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'Whole systems approach' needed to boost breastfeeding, says PHE

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Specialist professional support for breastfeeding is important but more work needs to be done to improve informal help for mothers if rates are to rise nationally, a leading early years advisor has said.

Public Health England’s maternity and early years lead, Alison Burton, acknowledged rates of breastfeeding continuation among mothers in England “are not as good as we’d like them to be” in comparison with other countries.

“There is more we need to do as a society at all levels about how we talk about breastfeeding”

Alison Burton

She denied recent claims of a “crisis” in breastfeeding support in the UK but said there was variation in provision of services across the country.

PHE’s own data for England in 2014-15 shows that while 74% of mothers try breastfeeding, by 8 weeks after birth only 43% have continued.

Recent figures published in The Lancet journal showed UK breastfeeding rates at 12 months after birth were the worst in the world,

This prompted a letter by academics and health visiting and midwifery organisations to ministers about a breastfeeding support “crisis” which they claimed was being worsened by cuts to local council public health funding.

Speaking to Nursing Times as part of Breastfeeding Awareness Week Ms Burton said: “Specialist support is really important but if we are going to shift our rates at a population level it’s going to be more than just speciality input – it’s going to be a whole systems approach.”

“Mums tell us when they are having difficulty getting their baby to latch on or worried they don’t have any milk, that doesn’t necessarily happen when the nurse or midwife is around,” she said.

“So making sure they have confidence and knowledge and are able to access informal support is also critically important,” she added.

She acknowledged there were challenges with public health funding but that there were many ways to provide support to mothers that did not cost a lot of money.

Public Health England

Call for ‘whole systems approach’ to up breastfeeding

Alison Burton

“In a lot of areas they’ve got really good peer support programmes, volunteer baby cafes. So, with those sort of approaches they don’t necessarily have to cost a lot of money,” she said.

Ms Burton also noted the UK often lacked community support for mothers from their peers, which other countries tended to have. She said “cultural” changes were also needed in the UK’s attitude to breastfeeding.

“In our country we tend to see breastfeeding as the individual woman’s choice. We don’t necessarily see it in the same way as it’s seen in other countries, particularly in developing countries where it’s an important public health intervention and saves babies’ lives.

“Here, because we’re not talking about mums making up formula milk with dirty water it’s not seen as prevention,” she added.

“While I agree healthcare services are really important, for this particular issue I don’t think that is just the answer,” said Ms Burton.

“There is more we need to do as a society at all levels about how we talk about breastfeeding, promote images of infant feeding, make it more acceptable and stop the dialogue about individual mother responsibility,” she said.

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Readers' comments (1)

  • Firstly, matching continuation rates of breastfeeding against rates of breastfeeding immediately after delivery is wrong. Mothers often state they are going to 'try breastfeeding' or 'do a mixture of breastfeeding and bottle feeding' when in fact they intend to put the baby to the breast for the few hours they are in the hospital (because they think it is expected) and bottle feed as soon as they get home. Secondly, for those who really do want to breast feed, it can be very difficult without continual help from midwifery staff. Unfortunately there are often just not enough staff to provide the level of support necessary in the first few hours and days. Lastly to judge our breastfeeding rates at 12 months with the rest of the world is ridiculous. We should concentrate on the crucial first six months and then let mothers decide when they want to wean.

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