Gaps and recommendations from First UK Report for World Breastfeeding Trends initiative (WBTi)

26th June 2017

In support of National Breastfeeding Celebration Week (#CelebrateBreastfeeding), a blog by Dr Alison Spiro, Specialist Health Visitor and member of the UK World Breastfeeding Trends Steering Group, on the gaps and recommendations from the  First UK Report for the World Breastfeeding Trends initiative (WBTi).  The iHV is a member of the Core group of the WBTi.

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The First UK Report for the World Breastfeeding Trends initiative (WBTi)

This report was launched in the UK Parliament last November, highlighting the state of breastfeeding and giving a snapshot view of policies and practices across all the four countries.

The WBTi tool is a systematic assessment, conducted through collaboration with key organisations involved in infant and maternal health. It uses a standardised toolkit, developed by the International Baby Food Action Network (IBFAN), based on the Global Strategy for Infant and Young Child Feeding and the Innocenti Declaration.

The ten key indicators cover the national strategy and co-ordination, the Baby Friendly Initiative, the International Code of Marketing of Breastmilk Substitutes, maternity protection in the workplace, healthcare and nutrition systems and health professional training, support for breastfeeding mothers in the community, information support, infant feeding and HIV, infant feeding in emergencies and mechanisms of monitoring and evaluation.

For each indicator, gaps were identified and recommendations made for both the UK as a whole and for all the four devolved countries.

Main findings of the report

The main findings of the report were that Scotland and Northern Ireland scored highly on national strategies and implementation of the Baby Friendly Initiative (BFI), whereas in England and Wales there were no national strategies, or leads, and no mandate or funding for BFI.

No gaps were identified for community support in Scotland and Northern Ireland, whereas England and Wales had uncertainty about future funding for health visiting and peer support programmes and some cuts in services had already been made.

The pre-registration standards for training in infant and young child feeding in several health professions, set by bodies such as the NMC (Nursing and Midwifery Council) and GMC (General Medical Council), showed numerous gaps which could be addressed in future standards. Data collection was found to be inadequate in England and Wales, with the cancellation of the Infant Feeding Survey and limited data available from Public Health England.

Gaps and Recommendations

Recommendations have been made to government agencies to call for commissioners to protect community support services – to enable women, who wish to breastfeed, access to the support they need to achieve their goals.

The main gaps and recommendations are summarised below:

Summary of key gaps

England has no national infant feeding strategy and there is no formal route to communicate or share best practice across the four home nations. The Unicef UK Baby Friendly Initiative is not mandatory in all relevant healthcare settings. The International Code of Marketing of Breastmilk Substitutes and subsequent Resolutions are not fully implemented or enforced. There is no legal requirement for breaks at work for breastfeeding/expressing milk. There is insufficient training of all health professionals in essential infant feeding knowledge and skills. Mothers in some areas lack access to skilled breastfeeding support. Data collection is inadequate.

 

Summary of key recommendations

UK Government to set up a permanent multi-sectoral infant feeding body in England to develop national strategy, and the home nations to have a formal arrangement to share best practice. All governments to achieve and maintain full implementation, with funding, of the Unicef UK Baby Friendly Initiative in all relevant healthcare settings. All governments to fully implement and robustly enforce the International Code of Marketing of Breastmilk Substitutes and subsequent Resolutions. All governments to update legislation to include breaks for breastfeeding/expressing milk and associated facilities in the workplace. All health professional training bodies to set standards for health professionals that meet World Health Organization/Baby Friendly Initiative guidelines. Commissioners throughout the UK to ensure full access to skilled breastfeeding support. All national infant feeding strategies to include the collection of quality data built into health systems.

Dr Alison Spiro,

Specialist Health Visitor and member of the UK World Breastfeeding Trends Steering Group