This guest blog post was written by Regina Keith from the University of Westminster. Regina is a Senior Lecturer at the University of Westminster and is on the Executive Committee of the World Public Health Nutrition Association, promoting increased global capacity in public health nutrition and the right to health and nutrition for all. 

Preventing the deaths of 823,000 children under five-year-olds each year can be achieved by exclusively breastfeeding all infants until six months, and then introducing nutritious complementary foods while continuing to breastfeed for up to two years. Breastfeeding not only provides the essential nutrients an infant needs to grow and achieve their full potential, it can also prevent around 20,000 cases of breast cancer each year.  Infants that are given even a few days of breastfeeding will benefit from the “liquid gold” effect of boosting their immunity and preventing childhood illnesses and allergies. Breastfeeding enhances cognitive development and is linked to the prevention of type two diabetes and obesity in later life. If a tablet existed to provide these benefits, it would be in high demand.

Despite these facts, only around 30% of UK infants are still being breastfed exclusively at six to eight weeks – reducing to 1% at six months. Some boroughs in London, such as Tower Hamlets, have put extra resources and support into increasing these figures, resulting in over 80% of mothers starting to breastfeed with over 40% still breastfeeding at six to eight weeks. The evidence is clear that peer support and counselling do lead to infants being breastfed for longer.

However, although we all know breast is best, there is often a ‘but’ attached: “I do not have time”, “I do not have enough milk”, “it is too hard”, “it is too sore”,” I need to go back to work”, “I was bottle fed and I am fine” .

Aggressive marketing of breastmilk substitutes, the need to go back to work, and the lack of effective support are some of the most common reasons given by mothers who choose to switch from breast to bottle feeding. With the increase of zero-hour contracts, more mothers are working without paid maternity leave. The following quotes are from a qualitative study on understanding infant and young child feeding practices in Tower Hamlets in 2017, that I was part of,  which help illustrate why some mothers are choosing not to breastfeed.

“You hear plenty about the benefits of breastfeeding. All over the hospital, there are big signs saying, “It’s good for you to breastfeed.” But, then you don’t actually get the support from the hospital staff” – a mother.

“There are just so many mixed messages. Some of the midwives and other workers have different attitudes. You have no idea what you’re doing at the beginning. You want a clear, calm person. Whereas, you’re getting different people coming in every hour, giving you different advice. Not quite being as sympathetic as you might need them to be. To them, it’s old hat and to you, it’s brand new. You don’t know what you’re doing, the baby doesn’t know what they’re doing. A bit more sympathy. They’re stretched, you know” – a mother.

Health workers, especially midwives, health visitors and nursery nurses, need to ensure women are provided with effective information and support for optimal feeding. It is important for a child to be in the same room as their mother, as hearing the baby cry can lead to the milk being ‘let down’. Knowledge of baby reflexes, such as sucking, swallowing and latching, can also help to prevent complications such as cracked nipples. 

We need to make sure that all health professionals and the media support exclusive breastfeeding of all infants until six months of age. This World Breast Feeding Week, I’m calling for more political commitment, support, and the implementation of the International Code of Marketing of Breast-Milk substitutes to help ensure the UK and other countries meet the Global Nutrition Target of increasing the numbers of exclusively breastfed infants to 50% by 2025.