Following the Lancet’s recent report on practices of the formula milk industry, Gail Barker, expert advisor on infant feeding at the Institute of Health Visiting and specialist community public health nurse, shares her insights on infant feeding.
Health visitors have a duty of care to share the best available evidence and research with parents and families so that they can make informed decisions on how they want to feed their baby.
The decision on whether or not to breastfeed is a woman’s choice, and health visitors will respect this and support all families regardless of how they choose to feed their baby.
The biggest problem that we face is that parents are bombarded by misleading advertising on the benefits of infant formula.
Therefore, it is really important that we ensure that they are able to make choices about infant feeding which are informed by accurate information, free from industry influence.
‘Too many women stop breastfeeding before they want to’
We are also not doing enough to support women to breastfeed when they want to. The evidence shows that most women know about the benefits of breastfeeding – about 80% start breastfeeding their baby from birth, but sadly too many stop before they want to due to lack of support and poor advice.
This trend is not helped by current workforce shortages in health visiting, with 40% fewer health visitors in England compared to 2015.
Getting the right information and support can make a big difference. Part of this preparation for parenthood involves sharing the benefits of breastfeeding with women during pregnancy.
There is a strong evidence base which shows that there are clear benefits to breastfeeding in terms of improved child health outcomes and reduced health inequalities for babies who are breastfed, compared to those who are not.
There is no other way of feeding your baby that achieves the same outcomes. There are also wider benefits from breastfeeding for the mother’s own health. Breastfeeding also helps to build close and loving relationships between parents and their babies, which lay the foundations for healthy relationships and resilience in adulthood.
Lowest breastfeeding rates in the world
In the UK, we have some of the lowest breastfeeding rates in the world, with eight out of 10 women stopping breastfeeding before they want to .
The impact of not breastfeeding can have a lifelong impact on individuals, as well as our society as a whole and even our planet. The evidence base is strong that breastfeeding has a beneficial impact on the prevention of cardiovascular disease, diabetes and obesity.
In the UK, the rates of breastfeeding have actually increased in the last 20 years, which is good news.
UNICEF-UK reports that 55% of babies are now receiving some breast milk at six weeks (rising from 48% in 2005), while at six months it was 34% (rising from 25% in 2005).
But overall, we do have a challenge with our use of formula milk in this country as we still have one of the highest rates of infant formula feeding in the world.
Sources of evidence-based advice for parents
The iHV and all health visitors comply with the WHO International Code of Marketing of Breastmilk Substitutes, and most are also part of the UK UNICEF Baby Friendly Initiative.
This ensures that the best available evidence is followed so they can provide effective professional support to parents on all aspects of infant feeding (both breastfeeding and bottle feeding).
Health visitors work across the whole system influencing wider infant feeding considerations within policy, practice and organisations. This supports consistent messages for parents and access to unbiased information to support feeding.
It also enables health organisations such as GP surgeries, hospital services, midwifery, health visiting, general practice nurses and universities training health professionals to work together and counteract the misleading and exploitative claims of formula milk marketing which is undermining breastfeeding across the globe.
It is therefore vitally important that parents have a place to go for optimal information and evidence-based support.