Monday, May 14, 2007

UK Breastfeeding Awareness Week begins

Well, I’m just back from Cardiff where I was invited to speak at an NHS Wales/Sure Start event marking the start of Breastfeeding Awareness Week.

The Department of Health has released the findings of the 2005 infant feeding survey today. Initiation rates are up to 76%. Still far off the 98% in Sweden and the tail off is far more rapid in the UK than in Sweden.

The more worrying thing found in past UK surveys, however, is that the majority of UK mothers who stop breastfeeding in the first weeks say they did not want to stop. It was because of problems they experienced with breastfeeding. In Sweden there is support for such mothers – the high rates there are not for biological reasons, but cultural ones.

You can find the survey on-line. I’ll write something about it when I’ve had time to go through it. See:
http://www.ic.nhs.uk/statistics-and-data-collections/health-and-lifestyles/infant-feeding/infant-feeding-survey-2005

If we want mothers to be able to say they stopped breastfeeding because they and their child had decided it was time to stop – whenever that may be – then much has to be done to provide a supportive environment.

The Breastfeeding Manifesto campaign is one thing Baby Milk Action is supporting to help achieve this. I'll write more about that later this week. You can find out more and sign up in support at:
http://www.breastfeedingmanifesto.org.uk/

Something else we do is accept invitations when we can to train health workers on the World Health Assembly marketing requirements for baby foods. The aggressive marketing of baby foods is part of the reason why breastfeeding rates are so low in the UK.

The event in Cardiff was opened by Rhodri Morgan, Welsh Assembly Member for Cardiff West and former First Member of the Assembly, who had to duck out of the meeting as discussions are still on-going over forming the new government following last week’s elections.

He spoke of his support for promoting cultural change to allow mothers to breastfeed, from support in the health care system to more tolerance in the community. Wales has a scheme that businesses can sign up to as breastfeeding friendly environments. Meaning that mothers won’t be directed to the toilets or told to stop if they wish to feed their child.

There was a great panel of speakers.

Sue Sky - the Welsh Assembly Government's Breastfeeding co-ordinator, spoke about the infant feeding situation in Wales, and reviewed the latest statistics and strategies for supporting mothers. She is taking a roadshow around Wales, which you can read about at http://www.24dash.com/health/20547.htm

There Sue is quoted:

---Quote begins
Breastfeeding, of course, also has the advantage that the baby can be fed immediately and so avoids the distress of a hungry baby having to wait for feeds to be prepared. And there is no need to wash and sterilise bottles.

The health service plays a crucial role in helping to advise and support new mums in particular on giving babies the best start in life - especially through explaining the importance of breastfeeding.

But while many women do want to breastfeed, and feel comfortable breastfeeding at home, many still feel they are unable to in public.

This is something that we must overcome and make it more socially acceptable to breastfeed in public, whether that be in a café, supermarket or shops. While breastfeeding is becoming more acceptable in public, more businesses and organisations also need to show support for mothers to breastfeed.

This is really important so mothers can choose to breastfeed and that is why this year's campaign is focusing on encouraging businesses to offer more opportunities to breast-feed.

More than 40 businesses across Wales have signed up to the Welsh Assembly Government's Breastfeeding Welcome Scheme, which aims to show that they welcome mothers to breastfeed their babies on their premises. These vary from businesses large and small including the National Pool in Swansea to Impact Café in Aberdare.

The events that have been organised across Wales are taking place in either shopping centres or supermarkets - places where mothers can spend time and should be able to breast feed. Therefore breastfeeding is not only good for mother, baby but business too.
---quote ends

Alyson Pugh spoke on her research on Factors Affecting the Initiation & Duration Rates of Breastfeeding. A Comparative Study between Areas of High Deprivation and the Surrounding Localities.

The message I took away was the impact of family and friends on infant feeding decisions. These can be very negative, and in one area of Cardiff the initiation rate was as low as 10%, with breastfeeding rapidly dropping to zero. The lack of breastfeeding culture can be self-perpetuating, as many children grow up never seeing a sibling or a neighbour’s child being breastfed.

Of interventions to support mothers in breastfeeding, it is peer support that seems to be most effective. Alyson introduced a mother from one of the peer support groups in the area, who gave an inspiring talk on how important the support of other mothers had been to her and how from her experience of breastfeeding she was inspired to give support to other mothers.

Gill Rapley, the winner of the first Julie Crawford Award from the Baby Feeding Law Group spoke on Babyled Weaning.

I have seen Gill’s talk several times, including at Baby Milk Action’s AGM where we were fortunate to have her as a guest speaker. I never tire of seeing it, because you are struck by how sensible it is.

Babies go through developmental stages, marked by things such as the first smile, first steps, first words. Though there is an age range in which these things usually occur, we accept the child is in charge and won’t do any of them before he or she is ready. We can stand a baby up, but cannot force it to walk. But with introduction of solid foods, it is a cultural norm to take charge of the time by feeding liquidised food on a spoon, usually around 4 months of age. Gill questions why this isn’t also led by the baby and has examined research on development that shows that hand-eye coordination and other factors necessary for eating come together at around 6 months. Research has shown that for optimum growth, babies have no need of solid foods before 6 months, so it seems there is some synchronicity going on here.

Gill has wonderful film clips from research she has done where infants are allowed to play with solid food from 4 months of age. Up until around 6 months that is all they do. Play. Exploring shapes, colours and this strange developing sense of taste. A breastfed child will already have been getting used to flavours through these coming through in the mother’s milk.

Pieces of solid food gradually progress from playthings to actual food. At a time of the child’s choosing. Monitoring of stools – inevitable when you change the nappy – shows when the food actually starts to be eaten. It’s simpler than pureeing foods. The child learns what it likes and does not like. In clips you see babies selecting what interests them and colours and textures are associated with the taste when it goes into the mouth.

Whenever I have seen Gill give this talk, many people comment that they wish they had seen it before going through the pureeing phase with their own children. The great news for anyone wanting to know more is there is now a DVD available.

You can order it at
http://www.markittelevision.com/

To go direct to the page try clicking here. Here's is a picture (linking to that on the site, so it may disappear at some point!).


My talk was about the World Health Assembly marketing requirements, our monitoring of the UK law, the findings set out in our Hard Sell Formula pamphlet and the international dimension and Nestlé boycott.

I aim to post this up on our website fairly soon with the slides I used and links to supporting documents in the hope it may be of some use!