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Call to change attitudes to breastfeeding

Social stigma is a major barrier to breastfeeding and more must be done to support women to continue breastfeeding beyond the first few weeks, experts say.

Released to coincide with the 25th anniversary of World Breastfeeding Week, guidance from the Royal College of Paediatrics and Child Health (RCPCH) warns that the rate of breastfeeding in the UK, which is currently one of the lowest in the world, shows little sign of improving. It cites figures from The Lancet , which suggest that just a third of UK babies are breastfeeding at six months of age, compared to over 70 per cent in Norway.

The RCPCH guidance recommends that mothers should be encouraged to breastfeed exclusively for up to six months, solid food should not be introduced before four months, and mothers should be supported to continue breastfeeding for as long as they wish.

The document makes the case for the health benefits of breastfeeding for both mother and child, as well as the cost savings to families and health services.

RCPCH president Professor Neena Modi said, ‘World Breastfeeding Week is 25 years old today, but the UK has little to celebrate in terms of its record. The health benefits of breastfeeding are beyond question, from reduced likelihood of intestinal, respiratory and ear infections to hospitalisation.

‘Regrettably the attitudes of a large part of society mean breastfeeding is not always encouraged; local support is patchy, advice is not always consistent and often overly dogmatic, support in the workplace not always conducive to continued breastfeeding and perhaps most worryingly breastfeeding in public is still often stigmatised. It is no wonder that for many mothers, there are too many barriers.’

The RCPCH has called for:

  • familiarity with breastfeeding to be included as part of statutory personal, social and health education in schools;
  • Government to legislate for employers to support breastfeeding through parental leave, feeding breaks and facilities suitable for breastfeeding or expressing breast milk;
  • local breastfeeding support to be planned and delivered to mothers in the form of evaluated, structured programmes;
  • the NHS to ensure the preservation of universal midwifery services;
  • Public Health England to develop a national strategy to change negative societal attitudes to breastfeeding.

Professor Modi added, ‘With the right support and guidance, the vast majority of women should be able to breastfeed. But although it’s natural, it doesn’t always come naturally. Some mothers cannot, or choose not to, breastfeed and this also needs to be respected. What society must get better at is removing the multiple barriers which can stand in the way of breastfeeding.

‘Women, their families, no less children and society at large need information that is sensible and not overly dogmatic. Mums need support at the right time and place, including in the workplace from their employers, and a culture that promotes and encourages breastfeeding as a natural and positive thing to do. There must be a coordinated and determined approach across all the society if the situation is to be improved.’

The call from the RCPCH comes as research is released by UNICEF and the World Health Organization (WHO) in collaboration with the Global Breastfeeding Collective, which says that no country in the world fully meets recommended standards for breastfeeding.

The Global Breastfeeding Scorecard, which evaluated 194 nations, found that only 40 per cent of children younger than six months are breastfed exclusively (given nothing but breast milk) and only 23 countries have exclusive breastfeeding rates above 60 per cent.

Dr. Tedros Adhanom Ghebreyesus, director general of WHO, said, ‘Breastfeeding gives babies the best possible start in life. Breastmilk works like a baby’s first vaccine, protecting infants from potentially deadly diseases and giving them all the nourishment they need to survive and thrive.’