Title: Increasing breastfeeding prevalence
1Increasing breastfeeding prevalence
- Phyll Buchanan Lorna Hartwell
- Infant Feeding Best Practice Advisers
- Department of Health
- 08.11.08
2The Government recognises
- that breastmilk is the best form of nutrition
for infants - It is committed to -
- supporting women to continue breastfeeding
- exclusively for the first six months then
alongside an increasingly varied diet for as
long as wished - WHO recommends that breastfeeding should be
continued for two years or beyond (WHO 2003)
Each month of breastfeeding duration was
associated with a 4 decrease in the odds of
overweight (OR 0.96, 95 CI 0.94-0.98) Effect
plateaus at 9 months Evidence on the long-term
effects of breastfeeding WHO. Horta B et al 2007
3Breastfeeding is a key priority for the
Government, and embedded in its Public Service
Agreements
- Child Health and Wellbeing PSA indicator 12
Prevalence of breastfeeding at 6-8 weeks after
birth
EARLY YEARS
- Child Health and Wellbeing PSA indicator 3 by
2020, reduce the proportion of overweight and
obese children to 2000 levels.
OBESITY
- PSA by 2010 to reduce health inequalities by 10
as measured by infant mortality and life
expectancy at birth
HEALTH INEQUALITIES
SMOKING
- Reduce smoking among pregnant women from 23
(1995) to 18 by 2005 15 by 2010
4Breastfeeding initiation rates are rising across
UK, but are still linked to poverty...
Incidence of breastfeeding by country, 1985-2005
Younger mothers, mothers from lower
socio-economic groups and mothers with lower
educational levels appear to be least likely to
initiate and continue breastfeeding. Mothers from
these groups are also more likely to introduce
solids, follow-on formula and additional drinks
at an earlier age - factors associated with
childhood obesity.
Breastfeeding initiation rates have increased
since 1990. The Infant Feeding Survey 2005 showed
current breastfeeding initiation is 76 across
the UK, compared to 69 in 2000.
5Breastfeeding rates drop off too early and still
do not compare well with other countries
In Norway prevalence at 6 months is 80
compared to 22 in UK
- Prevalence of breastfeeding at ages up to 9
months, United Kingdom 1995-2005
Source Infant Feeding Survey 2005 Bolling 2007
6Baby Friendly Initiative (BFI) and community
peer support programmes are effective
interventions to increase breastfeeding
- NICE recommends hospitals and community settings
implement a structured programme using UNICEF
Baby Friendly Initiative as a minimum standard. - BFI is a comprehensive package of measures and
training of staff necessary to increase
breastfeeding with ongoing audit, assessment and
external accreditation. - Peer support programmes integrated within
maternity care services gives more vulnerable
families additional support. - Breastfeeding rates rise faster in hospitals that
achieve UNICEF Baby Friendly accreditation and
those with lowest rates show greatest gains.
7Women want to breastfeed 9 out of 10 who stop
before week six said they wanted to breastfeed
for longer
- Fastest drop-off in the first 4 days - 12 stop
breastfeeding in this time - A third of women have stopped breastfeeding by
week 6 so that only 50 of babies get any
breastmilk at this stage. - By 6 months only 26 of babies continue to be
breastfed
Two PCTs the blue line shows the impact of a
coordinated strategy involving community
hospital, the pink line shows hospital
involvement only. Tackling low breastfeeding
rates needs clear leadership and coordinated
working, to include peer support, across the PCT.
Reasons for stopping are preventable or treatable
and can be overcome by sustained and accessible
skilled support by frontline staff and peer
supporters
8We are working to make breastfeeding the norm
key breastfeeding commitments in the Obesity
Strategy
- Our vision for early years is as many mothers
breastfeeding as possible, with families
knowledgeable and confident about healthy weaning
and feeding of their young children. -
- KEY COMMITMENTS
- Invest in an information campaign
- All mothers to have practical information on how
to breastfeed Bump to Breastfeeding DVD and
details of the National Breastfeeding Helpline - Encourage hospitals and community settings to
become accredited - with UNICEF UK Baby Friendly Initiative
- Provide access to peer support programmes to help
mothers start and continue breastfeeding
integrated within the Child Health Promotion
Programme - Pilot roll out the WHO Growth Standards showing
the optimum growth of infants - Encourage all NHS facilities to be free from
promotional materials from infant formula
manufacturers.
9We need societal change
Social determinants of health
In order to support breastfeeding all the factors
in each layer needs to be protecting promoting
breastfeeding for every mother and baby
10Delivery through Partners
LOCAL CO-ORDINATION LA, CCs Primary care
community health providers in partnership with
NGOs Regional Infant Feeding Co-ordinators to
provide Strategic leadership
NATIONAL
REGIONAL
Government Office, Regional Public Health Groups
Strategic Health Authorities Regional Directors
of Public Health, Regional Infant Feeding
Co-ordinator, Regional Childrens, Maternity,
Food Health Obesity Leads
DH DCSF working with OGDs Local
Authorities Nutrition CHPP teams providing
overall co-ordination
LOCAL DELIVERY
Universal service with capacity to identify and
target those less likely to start and sustain
breastfeeding
Employers Engagement with employers to
facilitate the continuation of breastfeeding on
return to work
Primary care community health providers Baby
Friendly practice in hospitals Community to
sustain breastfeeding, led by an infant feeding
coordinator
Voluntary Sector Peer support training and
ongoing supervision through peer support
programmes, led by peer support coordinator
Schools Early education on breastfeeding as
part of healthy living
Childrens Centres Antenatal and Postnatal
services
Media coverage of breastfeeding issues along with
positive examples of success