Sustaining breastfeeding together: Partnerships for the Goals

Sustaining breastfeeding together: Partnerships for the Goals

The theme for this year’s World Breastfeeding Week  is all about the importance of building multi-level partnerships to work together to support and protect breastfeeding and achieve the UN’s Sustainable Development Goals.

The final Sustainable Development Goal, number 17, calls for cross sectoral and innovative multi-stakeholder partnerships to achieve sustainable development.

Research has shown that the most effective way to improve breastfeeding rates is to implement policies and programmes at every level, from hospital to home and community, with support available from health professionals, peer supporters, friends, families and society.

One of the main WBTI recommendations outlines how this could be led from the top in the UK:

A national sustainable Strategy Board, including representatives from all the voluntary groups, health professional organisations, and NGOs to share best practice between devolved nations coordinated by a high level funded lead specialist.

A good breastfeeding journey for a family begins with birth in a Baby Friendly accredited hospital, and continues at home, surrounded by supportive family and friends, with easy access to skilled health professionals and mother support groups in the community. Once they return to work, mothers are supported by their employers to continue to breastfeed as long as they wish. Legislation protects families from misleading marketing by the baby feeding industry, and ensures safe and high quality breastmilk substitutes are available for those babies who need them.

A strong partnership between all sectors is essential to supporting families throughout their journey. The WBTi project was centred around building a strong partnership between organisations and agencies involved in maternal and infant health in order to monitor and assess the UK’s implementation of key infant feeding policies and programmes. The decision-making Core Group was responsible for determining the gaps and recommendations for the WBTi report and its member organisations had to be free from conflict of interest with regard to funding from the formula, baby food, bottle and teat industries. Organisations covering the full spectrum of maternal and infant health were invited to participate in the wider WBTi consultation.

Together, we can build a better future for Britain’s babies.

 

The WBTi Core Group

Association of Breastfeeding Mothers   https://abm.me.uk/

Baby Feeding Law Group    www.babyfeedinglawgroup.org.uk/

Baby Milk Action www.babymilkaction.org/

Best Beginnings   www.bestbeginnings.org.uk/

Breastfeeding Network   www.breastfeedingnetwork.org.uk/

Child and Maternal Health Observatory   www.herc.ox.ac.uk/downloads/health_datasets/browse-data-sets/child-and-maternal-health-observatory-chimat

Department of Health   www.gov.uk/government/organisations/department-of-health

First Steps Nutrition   www.firststepsnutrition.org/

Institute of Health Visiting ihv.org.uk/

Lactation Consultants of Great Britain   www.lcgb.org/

La Leche League GB   www.laleche.org.uk/

Maternity Action www.maternityaction.org.uk/

Northern Ireland infant feeding lead

NCT   www.nct.org.uk/

National Infant Feeding Network www.unicef.org.uk

Public Health England  www.gov.uk/government/organisations/public-health-england

Scotland Maternal and Infant Nutrition Coordinator www.gov.scot/

Start4Life www.nhs.uk/start4life/

Unicef UK Baby Friendly Initiative www.unicef.org.uk/babyfriendly/

 

Other organisations who participated in the WBTi consultation

British Dietetic Association. https://www.bda.uk.com

Cabinet Office https://www.gov.uk/government/organisations/cabinet-office

Department of Health http://www.gov.uk

General Medical Council  http://www.gmc-uk.org

General Pharmaceutical Council   https://www.pharmacyregulation.org

Nursing and Midwifery Council   https://www. nmc.org.uk

Public Health Agency Northern Ireland www.publichealth.hscni.net/

Public Health Scotland   http://www.gov.scot/

Public Health Wales http://www.wales.nhs.uk/

Royal College of General Practitioners http://www.rcgp.org.uk

Royal College of Midwives http://www.rcm.org.uk

Royal College of Paediatrics and Child Health https://www.rcpch.ac.uk

Royal College of Obstetricians and Gynaecologists http://www.rcog.org.uk

Unite, the Union of Community Practitioners and Health Visitors Association www.unitetheunion.org/

U K Standing Conference on Specialist Community Public Health Nurse Education

 

Relevant quotes:

The Lancet Series on Breastfeeding concluded that breastfeeding is the responsibility of all of society, not just the individual woman. http://www.thelancet.com/series/breastfeeding

It takes a village to raise a child………so says the African proverb.

UK Shadow Health Minister Jon Ashworth recently said ‘Children’s health is central to improving wellbeing and economic status of a country’.

 

By Clare Meynell and Helen Gray

Joint Coordinators

WBTi UK Working Group

#KingsBrelfie for World Breastfeeding Week 1– 7August

#KingsBrelfie for World Breastfeeding Week 1– 7August

World Breastfeeding Week (WBW)  (#WBW2017) takes place from 1 – 7 August 2017.  It is an initiative led by The World Alliance for Breastfeeding Action (WABA), supported by UNICEF, the World Health Organisation (WHO), and many breastfeeding organisations worldwide. It is now in its 25th year and it is all about working together for the common good.

In 2016 WABA started the journey to achieving the United Nations’ Sustainable Development Goals  (SDGs) by demonstrating the importance of breastfeeding to each SDG.  However, these goals cannot be achieved without strong partnerships at all levels.  The theme of SDG 17 is “Partnerships for the Goals”, which highlights the vital importance of partnerships between all organisations working towards a sustainable future. This partnership theme echoes  WBTi’s own emphasis on the importance of building partnerships and collaboration. #WBW2017 calls on all those involved to forge new and purposeful partnerships. The objectives for this year’s campaign are Inform, Anchor, Engage and Galvanise.

By Laura Godfrey-Isaacs

Picking up on this year’s campaign themes, a group of midwives at King’s College Hospital in London, including the Director of Midwifery, specialist midwives in Infant Feeding and myself, have come together to devise a campaign to support and celebrate breastfeeding at the Trust, and beyond.

Brelfie1

The “Brelfie”

Our ideas are based around the social media phenomenon of the ‘brelfie’ – a breastfeeding selfie. Celebrities and women of all backgrounds have posted these, often in defiant response to breastfeeding shaming in public. Many have gone viral, and last year WHO declared that the brelfie was a significant tool in normalising and empowering women to breastfeed. This is something that would be highly desirable to see in the UK where we have some of the worst breastfeeding rates in the world, and little acceptance of it in public. This was highlighted recently in a disastrous advertising campaign by the skincare brand Dove (owned by Unilever) which featured posters that appeared to endorse negative public attitudes towards breastfeeding, stating “75% say breastfeeding in public is fine, 25% say put them away, what’s your way?” which received much push back on social media. 

Embarrassment about breastfeeding in public

In addition the TV presenter Jeremy Clarkson outrageously equated breastfeeding in public to urinating, suggesting women should go ‘to a little room to do it’, presumably the toilet, and Claridge’s Hotel famously asked a woman to cover up while breastfeeding in their restaurant. Breastfeeding women have to endure these and many other ‘everyday’ incidences that include negative comments and looks, despite breastfeeding in public being protected in law by the Equalities Act since 2010, and our culture being saturated by women’s breasts being used to sell newspapers, promote music and advertise countless products – an environment, that, as performance poet and birth advocate Hollie McNish puts so well, in her award-winning poem ‘Embarrassed’ is ‘covered in tits’.

What I have also experienced first-hand, as a midwife, is many women telling me they feel nervous about breastfeeding in public, which highlights the lack of cultural support and acceptance that inevitably has a negative impact on women’s ability to sustain the practice, with all the constituent results for both her, the baby and society. More and more evidence points to the importance of breastfeeding on a cultural, public health, psychosocial, ecological and economic level, and the need to support, protect and promote it in all aspects of healthcare and society, as well as asserting breastfeeding as a human right for both babies and women.

The WBTi report identified many barriers along a mother’s breastfeeding journey. Among these there is a disconnect between exhortations to mothers to breastfeed and a prevailing negative attitude towards breastfeeding in public. This can lead to women feeling they are to blame for ‘failing’ to breastfeed, and over 80% give up before they want to. Cultural factors need to be addressed, which is where the power of the brelfie and social media campaigns can – and do – have a really positive effect in shifting attitudes and encouraging activism on the issue.

Nabilabrelfie2

 

#KingsBrelfie campaign for #WBW2017

The #KingsBrelfie campaign links to Indicator 6 of the World Breastfeeding Trends Initiative Report, which calls for community mother support for breastfeeding, as it will open up discussions with women about their own, and society’s attitudes to breastfeeding. It will help us encourage, support and signpost them to online and healthcare provided sources of information and facilitation, such as our King’s Milk Spot centres in the community. Our campaign will use images of King’s midwives breastfeeding, which also points to our commitment as a community of women together – midwives and women – and hopefully steer away from some of the negative feelings around midwives’ use of ‘advocacy rhetoric’ which women can unfortunately sometimes experience as pressure and judgment. As highlighted in WBTi’s Indicator 7 (communication and information) which calls for a national communications strategy around infant feeding, and for promotional activities including World Breastfeeding Week, we are directly exploring new ways to use communication strategies, that are women-led, to address the cultural barriers to breastfeeding in the UK, through an inclusive social media campaign.

The #KingsBrelfiecampaign is an invitation to all women to post a brelfie on social media during World Breastfeeding Week using the hashtag to help change attitudes, support mothers and assert the right to breastfeed wherever, and whenever women want or need to.

So let’s create a social media storm and celebrate women and breastfeeding together!

LauraGodfrey-Isaacs2017

 

Laura Godfrey-Isaacs

King’s midwife and birth activist

@godfrey_isaacs

 

 

Sustaining Breastfeeding: A Challenge for the UK

Sustaining Breastfeeding: A Challenge for the UK

Position Statement On Breastfeeding From The RCPCH

 Today is the start of World Breastfeeding Week. An open letter was published in The Guardian today, from the Royal College of Paediatrics and Child Health (RCPCH), co-signed by the WBTi team and 17 other organisations working in maternal and infant health. The letter calls for improved social attitudes towards breastfeeding to help reduce the barriers so that women are more able to sustain breastfeeding.

The revised RCPCH position statement on breastfeeding, also launched today, points out the rapid decline in breastfeeding rates (leading to fewer than half of all babies receiving any breastmilk at all by 6-8 weeks after birth), the research evidence on improved health outcomes and intelligence scores, and the economic impact. It lists key messages for health professionals and recommends government action to increase initiation and continuation rates. Roles and responsibilities of paediatricians include:

“All paediatricians should be aware of the RCPCH position on breastfeeding and encourage and support mothers, including those with preterm or sick infants, to breastfeed. They should avoid undermining breastfeeding through the inappropriate use of infant formula “top-ups”, and advise women that the use of infant formula may make it more difficult to establish exclusive breastfeeding.”

While the position statement mentions that the current training curriculum for general paediatricians “requires trainees to understand the importance of breastfeeding and lactation physiology, be able to recognise common breastfeeding problems”, the WBTi assessment found significant gaps in comparison to the WHO Education Checklist for infant and young child feeding topics. However, the curriculum is currently being revised and we very much hope this will improve such training for paediatricians.

Family-centred care

Indicator 5 in the WBTi UK report is about health and nutrition care systems.

Are the services provided by maternity units truly mother- centred? Are health professionals such as health visitors, GPs and relevant hospital staff, with an in-patient mother, baby or young child, really mother centred?

To achieve parent-centredness, the policies and protocols need to incorporate that ethos, and staff training needs to provide the necessary attitudes, knowledge and skills. The crucial element of Indicator 5 is, therefore, health professional training.

Training for health professionals

Our report showed significant gaps in training for most of the relevant professions. Those who support mothers with breastfeeding have much anecdotal evidence between them of extensive variation between health professionals in attitudes and knowledge, from being hugely supportive on the one hand to dismissive of breastfeeding on the other. If all had a positive attitude towards breastfeeding, accompanied by basic knowledge, that would surely help to improve breastfeeding rates, particularly for continuation?

 

Time for action

The recommendations by the WBTi Core Group mirror those of the RCPCH – action is needed at every level, from governments to health professional bodies. from the community to the workplace. Protecting our babies’ future is a responsibility we all share.

 

wbti ind 5 gaps recs
Key gaps and recommendations from the 2016 World Breastfeeding Trends Initiative report on UK infant feeding policies and programmes https://ukbreastfeeding.org/wbtiuk2016/

 

PW Photo for WBTi MAINN presentation

Patricia Wise is an NCT breastfeeding counsellor and a member of the WBTi Steering Group

Maternity Protection in the workplace: Tribunal fees ended!

Maternity Protection in the workplace: Tribunal fees ended!

WBTI Recommendations on tribunal fees

The World Breastfeeding Trends Initiative UK Report in 2016 includes the statements that “employment tribunal fees were introduced in 2013 (except in Northern Ireland) and it now costs £1200 to bring a discrimination claim. Employment tribunal fees constitute a significant financial barrier to accessing justice. The number of employment tribunal claims decreased by 70% following introduction of the fees.”

The unanimous recommendations by the WBTi Core Group organisations included:
“that governments ensure that tribunal access is available to women from all income brackets.”

Tribunal fees ended with immediate effect

The excellent news is that on 26th July 2017 the UK Supreme Court ended employment tribunal fees with immediate effect. The Parliamentary Justice Committee had recommended special consideration for pregnancy and maternity discrimination claims in 2016 but as no government action followed, the trade union Unison took the issue to court. Rosalind Bragg, Director of Maternity Action, has written about this in more detail:

https://www.maternityaction.org.uk/2017/07/an-end-to-employment-tribunal-fees-a-great-step-forward-for-maternity-rights/

 

The Press summary of the judgment explains that “The Fees Order is unlawful under both domestic and EU law because it has the effect of preventing access to justice. ” It indirectly discriminates against women under the Equality Act 2010 because more women make Type B claims, which include unfair dismissal, equal pay and discrimination.

https://www.supremecourt.uk/cases/docs/uksc-2015-0233-press-summary.pdf

Maternity discrimination in employment

This is only a start in tackling employment discrimination though and the Alliance for Maternity Rights Action Plan comprises several needs:

  • to build on existing legislation and not weaken it
  • for the government to show leadership in changinge the culture away from discrimination
  • for employer practices to improve
  • to improve access to information for both employers and women
  • to ensure proper protection of the health and safety of expectant and new mothers
  • for improved access to justice
  • for better monitoring of trends

https://www.maternityaction.org.uk/wp-content/uploads/AfMRActionPlanFINALOct2016.pdf

 

Another change to improve access to justice that is listed in the Plan is to extend the timeline for making a claim from 3 months to 6 months. Joeli Brearley set up Pregnant then screwed to tackle employment discrimination and her #GivemeSix petition aims to achieve this extension so that mothers can begin a tribunal claim after they give birth and avoid risking extra stress in pregnancy. The Early Day Motion (EDM15) to increase the time limit has been signed by 87 MPs so far, approaching the target of 100.

https://www.change.org/p/greg-clark-mp-give-new-and-expectant-mothers-six-months-to-pursue-discrimination-claims?utm_content=petition&utm_medium=email&utm_source=102275&utm_campaign=campaigns_digest&sfmc_tk=OyJbS47tFVxLRElMEsk%2bNSNfCtOF6k3%2fETm0uXsnz2ju4w8G3nxfLYMR7gqAqApc&j=102275&sfmc_sub=284797866&l=32_HTML&u=20470025&mid=7259882&jb=1560

Here is a short video that you can share on why maternity protection is important:

 

 

 

Patricia Wise is an NCT breastfeeding counsellor and a member of the WBTi Steering Group