The Politics of Breastfeeding
Janette Westman Midwife/Lactation Consulatant presentation at Eat Local -Think Global
La Tempesta by Giorgione, Venice, 15th Century
“Access to a safe, healthy diet is one of the most important public health actions that a country can take to improve health and increase economic gain”. (WHO, 1999)
Artificially-fed babies are:
- 5 times as likely to be hospitalised with gastroenteritis
- 5 times as likely to have a urinary tract infection
- Twice as likely to suffer from ear infections
- Twice as likely to have a respiratory infection
- Twice as likely to develop allergies (if there is a family history)
Some evidence suggests a reduction in the incidence of Necrotizing Enterocolitis in preterm infants
So how are we doing?.....
…..not very well !
- In the UK 9 out of 10 women stop breastfeeding before their baby is 6 weeks old
- Fewer than 2% of babies are exclusively breastfed at 6 months
Statistics hide inequalities
- Mothers in social classes III-V less likely to breastfeed
- Mothers who remained in full time education until they were 18 are 3 times more likely to breastfeed
- Three quarters of first time mothers aged 30 or over breastfeed their babies compared to less than half aged 20 or under
Effect of breastfeeding on gastro-intestinal illness by social class
The Global Picture
“Inappropriate feeding practices – suboptimal or no breastfeeding and inadequate complementary feeding – remain the greatest threat to child health and survival globally”
Innocenti Declaration 2005 on Infant and Young Child Feeding
Global strategy from 1990:
- Appoint national breastfeeding coordinator and establish multisectoral national breastfeeding committee
- Ensure every maternity facility practices Baby Friendly Initiative 10 step
- Implement all provisions of International Code in its entirety
- Legislation to protect breastfeeding rights of working women
- Ensure appropriate guidelines and skills for staff
5 Additional targets:
- Develop, implement and evaluate policy
- Ensure protection, promotion and support of exclusive breastfeeding for 6 months and continues breastfeeding up to 2 years or beyond
- Promote timely, adequate safe and appropriate complementary feeding with continued breastfeeding
- Provide guidance on feeding infants and young children in exceptionally difficult circumstances
- Consider what new legislation may be needed to give effect and to principles and aims of Code of Marketing of Breastmilk Substitutes
The National Picture - The Breastfeeding Manifesto
- Implement the global strategy for infant and young child feeding
- Implement postnatal care guidance from NICE and public health evidence into practice document
- Improve training for health professionals
- Work with employers
- Develop policy and practice to support breastfeeding in public places
- Include breastfeeding education in curriculum
- Adopt International code of marketing breastmilk substitutes
What are we doing in Bradford?
- Hospital the largest hospital, with most diverse population, in the UK to achieve UNICEF Baby Friendly accreditation
- Featured in publications for examples of good practice
- Multi-lingual Video/DVD
- Breastfeeding Strategy for the Bradford District
The International Code and the UK law - key differences
| The International Code | The UK Regulations |
| No advertising or promotion - anywhere | Advertising allowed in the health care system |
| No free samples or gifts to mothers / the public | Gifts to the public allowed - if not designed to promote sales |
| No free or subsidised supplies to hospitals unless for research | Less clear specification - loophole easily exploited |
| No free gifts to health workers; information must be scientific and factual | Gifts to health care workers allowed; ‘information’ not strictly controlled |
| No contact between mothers and company representatives | Contact between mothers and company representatives allowed if instigated by the mother - hence carelines etc. |
What the companies do:
- Start before they are born
- Co-opt health workers to promote brands
- Bombard women with formula promotion
What you can do:
- Visit www.breastfeedingmanifesto.org.uk
- Sign up
- Get your MP to sign up
- Report violations to the International Code
As a health professional:
- Ensure no formula leaflets
- Use professional code of conduct
- Encourage other colleagues to refuse freebies
- Limit access of formula company reps
- Press for policies to forbid formula advertising/sponsorship or display of logos
- Lobby journals to not accept advertising from formula companies
- Ensure education is free from commercial influence
- Raise these issues at local meetings
The challenge is to move from this
to this
