Socialist Health Association Promoting Health through Socialism

The Politics of Breastfeeding

Janette Westman Midwife/Lactation Consulatant

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 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

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

last updated 9/03/07