How are the UK nations progressing, one year on from the WBTi UK report launches?

How are the UK nations progressing, one year on from the WBTi UK report launches?

Our WBTi joint recommendations on health professional training were launched at Guy’s Hospital, London, in March 2025. The launch of our joint recommendations on policy actions, at the Houses of Parliament, followed in June.

What has changed since then? Below are some of the headline data available online or sent to us from the four nations of the UK. They show progress made by the nations in addressing some of our recommendations. Although health is devolved to the individual nations, there is some collaboration between the national departments of health. An example of a difference between the devolved health systems is the variation in the ages at which infant feeding data are collected.

Our WBTi 2024 Report recommends that all nations have a comprehensive, long-term, resourced strategy to help prioritise infant feeding. This blog focusses mainly on the national strategies and breastfeeding rates.

Courtesy: Shutterstock

England

Policy and guidance

In July 2025, the Department for Education published a broad strategy for infants and children, ‘Giving every child the best start in life’, which aims to simplify and improve the early years system. It is based on the evidence that integrated early years services can significantly benefit children’s lives in wide-ranging and long-lasting ways. £900m is being invested to ‘deliver a more connected, prevention-led system that improves outcomes for babies, children and their families. Services for the early years will be provided through a network of up to 1,000 Best Start Family Hubs across every local authority in England by 2028’ (DHSC personal communication).

This broad strategy does not address infant feeding directly. In March 2026, updated guidance focussed on infants and their families, ‘Best Start Family Hubs and Healthy Babies – Preparing for implementation April 2026′, was published jointly by the Department for Education and the Department for Health and Social Care (DHSC). Infant feeding is explicitly mentioned in this guidance (pp7,11,13,16). Start for Life was renamed as Healthy Babies so Family Hubs services for 0 to 5 year olds are now called Healthy Babies services.

75 local authorities with high levels of deprivation were previously funded for 3 years (2022-2025) to set up family hubs to deliver core services in perinatal mental health, parent-infant relationships and infant feeding. £50m was ring-fenced for infant feeding. £200m is being invested in these local authorities for 2026-29, of which £55m is specifically for infant feeding. Uses of the funding are to include upskilling the workforce, peer support services and joined-up services with clear referral pathways. Alongside the Family Hubs’ services, there is also continued investment in the National Breastfeeding Helpline and the Best Start in Life website (DHSC personal communication).

In March 2026, Sharon Hodgson MP was appointed Parliamentary Under-Secretary of State for Public Health and Prevention in DHSC and her portfolio includes Healthy Babies.

The Healthy Child Programme (HCP)

The HCP is the national framework for improving the health and wellbeing of children and young people. The update, launched in February 2026, provides refreshed delivery and commissioning guidance to improve consistency in public health nursing for children aged 0–19.

It focuses on early intervention, including mental health, obesity, and parenting support via health visitors (HV) and school nurses; it also ‘reaffirms breastfeeding as a public health priority, with High Impact Area 3 emphasising the role of health visiting in delivering consistent, evidence‑based feeding support from pregnancy through the postnatal period, particularly for families experiencing inequalities (DHSC personal communication). 

© 2013 Paul Carter / wdiip.co.uk

The HCP includes guidance at a community level, not just for individual HVs, and this covers partnership working, breastfeeding-friendly environments, implementing Baby Friendly standards and adherence to the WHO International Code.

Five face-to-face contacts are standard for all families (Universal-level offer) but extra support may be offered based on need (targeted and specialist-level offers). These contacts are health and development reviews, intended to be delivered by health visitors. There is guidance for health visiting on the high-impact areas (ages 0 to 5), including supporting breastfeeding. There is also guidance on data collection, including infant feeding.

With regard to funding, ‘Over the next three years, more than £13.4 billion will be provided to local authorities to fund public health services in England through the ring-fenced Public Health Grant, including for health visiting and family nurse services delivered through the Healthy Child Programme’ (DHSC personal communication).

Postnatal care toolkit

In January 2026, NHS England published a toolkit for integrated care boards to improve postnatal care, which is defined as the first 6-8 weeks after birth. The toolkit is intended to strengthen how services work together to achieve the standards of NICE guideline 194 on postnatal care.

A recommendation (3.2) is to improve training for health professionals, including in infant feeding/ breastfeeding support, but no specific standards are given.

Breastfeeding rates (from data collected routinely for DHSC)

The continuation rate at 6-8 weeks for any breastfeeding in England has improved since the 2024 WBTi Report was published. Rates vary with deprivation; in 2023-4, the rate in the most deprived areas was 59.1% and in the least deprived 81.3%.

The WBTi Report (hyperlink) recommended collecting data on infant feeding at various additional ages (10-14days, 6 months, 2 months and 2 years) but there is still no routine collection beyond 6-8 weeks. However, the results of the 2024 England Infant Feeding Survey were published on 4 June and these include later ages.


% Any breastfeeding

Year
Age data collected2024-20252023-24
Baby’s first feed breastmilkMore recent data not available71.8
6-8 weeks (any breastfeeding)55.652.7

Data page: https://fingertips.phe.org.uk/profile/child-health-profiles/data#page/1/ati/15

Page showing trends over time: https://fingertips.phe.org.uk/profile/child-health-profiles/data#page/4/gid/1938133228/pat/159/par/K02000001/ati/15/are/E92000001/iid/93932/age/309/sex/4/cat/-1/ctp/-1/yrr/1/cid/4/tbm/1/page-options/tre-do-1

Northern Ireland

Policy and guidance

The Northern Ireland Breastfeeding Strategy ended in 2024. The strategy review found that considerable progress had been made in several aspects, in which the work is now embedded as standard practice in many organisations involved with the strategy. Key priority areas identified by the strategy will be addressed via a new N.I. Breastfeeding Action Plan. A consultation with stakeholders on the draft action plan was held in the summer of 2025 and it is anticipated that the finalised version will be published by summer 2026.

Due to the current financial constraints, there are no resources to fund independent research, such as gathering qualitative data on women’s experiences (recommended in the WBTi Report), but the Department of Health is working with the Republic of Ireland through the All-Island Breastfeeding Policy Network to identify opportunities for learning and research. The Public Health Agency (PHA) is also exploring research opportunities in collaboration with local universities.

Breastfeeding rates

There have been gradual increases since publication of the 2024 WBTi Report (2021/22 data used), as the most recent data available (2023) demonstrates in the tables below.

Data collection pointYear (infant year of birth)
20232022
Breastfeeding attempted62.7%62.2%

% Any breastfeeding: total (% in brackets)*+ partial**
Data collection pointYear (infant year of birth)
20232021
Discharge from hospital50.9 (33.9)50.8 (35.5)
First visit (10 -14 days)45.6 (32.1)43.0 (31.6)
6-8 weeks37.2 (26.5)34.6 (26.0)
3 months (14-16 weeks)31.3 (23.3)29.3 (22.4)
6-9 months24.7 (18.6)22.4 (17.3)
1 year (12-14 months)16.7 (12.1)11.3 (8.4)

*Total breastfeeding=fed only breastmilk, both at the breast and expressed.

**Partial breastfeeding=fed breastmilk and other milk.

Data for 2023 supplied by PHA Health Intelligence, March 2026:

  • Breastfeeding attempted – Northern Ireland Maternity System (NIMATS); Live births to Northern Ireland resident mothers; excludes home births, free births and infants who died in the delivery suite. Note: Data presented for 2023 is based on NIMATS data but excludes births in South Eastern HSCT following transfer to EPIC on 9 November 2023.
  • Discharge to 12 months – Northern Ireland Child Health System (NICHS); Live births to Northern Ireland resident mothers. Data will include resident mothers who gave birth outside Northern Ireland. Note: Discharge data for 2023 will include births recorded on EPIC to mothers resident in the SEHSCT area which impacts data quality and recording.

Encompass/EPIC is a new electronic patient record system that will create a single digital care record for every citizen in Northern Ireland who receives health and social care. It aims to create better experiences for patients, service users and staff by bringing together information from various existing systems. The programme was launched in the South Eastern Health and Social Care Trust (HSCT) on 9 November 2023. The system also went live in Belfast HSCT on 6 June 2024, and Northern HSCT on 7 November 2024 with roll out to Southern and Western HSCTs on 8 May 2025.

Data used by WBTi for 2021/2022 available from the PHA Health Intelligence Briefing

Scotland

Policy and guidance

The Scottish government launched a new strategy, Breastfeeding and infant feeding: strategic framework 2025-2030, in June 2025. It sets out how it will ‘further implement recommendations from the 2019 Becoming Breastfeeding Friendly report, and integrate them into broader action including responding to the World Breastfeeding Trends Initiative (2024) report card for Scotland.’ The UN Convention on the Rights of the Child (CRC) is now embedded in Scottish law and the CRC Committee’s 2023 recommendations include strengthening breastfeeding support for mothers, implementing the WHO Code and raising awareness of the importance of breastfeeding among the general public.

In November 2025, the Scottish government refreshed its stretch aim to reduce the drop-off in breastfeeding rates at 6-8 weeks and it is now a 10% reduction by 2031. The rate of drop-off has reduced from 34.5% in 2017-18, when the stretch aim was announced, to 25.3% in 2024-25.

An annual update on progress will be provided in the coming months, together with a forward look.

As of 2025/26, 85% of neonatal units are Baby Friendly accredited. Other services are 100% accredited: maternity units (achieved 2015), community trusts (2018) and universities (2021).

For staff training, there is a permanent national programme lead, and various resources. Breastfeeding is included in the national curriculum for secondary schools (section 2.3.7).

Breastfeeding rates

The rate of any breastfeeding at 6-8 weeks in Scotland has increased steadily over the past 10 years, from less than 40% to 49% (2023-34), more so among groups that traditionally did not breastfeed, thus helping to reduce inequalities.

The 2016 WBTi Report recommended routine data collection beyond 6-8 weeks, which the Scottish government was then considering, and later implemented.


% Any breastfeeding (% excl.*)

Year
Age data collected2024-252023-24
Birth (ever breastfed)6966
10-14 days61 (39)59 (38)
6-8 weeks51 (34)49 (33)
13-15 months22% (10% excl for milk feeds)21% (10% excl for milk feeds)

Data are from the financial years:

2024-25 https://publichealthscotland.scot/media/35987/2025-11-11-infant-feeding-statistics-report-final.pdf

2023-24 https://publichealthscotland.scot/media/29816/2024-11-12-infant-feeding-statistics_report.pdf

* Figures in brackets are for exclusive breastfeeding. At 13-15months, this means 10% were receiving only breastmilk for their milk feeds.

Wales

Policy and guidance

Our 2016 Report recommended having a high-level funded specialist lead, and the role of National Breastfeeding Lead Midwife at Public Health Wales was recently made a permanent position.

There is a 2025-27 delivery plan for helping prevent and reduce obesity which includes a section on infant feeding and encouraging breastfeeding. An action is to develop and deliver a new feeding action plan, replacing the 2019-2024 plan.

A recent assessment of maternity and neonatal services, published in February 2026 recommends ‘that the Welsh Government requires all maternity, neonatal and relevant education providers to actively progress through the stages of UNICEF UK Baby Friendly Initiative accreditation’ (p.129). This aligns with the WBTi report recommendation to implement and maintain Baby Friendly standards across all health boards in Wales.

The digital data system, BadgerNet, replacing hand-held notes, is being rolled out across Wales and the national dataset it will cover has been agreed. The WBTi Report recommended that Public Health Wales and Health Boards work together to improve the collection of data.

Breastfeeding rates

Rates of any breastfeeding continued their gradual rise at all ages where collected (birth, 10 days, 6 weeks, 6 months).


% Any breastfeeding (% excl.)

Year
Age data collected20252023
Birth6665.2
10 days60.755.4(37.9)
6 weeks49.240.7(29.1)
6 months35(20.9)

Note: exclusive breastfeeding rates in brackets; 2025 Welsh data are for July-Sept.

Conclusion

The devolved nations vary in their progress towards having a current infant feeding strategy. England has taken a different route, with a broad strategy for infants and children and accompanying guidance covering infant feeding.

Data collection is a key foundation for governments to monitor quality improvement, and to help target resources. The four nations collect data at different ages, making comparison between them difficult. England still does not collect data routinely beyond 6-8 weeks but does now have the survey results.

All the nations have made some progress in line with recommendations in the WBTi UK Report and shown improvements in breastfeeding rates. These are very welcome but it is essential that improvements continue as so many mothers still do not achieve their breastfeeding goals. The newly published survey for England found 72% of mothers who stopped by the time their baby was 4-6months old would have liked to continue breastfeeding for longer!

Author: Patricia Wise

Patricia Wise is an NCT Breastfeeding counsellor and a member of the WBTi UK Steering Group. She has a particular interest in health professional training in breastfeeding and her e-book, Supporting mothers who breastfeed: a guide for trainee and qualified doctors, is available on the WBTi website. 

Adjournment debate in UK Parliament on infant feeding

Adjournment debate in UK Parliament on infant feeding

On 1 July, Chichester MP Jess Brown-Fuller led her first adjournment debate in the House of Commons Chamber. 

She raised key concerns with the Government, calling for a national strategy for England. In her role as chair of the All-Party Parliamentary Group (APPG) on Infant Feeding she focuses on specific policy areas, beyond her constituency work. She aims to hold the government to account, by raising identified gaps in policy with the relevant government minister. Such debates apply pressure to increase accountability so may lead to a change in the law. 

Jess highlighted her own positive experience of a network of community support when her children were born a decade ago but which is now, at best, patchy or non-existent. She urged the government to implement all eleven Competition and Markets Authority (CMA) final report recommendations to protect families from the current unacceptable exploitation by the infant formula market.

Several MPs supported the debate by sharing both their own experiences and stories from constituents about the importance of skilled breastfeeding support.

WBTi in Parliament

For the first time, the WBTi report was mentioned by a minister on the floor of the House of Commons. Ashley Dalton, Parliamentary Under-Secretary of State for Public Health and Prevention in the Department of Health and Social Care, replied on behalf of the government:

 “We recognise the concerns raised in the World Breastfeeding Trends Initiative’s United Kingdom report and are considering the recommendations” and “we know through the report that England scores poorly, and we want to change that.” See Column 260 in the Hansard report of the debate.

MPs who attended:

Maya Ellis, Labour MP Ribble Valley

Jim Shannon, DUP MP Strangford ( Northern Ireland ) 

Connor Rand, Labour MP Altrincham and Sale West

Samantha Niblett, Labour MP South Derbyshire

David Reed, Conservative MP Exmouth and Exeter East

David Chadwick, Liberal Democrat MP Brecon Radnor and Cwm Tawe (Wales)

Dr Danny Chamber, Liberal Democrat Winchester

Article in the Sussex Express

Media follow-up

An article in The Independent on 11th August by journalist Abbie Llewellyn followed up on the Adjournment Debate.

Other outlets which picked up on the WBTi Report launch and the debate:

ITV Regional News interviewed Jess Brown-Fuller regarding the outcome of the CMA report, (a market study on infant formula and follow-on formula) set to be released on 1st September 2025.

The i Paper ran an article by journalist Emma Morgan on infant formula marketing.

Parliament News magazine ran a piece by Jess Brown-Fuller MP: Building the ‘healthiest generation ever’ starts with making sure every child has a fair start in life.

The Nursing Times published an article about the WBTi Report launch and policy event, hosted by Jess Brown Fuller, highlighting quotes from iHV CEO Alison Morton, Vicky Sibson of First Steps Nutrition Trust, and Jess Brown-Fuller.

The British Medical Journal on 26 June included a further news article by Gareth Iacobucci, about the WBTi launch and our Call to Action for the government to implement the CMA recommendations in full: “Formula milk: Overpriced and misleading products are risking child health, say campaigners.” BMJ 2025; 389:r1333.

Other recent relevant contributions by Jess Brown-Fuller MP to Parliamentary debates 

Prior to the Adjournment debate on 1st July there was a Parental Leave Review debate led by Justin Madders MP, the Parliamentary Under-Secretary of State for Business and Trade. Various members of the APPG on Infant Feeding attended the meeting. Jess Brown-Fuller asked about the impact of breastfeeding policies on mothers returning to work. Despite the WBTi findings that mothers are struggling with continuing to breastfeed upon return to work, Justin Madders explained that this fell slightly outside the scope of the review but he was happy to correspond on the matter.

On 7th July there was a debate on Giving Every Child the Best Start in Life Strategy, led by Bridget Phillipson MP, Secretary of State for Education. Jess Brown-Fuller asked for confirmation that Best Start centres will be firmly rooted in evidence-based feeding support. The Secretary of State gave an assurance. 

Photo credit: Office of Jess Brown-Fuller MP

Jess Brown-Fuller MP looking at the WBTi Report with Clare Meynell

Author: Clare Meynell RM (rtd), IBCLC

Clare had a long career as a midwife and infant feeding lead achieving the UNICEF UK Baby Friendly Initiative Gold award accreditation at her local hospital. Currently, with Helen Gray, she jointly coordinates the UK WBTI working group and co-presented the first report for the UK in Parliament in November 2016 and the second in 2024.

Clare still volunteers her knowledge and experience at a regular mother and baby support group. 

Her focus recently has been to create “Actions for Change” through the WBTi report recommendations so that the next generation of mothers are enabled to achieve their personal breastfeeding goals and that society better understands the health-giving properties of human milk as the physiologically normal first food for babies. 

Presentation at the APPG on Infant Feeding

Presentation at the APPG on Infant Feeding

WBTi UK Steering Group members, Helen, Clare, Alison and Patricia, were very pleased to be invited to give a presentation on the 2024 Report to the All-Party Parliamentary Group (APPG) on Infant Feeding on 18 June, 2025. This APPG, an informal cross-party group, is hosted by Liberal Democrat MP for Chichester, Jess Brown-Fuller, who is a staunch advocate for breastfeeding. Meetings are quarterly.

(left to right) Jess Brown-Fuller MP, Helen and Patricia during the presentation

The hybrid event was held in Portcullis House, which is close to the Houses of Parliament and overlooks the River Thames.

At the meeting, Helen and Patricia gave an overview of the Report’s findings. This triggered a range of questions from the audience in the room and online. Attendees included Labour MP for Ribble Valley, Maya Ellis, and Liberal Democrat MP for mid-Sussex, Alison Bennett, along with representatives of Royal Colleges and local public health teams, as well as the breastfeeding support organisations.

(left to right) Jayne Joyce and Emily Lunny (LLLGB), Helen Gray and Patricia Wise (WBTi Steering Group) and Katie Pereira-Kotze (First Steps Nutrition Trust)

Presentation title slide

APPG meetings

If you would like to be notified about future Infant Feeding APPG meetings, please contact Edmund Legrave, Parliamentary Assistant for Jess Fuller-Brown: edmund.legrave@parliament.uk

Author: Patricia Wise

Patricia Wise is an NCT Breastfeeding counsellor and a member of the WBTi UK Steering Group. She has a particular interest in health professional training in breastfeeding and her e-book, Supporting mothers who breastfeed: a guide for trainee and qualified doctors, is available on the WBTi website. 

New WBTi Report: Parliamentary launch

New WBTi Report: Parliamentary launch

Jess Brown-Fuller, MP for Chichester, hosted the formal launch of the WBTi 2024 UK report on July 24th 2025 in the Jubilee Room at the Houses of Parliament. 

(left to right) Patricia Wise, Clare Meynell, Jess Brown-Fuller MP with visiting baby Niamh, Helen Gray, Alison Spiro

Kate Quilton

Investigative journalist Kate Quilton drew on her own experiences in emphasising the importance of a  policy framework, and chaired the Q&A.

What do policymakers need to do, to protect and support breastfeeding? 

The WBTi 2024 report made a number of key policy recommendations on maternity rights, marketing regulations and food safety.

WBTi’s ‘big ask’

The aim of the WBTi project is to galvanise action to implement report recommendations, thus improving support and protection for infant feeding. Our single most immediate actionable ask is for the UK and devolved governments to adopt the eleven recommendations of the Competition and Markets Authority (CMA) report on regulating misleading infant formula promotion. Adopting these would help to end the profiteering we have seen in recent years (formula prices have gone up by 24%! including one by 49%!). This would also help families make informed infant feeding decisions and for them to be able to access affordable products to feed their babies if needed.

The CMA recommendations encompass many of the WBTi UK recommendations on protecting families from exploitative marketing. In addition, WBTi calls for the regulations to apply to ALL formulas from 0-36 months. This would help end the loopholes that companies use in the marketing of formulas for older babies and toddlers, or for special medical purposes.

Professor Nigel Rollins

Professor Nigel Rollins, who formerly worked for the World Health Organisation and is now at Queens University, Belfast, gave a policy overview and more details about our ‘Call to Action’. 

Parents are struggling

Professor Amy Brown of Swansea university stunned the room when she revealed some of the shocking findings of her research into the challenges families are facing to afford the high prices of formula.

Professor Amy Brown

Her presentation called for:

  • Lower priced milks – consistent, reliable and affordable pricing
  • Accurate information, not adverts
  • Parents should be supported to feed their baby without worrying about cost
  • For the health and well-being of parents and babies to be put before profits

She shared powerful testimony about the impact of the high cost of formula from parents themselves:

Breastfeeding is important

“Breastfeeding is a human right for both mother and child” (UN human rights joint statement 2016).

WBTi work is built on a foundation of human rights. UN human rights experts have made it clear that breastfeeding is a right of the dyad, the mother and infant together. The rights of one don’t supercede the other; mother and baby have rights as a dyad. It is the responsibility of our governments to support and protect those rights, by providing skilled health care, maternity protection at work, and protecting the rights of women and families to make their own informed decisions about how to feed their baby, without commercial influence.

What is the impact of low breastfeeding rates in the UK?

High costs for the NHS:

Low UK breastfeeding rates are costing the NHS £millions:

  • 54,000 more GP appointments
  • 9,500+ additional hospitalisations

Research has shown that basic interventions to support more mothers to breastfeed for longer could pay for themselves within a year. (Renfrew et al 2012)

Costing our planet:

The formula and dairy industries have a significant footprint both of greenhouse gases and water.

“For the UK alone, carbon emission savings gained by supporting mothers to breastfeeding would equate to taking between 50,000 and 77,500 cars off the road each year” (Joffe et al 2019)

Key recommendations from the WBTi Core Group

Our governments must address the ‘baby blind spots’ in national policies:

  • Protect all infants by adopting in full the recommendations of the CMA, and extending the regulations to cover all infant milks up to 3 years, in order to address current loopholes in marketing formulas for older infants or for special medical purposes.
    • WBTi recommends that regulations on safety and on marketing should be applied to feeding equipment such as bottles, teats, and other equipment, as well.
  • Protect infants and young children in emergencies by developing guidance on their care.
  • Protect the health and the rights of women and children by providing statutory rights for flexible breastfeeding/ expressing breaks and suitable facilities in the workplace and in education.
  • Develop a national infant feeding strategy and leadership for England.
  • Improve monitoring and evaluation by strengthening and coordinating data collection systems.

Find our 2016 and 2024 reports here.

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Author: Helen Gray

Helen is a member of the Steering Group for  the World Breastfeeding Trends Initiative (WBTi) project in the UK.

An IBCLC and La Leche League Leader (breastfeeding counsellor), she has served as both Communications Co-Chair and Policy and Advocacy Lead for Lactation Consultants of Great Britain. She represents La Leche League of Great Britain on the UK Baby Feeding Law Group (BFLG), which works to bring the International Code of Marketing of Breastmilk Substitutes into UK law.

Helen’s background in anthropology and human evolution has influenced her interest in how breastfeeding and the way we nurture our babies are influenced by both human biology and culture.

She is currently doing a research degree on the need for strong policies to protect infant feeding in emergencies. She has written several articles and chapters on the subject and served on the Advisory Panel for a London Food Resilience research project. She now represents BFLG on the global Infant Feeding in Emergencies Core Group.

New WBTi report: first findings

New WBTi report: first findings

Health professional training needs to include more on infant feeding

Gaps in health professional training on infant feeding have been one of the most talked-about findings of the WBTi project in the UK.

The soft launch of the second WBTi Report on UK infant feeding policies and programmes was held at Guy’s Hospital, London, on March 25th, with a focus on gaps in pre-registration training for health professionals.

The WBTi assessment also includes in-service training. In the UK, the main source is UNICEF Baby Friendly Initiative training.

What were the gaps?
Little has changed in these high level universal standards since the 2016 WBTi report. The most striking gap is that the general requirements for all nurses do not explicitly include infant feeding; this means that university health visitor training programs are not required to include much on breastfeeding, unless they are UNICEF Baby Friendly-accredited. Only 21% of university health visitor training programmes are BFI-accredited, although many health visitors will go on to receive in-service training as  69% of health visiting services in the community are now BFI- accredited.  Nurses in other parts of the health system, from emergency rooms to oncology or women’s health, and even in paediatric and neonatal wards, have not routinely received training in breastfeeding.  

Little support for hospitalised mothers

The WBTi team also conducted a survey of infant feeding leads on NHS Trust policies to support hospitalised mothers who are breastfeeding in wards other than maternity, for example to maintain their milk supply. We found that many Trusts lack such a policy. Scotland does have a guideline that has now been rolled out across the NHS in Scotland.

Sharing our findings

The event was well attended by key stakeholders, including representatives from the Department of Health and Social Care and devolved nations, health professional bodies, UNICEF Baby Friendly Initiative, and members of the WBTI Core Group.

The WBTi Steering Group – Helen, Clare, Alison and Patricia

Dr Bob Boyle of Imperial College set the scene with an historical background of infant feeding in the UK and globally. The WBTi team gave an overview of the report, emphasising the importance of every mother in the UK having access to an integrated network of infant feeding support, and the essential need for political commitment to enable this.

Mapping of pre-registration training standards against the WHO Education Checklist

The UK WBTI assessment maps national minimum standards for training on infant feeding topics against the Educational Checklist from WHO.

The WBTI mapping shows what any family, in any part of the UK, can expect as a minimum from their local health professionals, including not only midwives and health visitors, but also GPs, paediatricians, dietitians and pharmacists. 

The assessment found some improvements, but many gaps remain, as can be seen in the chart below, with the red indicating the gaps. It is essential that everyone caring for parents have knowledge of breastfeeding. Health workers should be able to support parents’ goals, and avoid inadvertently undermining their infant feeding decisions. 

WBTi summary table of breastfeeding topics in health professional standards

Table of basic standards in breastfeeding topics. More details can be found in Indicator 5 in the full report (Part 1). See Part 2 for a more detailed breakdown.

Author

Dr Alison Spiro is a member of the WBTi Steering Group. She is a retired NCT breastfeeding counsellor, specialist health visitor and hospital and community infant feeding lead, taking both trusts to Baby Friendly accreditation. She completed her MSc in 1994 and PhD in 2004 on Gujarati culture and breastfeeding, doing her fieldwork in Harrow and India. 

Alison is the author of a book ‘Breastfeeding for Public Health, a guide for community health professionals’ published by Routledge. 

WBTi is at BFN Conference 2023!

We are delighted to have been invited to present an overview of the WBTi UK project to the 2023 Breastfeeding Network Conference!

Check back on our blog, or sign up to the blog for notifications, to get all the advocacy links we talk about.

See you there!

‘Let’s make breastfeeding work – optimal maternity leave and workplace accommodations support an environment that enables breastfeeding’

August 1-7th marks the World Breastfeeding Week. The theme is ‘Let’s make breastfeeding and work, work!’ The benefit of breastfeeding to health, the economy, work and the environment is widely documented. However, the UK remains one of the countries in the world with the lowest breastfeeding rate. Although 81% of mothers set out to breastfeed, only 1% of babies in the UK are still exclusively breastfed at 6 months. The question has always been why is breastfeeding rate so low in the UK? 

Photo credit: Dr Paige E. Davis

Return to work is one of the key barriers to breastfeeding especially where the workplace is not breastfeeding friendly. A study published in 2007 by the Cohort Group found that mothers employed part-time or self-employed were more likely to breast-feed for at least 4 months than those employed full-time. The longer a mother delayed her return to work postpartum, the more likely she was to breast-feed for at least 4 months. Mothers were more likely to breastfeed for at least 4 months if their employer offered family-friendly or flexible work arrangements, or they received Statutory Maternity Pay plus additional pay during their maternity leave rather than Statutory Maternity Pay alone. This demonstrated that return to work could have a negative impact on breastfeeding if the mother is not properly supported. 

Currently the UK does not have a legal framework that protects and promote breastfeeding in the workplace. The 1001 critical days strategy is there but does not have a legal backing to ensure that mothers are properly supported to continue breastfeeding should they choose to return to work early. A general assumption is made that mothers would take the full 52 weeks of maternity leave even though the leave is not properly paid.  Mothers returning to work find it challenging to understand what they can and cannot do. 

Though many employers are quick to showcase how family friendly they are in supporting working parents, breastfeeding remains an area in need of significant improvement. This is predominantly because the government has failed to recognise the benefits of breastfeeding and has failed to embed it in the current family friendly rights. Ideally, maternity leave should naturally go with a workplace breastfeeding policy. Other family friendly policies such as shared parental leave is not achieving its desired impact partly because of the lack of breastfeeding support in the workplace. 

Mothers who intend to breastfeed for long may not share their maternity leave with their partners if support is not in place in the workplace.

These challenges were clearly articulates in the breastfeeding documentary titled ‘Breastfeeding: Not on the Agenda’which was followed by a call to action for the government to include breastfeeding in the family friendly rights to Make Breastfeeding and Work, Work.

NOTE from the WBTi team:

This petition incorporates many of the WBTi recommendations for action:

  • Embed breastfeeding in the school curriculum and relevant health  professionals training.
  • Provide a policy on breastfeeding in the workplace which will protect the rights of breastfeeding mothers in the workplace.
  • Mandate all large public places like shopping malls, community centres, public libraries, museums, etc to provide breastfeeding rooms or spaces.
  • Fully adopt The Code of Marketing of Breastmilk Substitutes to protect babies and their families from harmful commercial influences and undermining of breastfeeding for commercial profit; and to protect families who formula feed from the escalating costs of premium brands.
  • Provide adequate 24/7 specialist lactation support in maternity services to actively counteract the culture of formula top-ups in hospitals; and to enable human donor milk to be more accessible as an option when mother’s milk is not immediately available.
  • Guarantee a sustained funding support to breastfeeding organisations who play a key part in supporting mothers.
  • Include breastfeeding support on the Net Zero Environmental Agenda.

Dr Ernestine Gheyoh Ndzi is the Associate Dean for Law and Police Studies at York St John University. Her research interest lies in Company Law and Employment Law. Ernestine has in the past four years been researching on shared parental leave and breastfeeding. Ernestine is a member of the Board of Trustees for The Breastfeeding Network. She is the producer of the breastfeeding documentary titled ‘Breastfeeding: Not on the Agenda. She is running a 9-webinar series exploring the benefits and challenges of breastfeeding. She is also leading on the campaign for change to support breastfeeding in the UK.

The Defence Breastfeeding Network

The Defence Breastfeeding Network

When you think of the UK Armed Forces, many of our minds will go to an infantry soldier fighting stoically on the battlefield, or perhaps bearskins guarding the King at the palace. Not many people think of breastfeeding mother. But we do have them.

The Defence Breastfeeding Network launched in June 2020, to support breastfeeding soldiers during their maternity and return to work phase. Initially, we started with a Facebook group for some community support. We then created a partnership with Families and Babies Lancashire, who train members of the DBN to become level 2 breastfeeding peer supporters. As a network, we have currently trained over 60 peer supporters who give back to our members but also in their own communities. A project the DBN is currently working on is the establishment of breastfeeding/ wellness rooms within our infrastructure. These rooms all have a lockable door, comfortable seating, access to fridge space, access to clean running water and electricity. Many of the rooms are made comfortable with extra facilities such as tea and coffee stations, TV’s/radios, microwaves and more, with credit to the individuals within units that set these rooms up for all to benefit from. These rooms are more than just set up for those that need it now, they’re set up for when they are needed in the future. As an organisation, the Armed Forces are setting an example that I would encourage every employer to follow. 

In 2021, the Defence Breastfeeding Policy was launched, providing clear and concise information for line managers on how to effectively manage and support breastfeeding mothers in the workplace, from risk assessments to medical gradings and through to deploying into a field environment which can mean living outside for extended periods of time. This does not mean we are sending breastfeeding mothers away from their children for months on end with little notice but takes into account the fact that we are soldiers, aviators and sailors. Gone are the days where women were dismissed from the military for being pregnant, and now as an organisation we are aiming to be proactive with breastfeeding support rather than reactive. Service life isn’t always easy on the service person or their immediate family, and as a network, the DBN is there to be as much of a village as possible. Education is really important, and the DBN attends unit health events and gives briefings across the UK to raise awareness of policy and the networks existence, in order to create more allies within the Armed Forces. 

I have personally been on a field exercise (in the UK) with a manual breastpump in my bergen. It was handled wonderfully, I was able to take a small fridge to store my milk and was able to be transport it back to a freezer too. I was given the time, space and respect to express milk comfortably and was treated with dignity. I went on to feed my son for 2.5 years. 

So how do we make breastfeeding work? We need support. We need employers that are proactive and view mothers as an asset and not a hindrance. We need support from everyone else; our families, friends, and strangers in the street. And I’m proud to say that the Armed Forces is a great champion.

LCpl Natasha Day MBE joined the British Army in 2014 as a Combat Medical Technician, deploying to South Sudan and Kenya before studying to become a Paramedic in 2021. After the birth of her son Charlie, she established the Defence Breastfeeding Network (DBN) in 2020 to support members of the Armed Forces and their families in their breastfeeding journey. The DBN supports over 1300 families and has collectively opened 83 breastfeeding and wellness rooms across Defence infrastructure. Natasha is currently posted to the NHS as a Paramedic. 

Shared Parental Leave policy failing to make Breastfeeding and Work, Work 

Shared parental le­­­ave is a policy that was introduced in the UK in 2014 with the aim of giving parents more choice and flexibility in how they care for their child in the first year. However, it means that the mother would have to share part of her maternity leave with her partner. This would reduce the time a mother can spend on maternity leave. While the shared parental leave policy is great in encouraging fathers to take a more active role in the early days of the child’s life and enabling mothers to return early to the labour market, it presents a unique challenge to mothers who choose to breastfeed.

Barriers in the workplace are some of the key challenges to breastfeeding mothers who choose to return to work early after childbirth. Returning to work often means mothers must constrain their breastfeeding, which sometimes results to mothers ceasing breastfeeding.

The lack of a legal framework on what employers are expected to do to support breastfeeding mothers makes shared parental leave unattractive to parents who desire to exclusively breastfeed for six months and to continue according to the WHO breastfeeding recommendations. While there is ACAS guidance and the Health and Safety Policy on what employers should be doing to support breastfeeding mothers returning to work, employers are not obliged to follow it and there are no consequences where they do not follow the guidance. Furthermore, flexible working remains a request not a right and does not go far enough to protect breastfeeding mothers in the workplace. 

Shared parental leave policy has been criticised as not fit for purpose for reasons such as financial constraints, the complexity of the policy, societal perception, childcare responsibilities, lack of workplace support and breastfeeding. While the recent evaluation report recognised that there are challenges with the shared parental leave policy, it failed to identify breastfeeding as a challenge. The study that informed the report did not consider breastfeeding as a factor to evaluate its impact on the policy. It is extraordinary that a policy that is meant to provide parents with flexibility on how they care for their child, do not consider breastfeeding as a key factor. 

A study with mothers that were breastfeeding and took shared parental leave demonstrated that shared parental leave only worked well where the workplace was supportive and made provision for the mother. 

It is important that mothers are supported in how they decide to feed their babies. Breastfeeding need to be part of the family friendly rights in the UK. This would ensure that breastfeeding is factored into policies that concerns nursing mothers such as maternity leave and shared parental leave. 

Dr Ernestine Gheyoh Ndzi is the Associate Dean for Law and Police Studies at York St John University. Her research interest lies in Company Law and Employment Law. Ernestine has in the past four years been researching on shared parental leave and breastfeeding. Ernestine is a member of the Board of Trustees for The Breastfeeding Network. She is the producer of the breastfeeding documentary titled ‘Breastfeeding: Not on the Agenda. She is running a 9-webinar series exploring the benefits and challenges of breastfeeding. She is also leading on the campaign for change to support breastfeeding in the UK.

New Toolkit for Employers supporting breastfeeding mothers 

New Toolkit for Employers supporting breastfeeding mothers 

Maternity Action have produced a new resource for employers which aims to help manage pregnant women and new parents at work, including breastfeeding mothers.  Our in-house legal team have developed the Employers Toolkit, drawing on the extensive knowledge of potential workplace issues that we have gained through our advice work. With this resource, we are aiming to encourage employers to support women to have healthy pregnancies and to improve women’s experiences at work during pregnancy, maternity leave and on their eventual return. 

The resource is also based on feedback that we have had from employers – for example, we know that many smaller employers don’t have HR capacity and cannot get the right information at the right time, which leads to uncertainty of their legal obligations. The toolkit is designed to make life easier for employers – there are checklists for different stages of pregnancy, maternity leave and return to work so that employers can be confident that they have done everything they are required to do.  

In addition to this, the toolkit also contains a template for risk assessment and a number of model policies, including on maternity leave and pay and on breastfeeding.  The model breastfeeding policy comprises best practice examples, information about Health and Safety protection and suggestions for possible adjustments. The toolkit builds on our previous work with the UK breastfeeding organisations to develop a Maternity Action resource for employers, and with Acas in 2013, developing their guidance on accommodating breastfeeding on return to work.

Many employers want to do the right thing for their employees and indeed many already do, recognising that supporting the transition back to work for their women employees is a small, short-term investment that has longer term benefits such as loyalty and staff satisfaction. With this toolkit, we aim to provide employers with answers to common questions about managing pregnancy, maternity, adoption, paternity and other family leave provisions in the workplace. We hope that this will help inform good employment practices.

Maternity Action is working with Greater Manchester Good Employment Charter to engage employers in the region. Acas North West hosted the launch of the resource and we are working together to promote the resource more widely. We are also looking at other ways to get the resource out to the employers who need it. Please get in touch if you would like to get involved in this.

The toolkit is funded by the VCSE Health and Wellbeing Fund, part of a partnership programme between Department of Health & Social Care, NHS England and UK Health Security Agency.

Get in touch: info@maternityaction.org.uk

Annah Psarros is Senior Policy Officer at Maternity Action. Annah is particularly interested in health inequalities and the social factors contributing to maternal health and wellbeing. She is currently working on a research project about the cost of living crisis and its effects on mothers and families, due in the autumn.