A major new report on baby feeding policies across the UK has highlighted a lack of clear training standards for health professionals, including nurses and health visitors.
The first World Breastfeeding Trends Initiative (WBTI) UK report, compiled with the help of nearly 20 government bodies, professional organisations and charities, has revealed gaps in policy and leadership, especially in England.
“The report lays bare the most important actions to take from policy down”
It scores the UK and its constituent four nations on a range of performance indicators, including training for professionals, community-based breastfeeding support and overarching national policy.
When it comes to national policy and co-ordination, England was rated as just one out of 10, while Wales scored four out of 10. In contrast, Scotland and Northern Ireland, where infant feeding underpins health programmes, both scored 10 out of 10.
The new report follows a research series recently published in The Lancet that shows the UK has one of the lowest breastfeeding rates in the world.
The report highlighted a lack of minimum standards relating to training health professionals on feeding for babies and young children.
It said: “It is of concern that most universal minimum standards of pre-registration training for healthcare professionals who work with mothers and babies, including health visitors, GPs, paediatricians and dieticians, show significant gaps, with infant feeding sometimes not being mentioned at all.”
“The future of health visiting services in England is uncertain”
The Nursing and Midwifery Council’s standards for nursing and health visiting are “of particular concern”, it stated.
The report highlighted the crucial role of infant feeding advisers – often midwives in hospital setting and health visitors in community settings.
Some have undergone extensive training, but the report noted “there is no standard job description, competency framework, training standards, mentoring or regulation”.
It called on professional bodies to set detailed minimum training standards based on those promoted by Unicef UK’s Baby Friendly Initiative, which champions breastfeeding and accredits services on their support for it.
When it comes to breastfeeding support, the report painted a picture of patchy provision. While there are some excellent support services, many peer support programmes had been cut and women with complex needs did not always have access to skilled, specialist help, it said.
Again, the report highlighted particular issues in England. “The future of health visiting services in England is uncertain and, in some areas, there is little or no integration of NHS community services with voluntary sector breastfeeding support, and no clear access to a skilled lactation specialist,” it said.
Cheryll Adams, executive director of the Institute for Health Visiting – one of the organisations involved in compiling the report – hoped it would prompt further efforts to improve breastfeeding rates.
“This must happen at many levels,” she said. “The report lays bare the most important actions to take from policy down.”
These include establishing national infant feeding strategies in England and Wales.
The report also said all maternity and community settings should meet the Baby Friendly Initiative standards.
In addition, it called on local authorities to commission a “joined up range of support in the community, including health visiting services, peer support and access to a breastfeeding specialist for complex cases”.