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Encourage mothers to breastfeed beyond six months, says Royal College

Nurses, midwives and health visitors should encourage mothers to breastfeed beyond six months, alongside giving solid food, according to new recommendations from the Royal College of Paediatric and Child Health (RCPCH).

In a position statement on breastfeeding, published today, the RCPCH also recommends advising mothers that using infant formula supplements, or combining formula feeding with breastfeeding, make it more difficult to establish exclusive breastfeeding.

For those mothers who cannot, or choose not to, breastfeed, the RCPCH recommends appropriate support and education on infant feeding should be provided.

The statement also extends its recommendations to local authorities, with the College calling on Public Health England to develop ‘a national strategy to increase initiation and continuation of breastfeeding’.

Dr Cheryll Adams, executive director of the Institute of Health Visiting, welcomed the recommendations. She said: ‘We warmly welcome this new guidance from RCPCH on supporting women to continue breastfeeding beyond the first few weeks. Breastfeeding is natural, but not all mums find it easy, and some mums cannot or choose not to do it, so we must respect that too. Mums often need support, and health visitors are one of the key healthcare professionals to help mothers establish breastfeeding through the universal health visiting service’.

RCPCH recommendations for healthcare professionals:

  • RCPCH strongly supports breastfeeding, the promotion of breastfeeding, the provision of advice and support for women, and national policies, practices, and legislation that are conducive to breastfeeding.
  • Breastfeeding is a natural process, however mothers may require support, knowledge and education. With such support, the expectation is that most women will be able to breastfeed.
  • Mothers should be advised that the use of infant formula supplements or combined breast and formula-feeding may make it more difficult to establish exclusive breastfeeding.
  • Mothers should be supported to breastfeed their healthy term infant exclusively for up to six months
  • All infants require solid foods from six months for adequate nutrition. Solid food should never be introduced before four months (17 weeks) as this is associated with increased short-term risk of infection and later risk of obesity, allergy, and coeliac disease
  • We recommend that mothers should be encouraged to breastfeed beyond six months, alongside giving solid food.
  • Mothers should be supported to continue breastfeeding for as long as they wish; in countries such as the UK evidence is lacking to recommend any particular duration of breastfeeding.
  • Mothers need to feel confident in their ability to breastfeed and to feel comfortable breastfeeding in public; this requires support from family, friends, professionals, the workplace and society at large so that breastfeeding is regarded as normal and natural.
  • Some women cannot or choose not to breastfeed; this should be respected and appropriate support and education on infant feeding provided.