Since I got back from the Unicef Baby Friendly conference last week, it’s all been a bit eventful in the breastfeeding world – there was a poorly written and researched article published in New Scientist (the Unicef response is here), longer-term breastfeeding was discussed (again) on This Morning, with a GP who didn’t know her stuff on the subject, there was a furore in the Daily Mail and on social media over a mother refused a parking voucher from Tesco because she only bought infant formula (see Baby Milk Action’s excellent discussion of this here), and we discovered that the CPHVA conference, for health visitors, has sessions (and no doubt exhibition stands) sponsored by formula manufacturers. The publication of the WBTi (World Breastfeeding Trends Intiative) report on breastfeeding in the UK couldn’t be more timely – it’s abundantly clear that we need a strategy if we are to counter the anti-breastfeeding culture that we have in the UK.
The WBTi report, published today (15 November) and launched at the House of Commons tonight, is the culmination of two years of work by a huge number of people and organisations. Using a system developed by IBFAN, data has been collected for 10 ‘indicators’ – these correspond to policies and programmes recommended in the WHO Global Strategy for Infant and Young Child Feeding, which the UK supported when it was adopted by the World Health Assembly in 2002. In other words, although the WBTi system has been designed to be used internationally, it is very relevant for the UK and shows how we are doing against criteria that our government has signed up to. The idea is that the process is repeated every 3-5 years to track trends. On the international WBTi website you can see how other countries have scored.
The report begins with a series of 'Report Cards' that sum up the findings in a simple scorecard, with each country of the UK given a total out of 150, and an amalgamated score for the UK as a whole. The UK scored 81/150. England has the lowest score of all the four nations at 80.5/150; Scotland and Northern Ireland score much better, in part due to the fact that all their maternity units are Baby Friendly. For comparison, Afghanistan scored 80/150 in 2015. If like me you think that this isn't good enough, then the great thing about this report is that it offers a way forward. The work that's been done has identified the gaps in UK breastfeeding policy and made recommendations - that have been agreed upon by the contributors to the report (a host of breastfeeding organisations and public health bodies, among others) - that we could act on, right now.
The report's recommendations echo a growing consensus that currently, women in the UK who want to breastfeed are being failed - not only by a lack of skilled support for breastfeeding (the table in Indicator 5, which shows which health professionals have training in breastfeeding, is well worth a look), but also by an entire culture and society that undermines it. Other recent publications, including the Lancet series on breastfeeding, a special issue of Acta Paediatrica and Unicef's Call to Action make many of the same points. Dr Amy Brown, of Swansea University, has written extensively about the subject in her book Breastfeeding Uncovered.
Turning the situation around is not impossible. We know, from a mountain of published evidence, what works. The main problem - and one of the chief recommendations of this report - is that there is no national strategy on infant and young child feeding, no national coordinator and no means of sharing good practice UK-wide. To address this would be relatively simple and relatively cheap - what's needed is the political will to tackle it. From better national leadership on the issue, other improvements could follow: we could fully implement the Code, we could address gaps in the training of health professionals, we could collect better data, we could ensure that infant feeding is considered in the formation of other policy (like the obesity 'plan')... and then, as all these areas interact like cogs in a machine, we would see a shift in society's attitudes, increased breastfeeding rates, improved health outcomes and cost savings... and happier, better supported mothers. (This isn't just conjecture - see the breastfeeding gear model, which uses Brazil and Mexico as examples, on p68 of the report.)
This report, with its overview of the current situation, could be hugely important - it can inform what we do, and where we direct our campaigning efforts. Do read the whole thing if you can, and reflect on what you could do to make a difference.