Why does the U.K. have such low breastfeeding rates and how to buck the trend?

By Cordelia Uys, NCT Breastfeeding Counsellor

Emma with baby Isabella

This article looks at breastfeeding rates in the UK compared to other countries, explores why they are so low, and suggests ways women can maximise their chances of successfully establishing breastfeeding.

  • UNICEF and the World Health Organization recommend exclusive breastfeeding for the first six months of a baby’s life, and continued breastfeeding, alongside the introduction of solids, for two years and beyond.

  • Breastfeeding protects mothers and babies from a wide range of illnesses.

  • It is estimated that circa 97.5% of women are physiologically capable of producing all the milk their baby, or babies, needs.

  • More than 80% of new mothers in the UK say they would like to breastfeed.

Here are the key findings of the last UK-wide Infant Feeding Survey in 2010:

  • Breastfeeding initiation: 81%

  • Exclusive breastfeeding at six weeks was 24% in England, 17% in Wales and 13% in Northern Ireland

  • Exclusive breastfeeding at three months: 17%

  • Exclusive breastfeeding at four months: 12%

  • Exclusive breastfeeding at six months (as recommended by the World Health Organization) 1%

    (In Canada, 34% of mothers exclusively breastfeed to 6 months)

At 6 months - percentage of babies getting any breastmilk:

  • The UK: 34%

  • Sweden: 62%

  • The United States: 49%

  • Norway: 71%

At 12 months – percentage of babies getting any breastmilk:

  • The UK: 0.5%

  • The United States: 27%

  • Germany: 23%

  • Brazil: 56%

  • Senegal: 99%

So why does the UK have some of the lowest breastfeeding rates in the world?

Clearly, British women’s breasts are no different from those of women in Norway, Brazil, Germany, Senegal or the US. And our low rates can’t be due to maternity leave, since the UK has some of the most generous maternity leave in the world, whereas the US has no statutory paid maternity leave at all.

The reasons for the UK’s low breastfeeding rates are undoubtedly complex, but the biggest factor is that we live in a culture where bottle feeding is the norm. If I type the word ‘baby’ into my iPhone, an emoji of a bottle is suggested. Bottles are synonymous with babies. There is evidence that how new mothers feed their babies is strongly influenced by how they see other mothers feeding their babies. Humans do not instinctively know how to breastfeed, we need to learn it from our mothers, sisters, aunts, cousins and friends. Take a look at this remarkable story about the new mother gorilla in Ohio zoo. https://blogs.iadb.org/desarrollo-infantil/en/the-nurse-in-and-the-gorillas/  

If we live in a culture where we mostly see babies being bottle-fed, it’s very hard to have faith that breastfeeding will work, or even to hold our babies in positions that facilitate a good latch. If a mother holds her baby in a traditional bottle-feeding position, it’s unlikely her baby will be able to get a deep enough mouthful of breast for breastfeeding to be comfortable and effective, meaning that many women find breastfeeding painful. And of course, those women who do breastfeed can find it very challenging breastfeeding outside of their homes in a society where it’s not the norm. Many breastfeeding mothers worry about being criticised for ‘exposing’ themselves.

 

The fact that after 2010, the UK government cancelled the 5 yearly Infant Feeding Survey tells us how little breastfeeding is valued by our politicians. The walls of British maternity wards are plastered with posters encouraging women to breastfeed, but there isn’t enough investment in training doctors and midwives so that they have the skills and correct information needed to support new mothers who would like to breastfeed. It’s common for new parents to get a lot of conflicting advice about breastfeeding from midwives while in hospital, and for GPs not to know much, which isn’t surprising given that in 6 years of medical school, medical students are unlikely to be taught anything about breastfeeding.

 

However, things are starting to change, even if slowly:

  • In February 2019, the Royal College of Paediatrics and Child Health announced they would no longer accept funding from formula milk companies.

  • In March 2019, the BMJ stopped carrying adverts for formula milk.

  • Some remarkable female doctors recently created a reliable source of information on infant feeding for GPs and hospital doctors (GPIFN and HIFN)

  • The Hearts Milk Bank, the UK’s first independent, non-profit human milk bank, was set up in 2018.

Here are some suggestions to make sure you have the best possible chance of breastfeeding your baby:

  • Expose yourself to breastfeeding before your baby is born: spend time with a mother who is successfully and exclusively breastfeeding her baby.

  • Prepare yourself antenatally: do an antenatal breastfeeding workshop with an IBCLC Lactation Consultant or a Breastfeeding Counsellor from one of the four Breastfeeding Charities (NCT, ABM, LLL or BfN).

  • Find out about local breastfeeding support antenatally and ask for help ASAP if you are experiencing difficulties postnatally. Check the person supporting you is an IBCLC Lactation Consultant or a Breastfeeding Counsellor.

  • Join a Facebook support group for breastfeeding mothers.

  • After your baby is born, search out other local breastfeeding mothers and make friends with them.

 

Links: 

https://www.thelancet.com/series/breastfeeding

https://www.theguardian.com/lifeandstyle/2017/aug/01/uk-attitudes-to-breastfeeding-must-change-say-experts?CMP=share_btn_link&fbclid=IwAR1W5hP2EQYaGai-BoBj3s1uRIaEG39RAiBziKW-b-KsgmJZJHUUXqly1c0_aem_ARVBQywBlm36X1HJNRPMf6HUPxlTUr-X04UnJhe-2A3WvLbpoCrmW6An8tG3EDmLE9o

 https://data.unicef.org/wp-content/uploads/2018/05/180509_Breastfeeding.pdf

 https://www.unicef.org.uk/babyfriendly/support-for-parents/low-milk-supply/

UK has the worst breastfeeding rates: https://www.bbc.co.uk/news/health-35438049?fbclid=IwAR3vaTkbxu4IDqsGuf6Z7lx5EpK0QzqXPAOabaigzsXCEAc6cnAZBkS7HkE

Percentage of infants aged 0 to 5 months who are exclusively breastfed: https://www.nuffieldtrust.org.uk/chart/percentage-of-infants-aged-0-to-5-months-inclusive-who-are-fed-exclusively-with-breastmilk?fbclid=IwAR1ymFZ0r2VdkfnZIK5z6LdFbBQC0uRie2RuEOyyUF9WOC0-LU_vljQSykM

 

Mother and baby gorilla in Ohio Zoo: https://blogs.iadb.org/desarrollo-infantil/en/the-nurse-in-and-the-gorillas/

 

U.K. attitudes to breastfeeding must change: https://www.theguardian.com/lifeandstyle/2017/aug/01/uk-attitudes-to-breastfeeding-must-change-say-experts?fbclid=IwAR1ShAFZzcoWIn1vyPrsS3bB7YvUCIPRDvUl1nBo8As2Ke7dV6TUjwGDJic

 

Channel 4 Dispatches documentary on breastfeeding: https://www.independent.co.uk/life-style/breastfeeding-rates-britain-lowest-world-channel-4-dispatches-kate-quilton-a8468416.html

 

Royal College of Paediatrics announcement: https://www.rcpch.ac.uk/news-events/news/rcpch-statement-relationship-formula-milk-companies

 

BMJ stops carrying formula milk adverts: https://www.bmj.com/company/newsroom/bmj-calls-time-on-formula-milk-adverts/

 

https://gpifn.org.uk/ and https://www.hifn.org/

 

http://heartsmilkbank.org/about-us/