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Breastfeeding is the best way to feed a baby. Breast milk provides all the nutrients a baby requires for the first six months of life.
Why is it important?
There is a range of benefits to breastfeeding to both the mother and the baby. Breastfed infants are at reduced risk of gastro-intestinal infections; respiratory infections; ear infections; type 1 and type 2 diabetes; overweight and obesity; allergic disease; childhood leukaemia; and sudden unexpected death in infancy (SUDI). For mothers the benefits include reduced risk of breast cancer, ovarian cancer and hip fractures. Breastfeeding also promotes bonding between a mother and her baby.
However, breastfeeding shows inequalities, and is more common in the higher socioeconomic groups and older mothers. Mothers who don’t breastfeed often have a poorer diet themselves, and are more likely to introduce solids early; this can leave their children prone to becoming obese in later childhood.
There are also cost benefits to breastfeeding. The reduced risk of infections results in fewer visits to the GP and to hospital, and so reduced cost to the health service. There is also a reduced environmental cost with breastfeeding. Bottle feeding results in bottles and packaging being sent to landfill, whilst transporting formula increases the amount of traffic on the roads.
Where are we now?
Breastfeeding initiation in Cornwall and the Isles of Scilly has shown a steady increase from around 65% in 2006. It has now stabilised at around 80%. However, by 6-8 weeks less than 45% are still breastfeeding. The reasons for this drop off are complex. However, they include difficulties in attachment of the baby to the breast, which can lead to pain and discomfort; the mother believing that she doesn’t have enough milk for the baby; a desire to get back to a ‘normal’ life; and sometimes embarrassment at feeding in public places.
What is being done?
NHS Cornwall and Isles of Scilly has recently completed the long process of full Unicef BFI accreditation. It is a three stage process that tests the knowledge and training of health staff, as well as how effectively this knowledge is passed on to mothers. All stages have now been achieved in the community, the hospital and the children’s centres and we are the first county in the country to achieve accreditation in all these areas, something that should be celebrated.
Evidence suggests that the first few hours and days are crucial as to whether or not a mother continues to breastfeed. In response a pilot project has been undertaken to contact all new mums, regardless of their chosen feeding method, within 72 hours of leaving hospital or a home birth. A trained peer supporter, offers advice or can refer the woman on to her local peer support group as appropriate. A mother who is formula feeding can be given advice on how to make up formula safely. This project run by Real Baby Milk has now been completed with some promising results. Future plans will consider the best way to use this experience.
There are many peer support groups around Cornwall and the Isles of Scilly. Mothers who use peer support groups generally find them to be very supportive and helpful.
However, overall the evidence has little information about what works when trying to increase breastfeeding rates. The evidence base will continue to be reviewed as part of future planning.
What else is planned?
In previous years, there has been funding from the Department of Health and the Local Area Agreement to support breastfeeding. However, this additional funding is no longer available. Therefore, the entire infant feeding agenda is being reviewed to establish the most efficient way to use the available funding.
Our future strategy will continue to develop based on local and national evidence, data and experience.
Nationally, the following will be used to track progress towards increasing breastfeeding:
- Breastfeeding at 6-8 weeks
- In the future there will be a requirement to monitor breastfeeding at 5-7 days, at 10-14 days, and at 16 weeks. The timescale for this requirement has not yet been determined.
Additionally, we will also be locally monitoring progress in the following areas:
- Breastfeeding initiation
Kayley (not her real name) is a 20 year old mum from the Camborne area. Her second baby was born at the beginning of 2012. Her first baby had been formula-fed.
At first, Kayley was reluctant to talk about breastfeeding as she was mainly formula-feeding her baby, and had all but given up on breastfeeding. Therefore, the adviser talked instead about how to make up bottles safely. Gradually, as the relationship developed, the adviser was able to talk to Kayley about having lots of skin-to-skin contact with her baby, and offering expressed milk. A local peer supporter made contact with Kayley, and supported her to attend her local group.
Over a period of several weeks, with lots of support, Kayley was able to increase the amount of breast milk she gave to her baby. By the time the baby was 11 weeks old, she was fully breastfed, and Kayley was expressing an interest in becoming a peer supporter.