During #BreastfeedingCelebrationWeek, the first European report on infant and young child feeding policies and practices was launched yesterday. It compares 18 countries and identifies the considerable improvements they need to make in supporting mothers who want to breastfeed.

The COVID-19 pandemic has shown how important it is for countries to protect their citizens from illness. Babies who are breastfed have better health and resistance to infection, and most mothers want to breastfeed. Yet many European mothers stop or reduce breastfeeding in the early weeks and months, and bottle feeding is prevalent, due to inadequate support from health systems and society.

This new report, Are our babies off to a healthy start?, compares the  implementation of WHO’s Global Strategy for Infant and Young Child Feeding by 18 European countries. The comparisons show clearly that inadequate support and protection for breastfeeding mothers is a Europe-wide problem. The health of babies, mothers and whole populations  loses out as a result. However, countries do differ considerably. Turkey rates highest overall; the five countries with the lowest scores belong to the European Union.

The scope of the assessment is wide-ranging, with ten policy and programme indicators, including national leadership, hospital and community practices, marketing controls on breastmilk substitutes, health professional training, emergency preparedness and monitoring. There are also five feeding practices indicators, such as exclusive breastfeeding for 6 months, a WHO recommendation.

The indicators with the poorest overall scores are national leadership and, shockingly, emergency preparedness, where the UK scored 0/10.

During #WorldBreastfeedingWeek, the iHV is delighted to publish a report from its well-regarded breastfeeding conference held in April with the World Breastfeeding Trends Initiative (WBTi) and Royal Society for Public Health (RSPH).

The Breastfeeding: A Public Health Priority report gives a conference summary and implications for Public Health.

Dr Cheryll Adams CBE, Executive Director iHV, said:

“This highly successful breastfeeding conference included, as speakers, some of the leading researchers in the field, as well as a range of successful local initiatives. We are delighted to be sharing a report from the day.”

Dr Cheryll Adams opening the breastfeeding conference

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Families need joined up and integrated breastfeeding support services throughout their whole feeding journey, according to experts speaking at a conference hosted by the Institute of Health Visiting, Royal Society for Public Health and the World Breastfeeding Trends Initiative UK (WBTi) at the Royal Society for Public Health on 19 April.

However, a new survey by the Institute of almost 800 health visitors found that in the past 2 years 28% reported that their ability to support breastfeeding mothers had decreased, and 28% weren’t confident that other members of their teams, nursery nurses or peer supporters would be able to support mothers when they couldn’t.  This will be in part due to the fact that:

  • 50% of those surveyed reported recent cuts to breastfeeding support groups;
  • 54% reported cuts to breastfeeding support specialist services; and
  • 51% reported cuts to peer support programmes.

When asked what the health visitors felt were the most common reasons why mothers stop breastfeeding before they plan to, of the HVs surveyed:

  • 64% reported it was due to the attitudes amongst people around the breastfeeding mothers;
  • 58% felt that another issue was a lack of professional support;
  • 57% that breastfeeding doesn’t have a high enough national profile;
  • 44% that there is a lack of motivation to continue; and
  • 34% felt there is a lack of partner support.

These issues and more will be explored at this national conference (Breastfeeding: a public health priority) with speakers including: Dr Russell Viner (President of the Royal College of Paediatrics and Child Health) and Dr Natalie Shenker from the Hearts Milk Bank. Professor Amy Brown from Swansea University will also be presenting her latest research on the impact of breastfeeding on maternal mental health.

Dr Cheryll Adams CBE, Executive Director of the Institute of Health Visiting, said:

“Once again we quantify the devastating effects of the cuts to public health budgets which started in 2015. We know that this situation will worsen up until 2020.  Such cuts are so counterproductive to the public’s health.

“Giving every baby the best possible start in life has many benefits for their health throughout the life course.  Breastfeeding is particularly beneficial, as a protective factor for an individual’s future health.”

Shirley Cramer CBE, Chief Executive, RSPH, said:

“Making sure all families have access to the support they need during the critical early stages of a child’s life is an urgent health inequalities issue, yet ongoing cuts to public health budgets are hampering the capacity of health visitors to deliver that support and undermining the public’s health.

“The numerous and well-documented health benefits of breastfeeding, including its role in combatting childhood obesity, mean it is critically important that we strive to improve stubbornly low breastfeeding rates across the UK.

“Breastfeeding can be challenging for many mothers and we must ensure we are proactively working to cultivate an environment and culture where all breastfeeding mothers are fully supported in their communities.”

The WBTi UK report (2016) incorporates the UNICEF UK Baby Friendly standards and recommends:

Integrated services in the community should include:

  • basic health professional training
  • additional social and peer support including the voluntary sector
  • access to specialist lactation support for complex cases
  • Baby Friendly Initiative accredited community settings such as Children’s Centres

Clare Meynell, WBTi Joint Coordinator, said:

“We see health visitors as being the lynchpin of such community support.  However, many mothers need more time and practical “one to one guidance” to get breastfeeding off to a good start.  Every health visiting area should also have an associated trained peer support system to support new mothers through the common ups and downs of life with a new baby.

“In addition, some mothers with complex circumstances will require an access pathway to specialist support, such as a lactation consultant.

“Future families need a warm chain of support services with skilled guidance to support their feeding journey from start to finish. That means all the way through pregnancy, birth, home from hospital, in the community and back to work. All of us have a responsibility to ensure the chain remains unbroken with a wide range of support in place for mothers and babies.”

According to calculations in the Lancet and research by UNICEF UK, stronger integrated breastfeeding support could actually save the NHS over £48 million a year, and result in a boost of billions to the UK economy in increased cognitive ability across the whole population.

Breastfeeding is a public health priority, and an investment in every child’s future. It is essential that effective support services and skills are commissioned and well integrated into existing services, to avoid families falling through the gaps.

Breastfeeding: a public health priority conference takes place in London on 19 April – for more information

Follow the day’s proceedings on Twitter and hashtag #breastfeeding2018

A new report, published today by World Breastfeeding Trends Initiative (WBTi),  reveals that while there are good infant feeding policies and programmes across the UK, these are scattered. In England particularly, leadership is missing, support services have declined in recent years and many more are under threat.

Access to skilled support is too often a postcode lottery, with no national breastfeeding committee or coordinator at all in England (scoring just 1/10). Wales scores poorly on national infant feeding leadership (4/10); whereas Scotland and Northern Ireland score 10/10, with infant feeding and infant health underpinning health programmes.

The first World Breastfeeding Trends Initiative (WBTi) UK Report, on policies and programmes in infant feeding, is being launched in Parliament today (15 November). The report looks at gaps and successes across the UK, measured on an internationally-agreed scale, and provides targeted recommendations for action.

The WBTi UK Working Group consists of nearly 20 organisations, including the Institute of Health Visiting as well as government agencies, health professional bodies, and voluntary groups.

Dr Cheryll Adams CBE, Executive Director, iHV, commented:

“The authors of this amazing piece of work are to be commended for all the work which has gone into it and the understanding it brings on how each country can improve its breastfeeding rates. As they say, this must happen at many levels. The report lays bare the most important actions to take from policy down. I hope that its findings will be picked up by journalists and shared with the wider public who can then also play their part in supporting breastfeeding mothers.”

The recommendations in this report target issues where the UK does not meet internationally-agreed levels, are evidence-based and have broad support, helping policy-makers and commissioners to use resources more effectively.

Action is needed at every level, from communities and local government, in the health system, and at government level. National leadership is essential to drive change sustainably.8  This report is a ‘call to action’ to all our governments and to every level of society.