Millions of mothers are missing out on valuable peer support that encourages breastfeeding, according to a UK-wide survey.
The World Health Organisation recommends that infants should be exclusively breastfed for the first six months of life, and continued alongside complementary foods until at least two years of age.
Breastfeeding helps reduce rates of childhood infections and protects against later obesity and diabetes. For nursing mothers, breastfeeding also lowers the chance of breast cancer.
But the UK has one of the lowest breastfeeding rates in the world, with only one in 200 women still breastfeeding their children beyond their first birthday.
Both the WHO and the UK watchdog the National Institute for Health and Clinical Excellence recommend that breastfeeding mothers are mentored by “peer-supporters” in the community – usually unpaid women who have either themselves breastfed or who have the same socioeconomic background and ethnicity as the women they are helping.
But a new study has revealed that provision of breastfeeding peer support is patchy – a situation experts say is leaving many mothers without the help they need.
“Contrary to national guidance, which states that peer support should be available in the UK to aid the initiation and continuation of breastfeeding, we found that coverage both across the UK and within regions was variable,” said Dr Aimee Grant, a social scientist at Cardiff University who led the research. “Further work should now be undertaken to reach out to mothers from deprived areas, to prevent a further increase in health inequalities”.
Published in the journal Maternal and Child Nutrition by Grant and colleagues at Cardiff, the study involved surveying 696 infant feeding coordinators across 177 NHS organisations providing maternity services across the UK.
While response rate was low – only 19.5% of individuals replied – responses were obtained from 102 organisations. The survey data was also supplemented by a comprehensive search of NHS websites to assess peer support provision.
The results reveal that breastfeeding peer-supporters were available in only 56% of NHS regions, with breastfeeding support groups – which include those provided by charities such as the National Childbirth Trust (NCT) – available in 89% of NHS regions. Yorkshire and north-east London fared particularly badly, but the authors acknowledged that informal provision may be offered in those areas.
What’s more, although meeting the needs of poorer mothers was a priority for most peer-support groups, this was often unsuccessful: a quarter of respondents said that breastfeeding peer-support was not accessed by mothers from poorer social backgrounds, despite their best efforts.
Many of those surveyed cited a lack of adequate funding to improve their service but this was not universal; in fact in some places there had been significant recent investment. But, the authors say, this was piecemeal and not matched to demand for services in most cases.
Juliet Mountford, NCT director of parent services, said the trust trains 300 breastfeeding peer-supporters a year, and was disappointed but not surprised by the latest study: “Research shows that 80% of mums who stop breastfeeding in the early days do so before they wanted to, and women tell us how much they value skilled support to help them continue,” she said.
But Grant said that the UK’s issues around breastfeeding go further than a dearth of peer-supporters. “There needs to be a shift in societal values and attitudes to breastfeeding,” she said, adding that many mothers “are still made to feel uncomfortable and embarrassed when breastfeeding in public places – this is unacceptable and needs to change.”