women who are having problems, it isn’t really to do with a primary inability to breastfeed, it is to do with their experience,”
She agrees one of the issues facing new mothers is aggressive advertising by formula companies, but also says negative public perceptions of breastfeeding have seen women asked to cover up when feeding.
“Babies have to breastfeed in public – it is called eating,”
Duff agrees that breastfeeding should be welcomed.
“Everywhere should be parent friendly and baby-feeding friendly,”
Brown suggests raising breastfeeding rates could save the NHS millions due to a reduction in common infant infections. Mothers should not be entirely responsible for making this happen.
“The way forward is that we need a complete societal change to how we look at breastfeeding, how we accept it, but also how we accept and value mothering in general,”
In the UK, Baby Milk Action coordinate a project monitoring the baby food industry on behalf of the Baby Feeding Law Group a coalition of leading health professional and mother support organisations. Nestlé is not the only formula company who are aggressively marketing baby foods and targeting health workers to encourage them to endorse company products. You can read more about this here.
The UK is currently being assessed by the World Breastfeeding Trends initiative. Cross-party discussions lead by an All Party Parliamentary Group (APPG) have begun in parliament after a preliminary findings presentation in November last year. (Supporters were asked to contact their local Members of Parliament and request their attendance to initial meetings to ensure cross-party support.)
I’m hopeful that the APPG will help our government carry out changes to remove gaps in the Global Strategy. This in turn should encourage the re-institution of the National Infant Feeding Survey. Policy impact can then be adequately measured and made publicly available.
The full Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect paper is free to access if you want to read the original source of the quotes contained in this post. The authors,
“obtained information about the associations between breastfeeding and outcomes in children or mothers from 28 systematic reviews and meta-analyses, of which 22 were commissioned for this review”.
The more we do to normalise breastfeeding and help educate new mothers to make informed decisions, the more pressure we can put on our government to continue to make proactive steps to improving the UK’s low breast feeding rates. That way, more mums can feel they breastfed for they length of time they wished for!