The launch at the House of Commons on 15 November of the first UK-wide World Breastfeeding Trends Initiative (WBTi) report on infant feeding policies and programmes gave some clues to which “stepping stones” along a family’s feeding journey are missing, where families are struggling to meet their own breastfeeding goals. While most mothers in the UK (around 80%) do set out to breastfeed, breastfeeding rates plummet within weeks until fewer than 1% of babies in the UK are exclusively breastfed at 6 months.

MPs from across the political spectrum attended the parliamentary launch, hosted by Alison Thewliss MP, along with guests from Unicef UK Baby Friendly Initiative (who provided a screening of their new short video on their Call to Action) health professional bodies, voluntary organisations, breastfeeding experts and academic researchers. Nearly 20 organisations were involved in developing the report’s recommendations for action.

These recommendations cover the family’s whole feeding journey, and range from the fundamental importance of full Unicef UK Baby Friendly accreditation of maternity settings, to health professional training and access to skilled breastfeeding support in the community, all the way to maternity protection and the provision of breastfeeding breaks in the workplace.

Dr Amy Brown gave a keynote address demonstrating how the structure of joined up policies and programmes forms essential underpinning to the cultural change that is badly needed in the UK.

Lack of political and national leadership, uneven health professional training, formula milk marketing, poor data collection and patchy community support for mothers were identified as gaps in UK policies and programmes. The degree of variability in the minimum standards of training in infant and young child feeding training among different health professions – even those working most closely with mothers and infants – was surprising.

Eyebrows were also raised at finding that, while there is guidance on the care of zoo and circus animals in case of emergency or disaster, there is no national guidance for the care of mothers and babies in an emergency situation. Formula-fed babies would be at particular risk if access to clean water and electricity were interrupted, and it is vital that national guidance be communicated to all local authorities and emergency responders.

Scotland and Northern Ireland were found to have strong strategies and national leadership in place, but England and Wales fell short.

The Unicef UK Baby Friendly Initiative, however, was singled out as a “world leader” in its commitment to children’s rights and for the excellence of its training programmes, both in hospital settings and in the NICU and community.

The report provides the first broad-based assessment of the UK’s implementation of ten key policies and programmes to support women and babies during their feeding journey. The policies are drawn from the World Health Organisation’s (WHO) Global Strategy for Infant and Young Child Feeding, which the UK has endorsed since 2003.

Some of the recommendations from the WBTi Core Group were actions that MPs could lead on, including the full implementation in UK law the International Code of Marketing of Breastmilk Substitutes as well as its full enforcement, and the protection of breaks for breastfeeding or expressing milk for mothers returning to work. Recent studies from Save the Children and WHO have also shown that political will is pivotal in driving forward improvement in key strategies across the board to support infant feeding.

One of the key drivers for the WBTi project in the UK is women’s choices. Although the majority of mothers in the UK want to breastfeed, many of them are struggling. The majority of these mothers wanted to breastfeed for longer but did not get the support they needed to meet their goals. Mothers who stop breastfeeding early due to unresolved problems have double the risk of postnatal depression.

The impact of infant feeding on child and maternal health is well documented, but the impact on the national economy is less well understood. In addition to costing the NHS more than £40 million for five common diseases alone, the long-term impact of the UK’s low breastfeeding rates on cognitive ability, human capital and productivity across the whole population is estimated to cost the economy at least 0.53% of gross national income.

Breastfeeding rates in the UK are lowest in its most-deprived communities, exacerbating health inequalities. Breastfeeding could prove to be a powerful means of combating inequality.

The environmental footprint of formula feeding amounts to nearly 22 kilograms of CO₂, and 4700 litres of water, for every kilogram of milk powder produced. [12]

This first WBTi UK report provides a road map for policy makers and commissioners to target gaps in order to provide families with the support they need all the way through their feeding journey.