3. “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)
4. Artificially-fed babies are:
5 times as likely to be hospitalised with
gastroenteritis
5 times as likely to have a urinary tract infection
Twice as likely to suffer from ear infections
Twice as likely to have a respiratory infection
Twice as likely to develop allergies (if there is a
family history)
Some evidence suggests a reduction in the
incidence of NEC in preterm infants
5. So how are we doing?.....
…..not very well !
In the UK 9 out of 10 women stop
breastfeeding before their baby is 6 weeks
old
Fewer than 2% of babies are exclusively
breastfed at 6 months
6. Statistics hide inequalities
Mothers in social classes III-V less likely to
breastfeed
Mothers who remained in full time
education until they were 18 are 3 times
more likely to breastfeed
Three quarters of first time mothers aged
30 or over breastfeed their babies
compared to less than half aged 20 or
under
7. Effect of breastfeeding on gastro-
intestinal illness by social class
2
1.8
1.6
GI 1.4
illnesses 1.2
per Infant 1
in first I-IIIa
0.8 IIIb-V
year of 0.6
life
0.4
0.2
0
bottle Breast Breast Breast
<6w 6-12w >12w
Type of Milk Feed
8. 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
9. The Global Strategy from 1990
Appoint national breastfeeding coordinator and
establish multisectoral national breastfeeding
committee
Ensure every maternity facility practices Baby
Friendly Initiative 10 step
Implement all provisions of International Code in
its entirety
Legislation to protect breastfeeding rights of
working women
Ensure appropriate guidelines and skills for staff
10. Five additional targets
Develop, implement and evaluate policy
Ensure protection, promotion and support of exclusive
breastfeeding for 6 months and continues
breastfeeding up to 2 years or beyond
Promote timely, adequate safe and appropriate
complementary feeding with continued breastfeeding
Provide guidance on feeding infants and young
children in exceptionally difficult circumstances
Consider what new legislation may be needed to give
effect and to principles and aims of Code of Marketing
of Breastmilk Substitutes
11. The National Picture
The breastfeeding Manifesto
Implement the global strategy for infant and
young child feeding
Implement postnatal care guidance from NICE
and public health evidence into practice
document
Improve training for health professionals
Work with employers
Develop policy and practice to support
breastfeeding in public places
Include breastfeeding education in curriculum
Adopt International code of marketing breastmilk
substitutes
12. What are we doing in Bradford?
Hospital largest hospital, with most diverse
population in the UK to achieve UNICEF
Baby Friendly accreditation
Featured in publications for examples of
good practice
Multi-lingual Video/DVD
Breastfeeding Strategy for the Bradford
District
13. The International Code
and the UK law - key
differences
The 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.
14. What the companies do
Start before they are born
Co-opt health workers to promote brands
Bombard women with formula promotion
15. What YOU can do
Visit
www.breastfeedingmanifesto.org.uk
Sign up
Get your MP to sign up
Report violations to the International Code
16. As a health professional
Ensure no formula leaflets
Use professional code of conduct
Encourage other colleagues to refuse freebies
Limit access of formula company reps
Press for policies to forbid formula
advertising/sponsorship or display of logos
Lobby journals to not accept advertising from
formula companies
Ensure education is free from commercial
influence
Raise these issues at local meetings
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