This policy statement has been prepared by a specially convened working group made up of members of the BDA Paediatric Specialist Group.
Published date: January 2018
Review date: January 2021
The BDA strongly supports breastfeeding. We recognise that breastfeeding is the optimum form of nutrition for babies and that breastfeeding protects the health of babies and their mothers. Dietitians should support midwives, health visitors and family nurses and their efforts to enable all mothers to breastfeed or provide breastmilk for their infant/s if they want to and are able. Mothers should be supported to initiate and maintain exclusive breastfeeding from birth to around six months of age and from six months onwards breastfeeding should be supported alongside complementary foods for as long as the mother and infant wish to continue.
Breastfeeding rates in the UK remain very low when compared to similar countries around the world, particularly maintenance beyond the first few weeks. We therefore support all efforts to improve breastfeeding rates in the UK through active promotion of breastfeeding, the provision of support and advice to parents, and adherence to national and international policies and practices that protect, support and promote breastfeeding.
Research clearly indicates the benefits of breastfeeding. Breast-milk helps protect babies from ear[iii], gastrointestinal and respiratory tract infections[iv] as well as protecting low birthweight babies from necrotising enterocolitis[v]. Longer term breastfeeding leads to lower infectious morbidity and mortality[vi] than for babies who are breastfed for shorter periods, or not breastfed. There is a growing evidence base that suggests that breastfeeding might protect against obesity[vii] and type 2 diabetes later in life. Breastfeeding also has positive health benefits for mothers; it lowers the risk of postnatal depression[viii], it can prevent breast cancer, improve birth spacing, and may reduce the risk of type 2 diabetes and ovarian cancer.[ix]
Further research is needed to establish the full range of health benefits provided by breast-feeding for both mother and child.
UK breastfeeding rates are lower when compared to similar countries in Europe and North America. An analysis of global breastfeeding prevalence in the Lancet[x] found that in the UK 34% of babies are receiving some breast milk at six months compared with 49% in the US and 50% in Germany. At 12 months 0.5% of babies receive any breastmilk, compared to 27% in the US and 23% in Germany.
We know that breastfeeding is lowest amongst younger mothers and those living in the most deprived areas[xi]. There are also significant differences between parts of the UK. Prevalence of exclusive breastfeeding is higher in England and Scotland and lower in Northern Ireland and Wales. For example at six weeks, it was 24% and 22% in England and Scotland respectively, compared to 17% in Wales and 13% in Northern Ireland. In all cases this represents a significant drop from initial breastfeeding rates.
The BDA supports the Royal College of Paediatrics and Child Health’s position statement on breastfeeding[xii], which includes calls for:
Action is required to improve the understanding and support for breastfeeding and the need to extend beyond support for just the mother. The attitudes of partners, family, employers and society as a whole have an impact on breastfeeding rates[xiv] and a strategy is required to address these. This will require investment in education (for both children and adults) and potentially changes to regulations and legislation.
When a mother does not wish to breastfeed, or when a health condition makes breastfeeding impossible, she must receive support and information on the appropriate use of infant formula. All mothers and carers should be given the same quality and standard of care in a non-judgemental way regardless of feeding choice. Support and information about responsive feeding by the primary care givers is essential.