Breastfeeding and the First 1000 Days: the foundation of life

Breastfeeding and the First 1000 Days: the foundation of life

Breastfeeding: The Foundation of Life

The First 1000 Days of Life (from conception to the age of two years) are a critical window in a baby’s development. The 1000 Days concept was first widely used by the World Health Organisation and UNICEF, and there are currently numerous campaigns building on that theme.*

There is currently an inquiry into the First 1000 Days by the UK Parliamentary Select Committee on Health and Social Care. This blog brings together a few of the key concepts and resources on the importance of breastfeeding during the First 1000 days.

A joint supplement on the importance of breastfeeding in the first 1001 Days was produced by the UK breastfeeding organisations in 2015, which summarises much of the evidence.

A focused briefing on the the role of breastfeeding on infant brain growth and emotional development can be found here.

 

Breastfeeding: cornerstone of the First 1000 Days

Human babies are born extremely immature compared to other mammals; they are completely dependent on their mothers for milk, comfort and warmth.

  • “A newborn baby has only three demands. They are warmth in the arms of its mother, food from her breasts, and security in the knowledge of her presence. Breastfeeding satisfies all three.” ~ Grantly Dick-Read

Scientific research has continued to underscore the vital role that breastfeeding and breastmilk play in the development of the human infant. See our WBTi blog series for this year’s World Breastfeeding Week, from 31st July – 7th August 2018 for a review of the myriad ways that breastfeeding influences human development.

 

Breastfeeding: more than just food

This is the title of a series of blogs by Dr Jenny Thomas which focuses on some of the ways that breastfeeding contributes to immune development and more. Beyond physical health and development, however, breastfeeding also plays a key role in the healthy mental and emotional development of the infant. Breastfeeding provides optimal nutrition for the first months and years of life, alongside suitable complementary food after six months, but it also supports the development of the child’s immune system and protects against a number of non-communicable diseases in later life as well.

The World Health Organization commissioned high level reviews on a range of health and cognitive outcomes which were published in a special issue of Acta Paediatrica in 2015; these formed the foundation of the Lancet Series on Breastfeeding  which was published in 2016.

 

The impact of breastfeeding on maternal and infant mental health and wellbeing.

Breastfeeding can help strengthen mother and baby’s resilience against adversity, and can protect infants even when their mothers suffer from postnatal depression. It supports optimal brain growth and cognitive development. Unfortunately, if mothers don’t receive the support they need with breastfeeding, this can significantly increase their risk of postnatal depression. A summary of evidence can be found here.

The role of breastfeeding in protecting maternal and infant mental health is often poorly understood – mothers who are struggling need skilled support to resolve breastfeeding problems if they wish to continue breastfeeding

 

What does the future hold?

It is essential that policy makers, commissioners, and researchers understand the evidence and importance of breastfeeding, so that women who want to breastfeed get any support they need. The WBTI report outlines major policies and programmes that national infant feeding strategies need to include; other research on the psychological and cultural influences on mothers’ infant feeding decisions will help policy makers to develop sensitive and sound policies and programmes to support all families.

In the end, it will be essential that families themselves are heard, in order to create the support systems that our society needs.

 

 

*Unfortunately a number of infant milk and baby food companies have jumped on the “1000 Days” bandwagon too, despite the fact that breastfeeding is the centrepiece of the original 1000 Days concept, and replacing breastmilk with formula or baby food actually removes that fundamental building block from a baby’s development.

 

 

 

Helen Gray IBCLC photoHelen Gray MPhil IBCLC is Joint Coordinator of the World Breastfeeding Trends Initiative (WBTi) UK Working Group. She is on the national committee of Lactation Consultants of Great Britain, and is also an accredited La Leche League Leader. She is a founding member of National Maternity Voices. She represents LLLGB on the UK Baby Feeding Law Group, and serves on the La Leche League International special committee on the International Code.

WBTi UK report – first anniversary celebration – a Forum

WBTi UK report – first anniversary celebration – a Forum

It’s a year since the first WBTi UK report was launched in November 2016 at the Houses of Parliament, giving the first snapshot of the state of breastfeeding support in the UK across the indicators. The report has been used as a basis to advocate for improvements in legislation, in strategy, and in training. It has been shared with MPs, with government ministers, as well as shared widely throughout the breastfeeding community through our website.

During the year, we have hosted monthly blogs on our website, focussing on the various indicators in turn. We have an active social media planning group that publicises the WBTi findings, our blog and activities. The team have also produced numerous journal articles, posters and conference presentations in the UK and beyond. Our talented team of volunteers have also developed a video  about our findings. We continue to contribute to ongoing consultations about improving health professional training in infant feeding

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Policy Forum: Protecting Infants in UK Planning for Emergencies

On November 28th 2017, we will be holding a policy forum at the Houses of Parliament, in collaboration with Ruth Stirton of the University of Sussex and hosted by Alison Thewliss MP: “Protecting Infants in UK Planning for Emergencies.” This event both celebrates the anniversary of the report and aims to achieve change in Indicator 9, “Infant and young child feeding during emergencies,” which is the policy with the lowest scores across the UK. At present, there are no UK-wide or national strategies addressing the issue and it is not explicitly mentioned in local planning.

Unicef UK Baby Friendly Initiative

The jewel in the crown of breastfeeding support in the UK is the Unicef Baby Friendly Initiative. All maternity units in Scotland and Northern Ireland are accredited and most in England and Wales are working towards it. Many community NHS trusts and boards are also on the ladder towards accreditation. Some neonatal units, university midwifery and health visiting/specialist community public health nursing courses are also involved. All are helping to raise the standards of infant support provided by these health professionals.

Cuts to breastfeeding support around the country

Sadly, the WBTi assessment found that cuts in infant feeding lead posts, drop-ins and peer support programmes as well as specialist services were occurring and this has continued. For example, Blackpool’s service was decommissioned in June and the service in Kent is under threat. It appears that there is an assumption by some commissioners that health visitors can provide a sufficient service. Health visitors do have a responsibility to provide effective support with infant feeding, and should do so at statutory visits and other contacts. However, a significant number of mothers also require specialist support, which needs time as well as skill, and all mothers can benefit considerably from the social support that trained peer supporters can provide. It seems it is not well understood how challenging some breastfeeding situations are and the amount of training required to help effectively in those situations.

Ask YOUR MP to join the Call to Action!

These cuts in services for women and babies are likely to have a negative impact on Baby Friendly accreditations. Unicef UK is holding an event for MPs at the Houses of Parliament on December 5th, asking them to pledge their support for breastfeeding. How would it be if every current MP were contacted? Are you willing to contact your MP?

 

 

 

One key question before the election?

One key question before the election?
By Emma Pickett
Chair, Association of  Breastfeeding Mothers

I imagine like me you have watched some pre-election television debates in the last few weeks. It’s easy to start daydreaming and picture yourself in that audience putting our leaders on the spot. If you had the opportunity to ask that one key question of the main political leaders and get it broadcast on national television, what would you choose to focus on?

For many of us who have been involved in the WBTi project, it’s a no-brainer: What would they do to improve the situation around breastfeeding and infant feeding in the UK?

Except you’ve only got one sentence to outline a situation that took WBTi more than 70 pages.

You’re talking about health care professional training and the international code of marketing of breastmilk substitutes, national leadership, maternity protection in the workplace, data collection. Plus, you are talking to people who don’t even realise there is a problem in the first place or have little understanding of the complexity. There are few soundbites developed for an issue that affects families across the UK and for a situation that many of us see is in crisis.

Breastfeeding is a public health imperative

Politicians are nervous to touch on an issue which they often see as being about individual choice rather than a ‘collective societal responsibility’, as Dr Nigel Rollins described breastfeeding in The Lancet report last year. But when you look at the reality of what is happening in the UK, there is no need to fear having a conversation about breastfeeding. It’s not controversial to be disappointed to hear that 86% of women who stopped breastfeeding in the first two weeks would have liked to have continued for longer. Or 63% of those who stopped before 10 months. It’s especially not controversial when you learn more about the impact of breastfeeding on maternal mental health and its role in reducing inequality.

Which politicians wouldn’t be interested in something UNICEF describe as ‘a natural safety net against the worst effects of poverty’ or a factor shown to have a significant impact on the national economy? We can read through the manifestos of the political parties and see references to obesity and child health and mental health and find ourselves exasperated that infant feeding hardly gets a mention. However, it IS there. In every discussion about fighting inequality or improving chances or protecting the environment or stimulating the economy or supporting parents or focusing on mental health. They just don’t KNOW it’s there.

It is our duty to get this message across.

We may not be sitting in a Question Time audience but we meet our candidates. We have their emails and Twitter accounts. We can speak to them once they are sitting MPs.

Use the WBTi sample email and add your own messages to all the candidates in your own area. What are the gaps in breastfeeding services in YOUR area? Tell YOUR story.

It’s about emphasising why funding matters and why breastfeeding support in the community isn’t a nice optional extra. We are hearing about the huge variation in community-based support across the UK. Cuts to services in England are particularly a worry. Parents are finding groups closing, peer support services disappearing and when they are struggling with more complex problems, there is often nowhere to go. Specialist positions are either being lost or the integration of services means signposting to more qualified breastfeeding specialists such as IBCLCs is confused.

There is no point sighing about the crisis in infant feeding unless we also act. No point in putting a nice meme on your social media account, without also making sure you take 5 minutes to educate a politician who may simply not understand the basics. No point having anger towards our leaders if they are uninformed. WE are the ones who can do the informing: the new parents, the breastfeeding organisations, the healthcare professionals. It’s all too easy for social media to become a place where we all just talk to people who already agree with us. It has never been easier in history for us to directly contact our candidates and politicians. They won’t understand these issues unless we educate them. It starts with one email or one tweet or one conversation.

Have you done it?

For more information about cuts to community breastfeeding services, see WBTi’s 2016 briefing

See the Open Letter signed by dozens of royal colleges, health professional bodies, researchers and voluntary organisations

Responses from political parties

Baby Milk Action have asked all the major political parties about their breastfeeding and infant feeding related policies. You can read their letter, which refers to the WBTi UK report, and the responses they have received here.

 

Photo credit: Sophie Burrows

Emma PickettEmma Pickett IBCLC is Chair of the Association of Breastfeeding Mothers. She is also an ABM breastfeeding counsellor (www.abm.me.uk) in North London. She has supported breastfeeding mums in Haringey as a volunteer since 2008.

Emma is the author of You’ve Got It In You: A Positive Guide To Breastfeeding  and blogs at Emma Pickett Breastfeeding Support 

Cuts to breastfeeding support in England

A number of local and national breastfeeding support organisations have documented cuts to funding and services providing breastfeeding support. This briefing paper was developed by several organisations with the help of volunteers from the WBTi UK team, setting out the current situation in England. It includes a partial list of cuts at the time of writing. Funding situations do change so please send any updates or corrections to wbtiuk@lcgb.org.

The World Breastfeeding Trends initiative is a collaborative effort, bringing together all the key stakeholders in the country to evaluate breastfeeding policies and practices and how well they conform to the Global Strategy on Infant and Young Child Feeding.

Open Letter in response to Lancet series on breastfeeding

Lancet coverIt’s been a busy week for the WBTi UK team.

Following The Lancet’s series on breastfeeding, published on 30 January, reports in the press largely focused on Britain having “the worst breastfeeding rates in the world”. We knew that wasn’t quite right – rates of starting breastfeeding are relatively high, but they drop off rapidly. Yet, at the same time, the UK is experiencing profound cuts to breastfeeding support services – one of the very things needed to get those breastfeeding rates rising.

So, we organised an Open Letter calling on all four governments of the UK to safeguard public health budgets and end those cuts. The letter also outlines the series of measures needed to improve breastfeeding – rates, duration, and experiences. We are delighted that the letter has been signed by midwives, health visitors, lactation consultants, infant feeding leads, GPs, paediatricians, breastfeeding counsellors, peer supporters, university researchers, and others working in the area of baby feeding and health.