Australia’s National Health and Medical Research Council recommends exclusive breastfeeding (i.e. no solids or drinks) up to 6 months of age.
They recommend that breastfeeding should continue alongside suitable complementary foods for 1 year or as long as mother and child desire.
The World Health Organisation recommends breastfeeding for two years, or beyond if the mother and baby are happy to do so.
In Australia, 96% of mothers start out breastfeeding.
However, despite a strong desire to breastfeed, the statistics show a sharp decline in exclusive breastfeeding with each month after birth:
- 1 month – 56%
- 3 months – 39%
- 4 months – 27%
- 5 months – 15%
By 1 year only 28% of children are still being breastfed (which includes non-exclusively).
If we’re going to make a real difference in the number of mothers who breastfeed exclusively to around 6 months and continue breastfeeding to 1 year and beyond, there are a number of changes at a policy, practice, cultural and societal level that we could make.
In fact, other countries are already doing it. Cambodia were highly successful raising their exclusive breastfeeding rate (at 6 months) from 11% to 74%. All with very little money. Other countries like Kenya have done the same. Here's how they did it. So, what are we waiting for?
Here are 7 things that need to change to increase our breastfeeding rates:
#1: Early Formula Supplementation In Hospitals Needs To Be Reduced
The above statistics show that the largest drop in exclusive breastfeeding occurs within the first month.
Research tells us that healthy, full term babies who don’t receive any form of supplementation within the first couple of days are more likely to continue breastfeeding at 6 months. However, many babies are being supplemented while still in hospital.
The Academy of Breastfeeding Medicine Supplementation Protocol provides excellent evidence-based information about when supplementation is, and is not, indicated.
#2: Improved Breastfeeding Education For Health Professionals
It's important for health professionals to be appropriately trained to provide breastfeeding support and accurate, up-to-date and evidence-based breastfeeding information.
However, research indicates that many health professionals fall short when it comes to their breastfeeding knowledge. A better framework for educating many health professionals about breastfeeding needs to be established. Especially for those who are commonly the first point of contact for a new mother.
In BellyBelly's article about the shocking lack of breastfeeding education for healthcare providers, it talks about how most healthcare providers, including doctors, midwives, obstetricians, maternal health nurses and paediatricians, are receiving anywhere from 0-3 hours of breastfeeding education in their entire undergraduate courses. This is far from what's required for those in the first line of support for breastfeeding mothers. This is why IBCLCs are so important. They are breastfeeding experts, who are required to undertake a huge amount of education and experience hours. To retain the certification, regular retesting is required, to ensure knowledge is current and up-to-date.
#3: More Baby-Friendly Hospitals
There are several practices that hospitals can implement which can help get breastfeeding off to the best start possible. Practices such as:
- Skin-to-skin contact straight after birth
- Rooming-in (having your baby with you in your room)
- Giving no supplementation unless medically indicated (or the mother wants to)
- Providing new mothers with support by informed health care workers
If you plan to give birth to your baby in a hospital, choosing a Baby Friendly accredited hospital means the above practices (and more) will be hospital policy. These things will help you have a greater chance of successfully establishing breastfeeding and exclusively breastfeeding for longer.
#4: Implementation Of The WHO Code
Families who use formula need to be able to make informed decisions based on information they can trust. This information needs to be independent and not driven by profit motives and marketing hype of industry.
The WHO Code is designed to prevent exploitation through formula marketing. Australia’s response to the WHO Code was to introduce the Marketing in Australia of Infant Formula (MAIF) Agreement, a voluntary, self-regulatory code of conduct between manufacturers and importers of infant formula in Australia.
The MAIF Agreement states that companies cannot promote infant formula (0–6 months) or follow-on formula (6–12 months). The MAIF Agreement does not apply to many other things that are covered by the WHO Code, including toddler formula (from 12 months on).
Hence, marketing of toddler milks has no restrictions and these are aggressively marketed. Research shows that many parents don’t differentiate between infant and toddler formulas, but rather only recognise the brand.
While the MAIF Agreement helps somewhat to promote and protect breastfeeding, the implementation of the WHO Code would be much more effective.
#5: Improved Parental Leave Policies
Australia currently has a publicly funded Paid Parental Leave scheme that provides eligible employees with up to 18 weeks of paid parental leave at the national minimum wage rate.
Norway has a generous paid parental leave scheme of either 46 weeks with full pay or 56 weeks with 80% pay. Leave may be taken on a part-time basis until the child is three years old. Perhaps this is partly why in Norway 99% of women initiate breastfeeding and 80% are still breastfeeding at 6 months and 46% at 12 months.
#6: More Breastfeeding-Friendly Workplaces
Research tells us that returning to work does affect breastfeeding rates. For example, one study showed that among mothers returning to work at 6 months or earlier, 58% reported reducing or stopping breastfeeding to return to work.
The Australian Breastfeeding Association has developed initiatives to encourage workplace support for breastfeeding. The Breastfeeding Friendly Workplaces (BFW) program is a national consultancy service that aims to remove the workplace as a barrier to breastfeeding. Through an accreditation process, the BFW program assists employers to create a supportive environment for breastfeeding mothers returning to work. The program has developed specific criteria known to be supportive such as flexible work options, a supportive environment, lactation breaks and suitable facilities.
More BFW accredited workplaces would mean more mothers would be supported to return to work and continue to breastfeed.
#7: Normalise Breastfeeding
Seeing things over and over again has a significant impact on how we view the world. When things are seen often, they are familiar and enter deep into our consciousness. So, when mothers breastfeed in public, when photos of breastfeeding are seen on the internet, on magazine covers, on walls in medical clinics etc., this helps more people to realise that breastfeeding is normal. All these things will help to change our society, help to normalise breastfeeding – one public breastfeed, image and supportive message at a time.