Well, we have good research evidence for all of these … (read out list) And this is just the start: Mothers who breastfeed are also protected against breast and ovarian cancer and hip fractures in later life. Children who have been breastfed have less risk of obesity, high blood pressure and juvenile onset diabetes.
Refocussing upstream is a key theme of this report and of public health generally. It was popularised in the 1970s by Professor John McKinlay, the New Zealand medical sociologist who established the New England Research Institute in Boston. It refers t o the idea that the practice of medicine is equivalent to people who are constantly finding more efficient ways of pulling drowning people from a river. They are so engaged with improving their methods and technologies for doing this that they have no time to look upstream to see who it is that is pushing the people into the river in the first place (in other words the social, economic and political forces causing ill-health). Graphic courtesy of New England Research Institute, Boston; adapted by Paul Blackburn, Division of Public Health, University of Liverpool.
In the 15 years since adoption of original innocenti declaration a lot of progress has been made but improved breastfeeding practices could save the lives of more than 3,500 children every day, more than any other preventative intervention!!! Guided by the human rights principles, esp those in the Convention of the Rights of the Child the vision is of an environment that enables mothers, families or caregivers to make an informed choice about optimal feeding defined as exclusive bf for 6 months followed by the introduction of appropriate comp feeding and continuation of bf for 2 years. Requires skilled support
Research published in Economic Journal finds that increasing paid maternity leave to one year cold cut the UK infant death rate by 6.8% Study of maternity provision in 18 industrial countries found that each additional 10 weeks of maternity leave cuts the infant mortality rate by 2.6%.
OHT 12K (3-day course, 2005) Outline of the ways in which the UK Law is weaker than the International Code. Note particularly that allowing advertising within the health care system, and gifts to health workers, are huge loopholes in the UK law. Note Remind participants that these differences are in the restrictions on the marketing of infant formula . Only under the Code do they also apply to follow-on formula, drinks, weaning foods etc. Emphasise that, in the UK, companies do not have to abide by the Code but that, when seeking Baby Friendly accreditation, health care facilities must practise in accordance with it. NB: Participants should be encouraged to read Chapter 7A of the workbook for further information on the International Code.
Start before they’re born – get pregnant women to sign up for info Gifts and prizes. One company even targets registry offices Have uses Healthy start scheme to peg their products
Breastfeeding and Obesity
The Politics of Breastfeeding Janette Westman Midwife/Lactation Consulatant
“Access to a safe, healthy diet is one of the most important public health actions that a country can take to improve health and increase economic gain”. (WHO, 1999)
Artificially-fed babies are:5 times as likely to be hospitalised withgastroenteritis5 times as likely to have a urinary tract infectionTwice as likely to suffer from ear infectionsTwice as likely to have a respiratory infectionTwice as likely to develop allergies (if there is afamily history)Some evidence suggests a reduction in theincidence of NEC in preterm infants
So how are we doing?.....…..not very well !In the UK 9 out of 10 women stopbreastfeeding before their baby is 6 weeksoldFewer than 2% of babies are exclusivelybreastfed at 6 months
Statistics hide inequalitiesMothers in social classes III-V less likely tobreastfeedMothers who remained in full timeeducation until they were 18 are 3 timesmore likely to breastfeedThree quarters of first time mothers aged30 or over breastfeed their babiescompared to less than half aged 20 orunder
Effect of breastfeeding on gastro- intestinal illness by social class 2 1.8 1.6GI 1.4illnesses 1.2per Infant 1in first I-IIIa 0.8 IIIb-Vyear of 0.6life 0.4 0.2 0 bottle Breast Breast Breast <6w 6-12w >12w Type of Milk Feed
The Global Picture“Inappropriate feeding practices – suboptimal or no breastfeeding and inadequate complementary feeding – remain the greatest threat to child health and survival globally” Innocenti Declaration 2005 on Infant and Young Child Feeding
The Global Strategy from 1990Appoint national breastfeeding coordinator andestablish multisectoral national breastfeedingcommitteeEnsure every maternity facility practices BabyFriendly Initiative 10 stepImplement all provisions of International Code inits entiretyLegislation to protect breastfeeding rights ofworking womenEnsure appropriate guidelines and skills for staff
Five additional targetsDevelop, implement and evaluate policyEnsure protection, promotion and support of exclusivebreastfeeding for 6 months and continuesbreastfeeding up to 2 years or beyondPromote timely, adequate safe and appropriatecomplementary feeding with continued breastfeedingProvide guidance on feeding infants and youngchildren in exceptionally difficult circumstancesConsider what new legislation may be needed to giveeffect and to principles and aims of Code of Marketingof Breastmilk Substitutes
The National PictureThe breastfeeding ManifestoImplement the global strategy for infant andyoung child feedingImplement postnatal care guidance from NICEand public health evidence into practicedocumentImprove training for health professionalsWork with employersDevelop policy and practice to supportbreastfeeding in public placesInclude breastfeeding education in curriculumAdopt International code of marketing breastmilksubstitutes
What are we doing in Bradford?Hospital largest hospital, with most diversepopulation in the UK to achieve UNICEFBaby Friendly accreditationFeatured in publications for examples ofgood practiceMulti-lingual Video/DVDBreastfeeding Strategy for the BradfordDistrict
The International Code and the UK law - key differencesThe International Code The UK Regulations No advertising or promotion Advertising allowed in the anywhere health care system No free samples or gifts to Gifts to the public allowed if mothers / the public not designed to promote No free or subsidised supplies sales to hospitals unless for Less clear specification research loophole easily exploited No free gifts to health Gifts to health care workers workers; information must be allowed; ‘information’ not scientific and factual strictly controlled No contact between mothers Contact between mothers and company representatives and company representatives allowed if instigated by the mother hence carelines etc.
What the companies doStart before they are bornCo-opt health workers to promote brandsBombard women with formula promotion
What YOU can do Visitwww.breastfeedingmanifesto.org.uk Sign up Get your MP to sign up Report violations to the International Code
As a health professionalEnsure no formula leafletsUse professional code of conductEncourage other colleagues to refuse freebiesLimit access of formula company repsPress for policies to forbid formulaadvertising/sponsorship or display of logosLobby journals to not accept advertising fromformula companiesEnsure education is free from commercialinfluenceRaise these issues at local meetings