The UNICEF UK Baby Friendly Initiative Briefing Paper 2009

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Why don’t more women breastfeed? In the UK, 84 per cent of mothers say they are aware of the health benefits of breastfeeding and 9 out of 10 women who stop breastfeeding their child before six weeks say that they would have liked to have breastfed for longer. Despite this, only three-quarters of UK babies are breastfed at birth and just 1 in 4 still receives any breastmilk at six months 22 . Poverty and background Even though breastfeeding is the cheapest way to feed an infant, it is the poorest mothers who are least likely to breastfeed. Poor white women are the group least likely to breastfeed in the UK, while women in professional and managerial occupations, highly educated women and those aged 30 or over are most likely to breastfeed. At six months mothers aged 35 or over were more than five times as likely to be breastfeeding compared with mothers aged under 20 23 . Cultural background also plays its part. By the time their child is six months old, 23 per cent of white mothers are still breastfeeding compared with 37 per cent of Asian mothers and 57 per cent of black mothers 24 . Returning to work Research shows that returning to work when their child reaches six months is one of the reasons that women give for stopping breastfeeding. The number of women who stop breastfeeding because of returning to work decreased between 2000 and 2005, which indicates that extended maternity leave entitlement is having a positive impact on breastfeeding duration rates 25 . Whilst UNICEF UK welcomes this positive development, maternity leave in the UK is not meeting the standard set out in UNICEF’s Report Card 8 on early childhood education and care, which calls for parental leave of one year at 50 per cent of salary 26 . “A fair society means helping people to make healthier choices in many difference aspects of their lives. It doesn’t detract from personal responsibility or impose a nanny state…. Physical or mental ill health can remove every prospect of a fulfilled life. The fact that poorer people have the worse health remains an indictment on our society.” Alan Johnson, Secretary of State for Health, 2008 22. Bolling, K., et al (2007) Infant Feeding Survey 2005, Department of Health, London. 23. ibid. 24. ibid. 25. ibid. 26. Adamson P, et al (2008) Report Card 8. UNICEF Innocenti Research Centre www.childwellbeing.org.uk/pages.asp?page=15 6 The UNICEF UK Baby Friendly Initiative Improving the health of the UK
Lack of support Mothers do not breastfeed in isolation and it is known that mothers who have the support of their partner, family or friends are more likely to breastfeed for longer 27 . Unfortunately, as formula feeding has become the most common way 28 to feed babies, the understanding and experience of breastfeeding across society has been lost. This leaves many mothers without the support of anyone who is confident that they can be successful. Lack of knowledge Over the past 60 years in the UK, feeding babies and children with commercially manufactured formulas has become standard practice, which has led to a widespread lack of knowledge on how to initiate and sustain breastfeeding. This lack of knowledge extends to health professionals who are not receiving the training they need to support breastfeeding mothers effectively. Certain practices known to make breastfeeding more difficult, such as separating mothers and babies immediately after the birth and giving babies unnecessary formula supplements, therefore persist throughout the NHS. “My community midwife quickly identified that my baby was not latching on correctly and causing me a huge amount of pain. She showed me an alternative way to breastfeed lying down which greatly eased the pain and enabled me to continue breastfeeding for the next three years.” Mother who received the support of a community midwife trained by the UNICEF UK Baby Friendly Initiative 27. Dyson L, Renfrew M, et al. (2006) Promotion of breastfeeding initiation and duration Evidence into practice briefing. National Institute for Health and Clinical Excellence www.nice.org.uk/niceMedia/pdf/EAB_Breastfeeding_ final_version.pdf 28. Although three-quarters of women initiate breastfeeding less than 1 in 4 is still breastfeeding at all at six months. 29. op. cit. Inappropriate health-care practices Hospitals that place importance on practices such as keeping new mothers with their babies, teaching mothers how to breastfeed, avoiding supplementation with formula and encouraging baby-led feeding help to create the right environment for breastfeeding. Recent studies have shown that hospitals have a direct impact on the successful outcome of a mother’s intention to breastfeed. The 2005 Infant Feeding Survey found that mothers who had the most difficulties in breastfeeding were those who had used a combination of breast and formula (about half of all mixed-feeding mothers experienced problems) 29 .Those who do not receive help or advice for these problems after giving birth are more likely to stop breastfeeding within two weeks. Lack of training Health professionals such as midwives, health visitors, nurses and doctors can play a crucial role in helping women to initiate and sustain breastfeeding. Whilst recent policy developments in relation to breastfeeding are to be welcomed, the understaffing of maternity units has a negative impact on their ability to adequately support women to breastfeed. There has also been a historic lack of training around breastfeeding, meaning that most staff, if they learn skills at all (such as how to communicate successful breastfeeding positioning and attachment and how to express breastmilk), learn them on the job, often in an inconsistent manner. This inconsistency and lack of ingrained knowledge amongst staff can confuse and misinform the mother and mean that she feels unable to initiate and maintain breastfeeding. The UNICEF UK Baby Friendly Initiative Improving the health of the UK 7
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Page 3 and 4: Contents Executive summary 2 Page I
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Page 15 and 16: Focus on the four nations of the UK
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