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