Month: November 2015

Supporting mothers to breastfeed – more on Indicators 5 & 6

baby-holding-hand

74 percent of mothers initiated breastfeeding
44 percent of mothers were still breastfeeding at 6–8 weeks

– Public Health Outcomes Framework (England) 2014/15

90 percent of women who stop breastfeeding in the first six weeks report giving up before they wanted to

– David Bull, Executive Director UNICEF UK

Most mothers in the UK want to breastfeed, yet most mothers stop breastfeeding before they want to. Why?

The fact is that while breastfeeding is natural, mothers need skilled support to be able to breastfeed. Yet many of the health professionals who work with mothers and babies do not have the knowledge or skills to help them.

Indicator 5 of the WBTi examines how well healthcare systems support breastfeeding. It looks in detail at the training of all health professionals who interact with mothers and babies – midwives, health visitors, GPs, paediatricians, lactation consultants and others – both before and after they qualify in their profession. You can see the full education checklist here.

It also asks whether health workers understand their responsibilities under the International Code of Marketing of Breast-milk Substitutes, and whether mothers and babies are able to stay together when one of them is sick.

Support for mothers comes from many sources, not just health professionals. It can come from family, friends, the community at large, and particularly breastfeeding peer-support groups. In the UK, these are run by organisations like the Association of Breastfeeding Mothers, Breastfeeding Network, La Leche League, NCT, as well as by the NHS itself. Mothers who have breastfed their own babies – and who have received training to provide breastfeeding support – are able to provide valuable help to new mothers.

In the UK, just 1 percent of babies are exclusively breastfed for the recommended six months. Common reasons that mothers give for stopping breastfeeding include:

  • finding breastfeeding painful
  • concerns about their milk supply
  • conflicting advice from health professionals
  • lack of support
LLL Mother support group
Trained support is needed at all levels, from peer supporters to lactation consultants. Click here for details of the different roles.

Peer supporters are “informed friends” who can help mothers understand what’s normal and help with many common breastfeeding concerns. They offer a compassionate and empathetic ear to new mothers.

This importance of this community-level support is recognised in Indicator 6 of the WBTi, which looks in detail at access to skilled mother support and community outreach. Good peer-support programmes can increase the length of time that mothers exclusively breastfeed their babies. In other words, they can help mothers who want to breastfeed to carry on for as long they choose.

Getting breastfeeding to work – more on Indicator 4 of the WBTi (Maternity Protection)

breastfeeding at workWhen the Industrial Revolution began, women started to go out to work in large numbers and breastfeeding began to decline, spurring the development of alternative ways of feeding babies. Yet, 200 years on, the question of how to combine breastfeeding and work still remains for women around the globe.

In the UK in 2015, MPs themselves are struggling to secure the right to breastfeed their babies in the chamber of the Houses of Parliament itself!

Once again, the Global Strategy on Infant and Young Child Feeding is clear that there are proven ways to make this work. It calls on governments to produce “imaginative legislation” to protect the breastfeeding rights of working women.

In particular, it recommends that legislation be compatible with the International Labor Organisation’s standards, which state that there should be an entitlement to:

  • health protection, job protection and non-discrimination for pregnant and breastfeeding workers
  • at least 14 weeks of paid maternity leave
  • one or more paid breastfeeding breaks or daily reduction of hours of work to breastfeed

as well as recommending that space be provided nearby for working mothers to breastfeed or express their milk.

There is also a recognition of the extra challenges faced by women who work in the “informal economy”, such as those in casual or freelance work, who don’t always have the same protections as other women.

Each year, the World Alliance for Breastfeeding Action produces a snapshot of the state of maternity protection around the world, which makes for some interesting comparisons.

WABA 2015
WABA 2015

Indicator 4 of the World Breastfeeding Trends initiative (WBTi) looks in much more detail at the laws and practices in each country to score them on the maternity protection they offer. Fathers are recognised too, because of their important role in nurturing babies and supporting breastfeeding, so the length of paternity leave is also included in the score.

How do you think the UK compares to other countries in protecting breastfeeding mothers at work? What was your experience of returning to work while breastfeeding? What would have made it easier?