Response to New Scientist article on breastfeeding and the Baby Friendly Initiative

Home > Response to New Scientist article on breastfeeding and the Baby Friendly Initiative

A recent article published in the New Scientist questions the value of breastfeeding and the World Health Organisation (WHO) / Unicef Baby Friendly Initiative. Whilst it rightly highlights the importance of providing sensitive, parent-centred care, we would question many of the claims made in this article.

The benefits of breastfeeding are irrefutable. There is resounding evidence that breastfeeding saves lives, improves health and cuts costs in all countries, rich and poor alike.[1],[2],[3]

Based on a large body of evidence, WHO, all four UK Departments of Health and the National Institute for Health and Clinical Excellence (NICE) recommend introducing solid food to babies at around 6 months.[4],[5],[6]

The Baby Friendly Initiative was developed by WHO and Unicef in recognition that mothers were not receiving evidence based, consistent care from health services to enable them to breastfeed. Improving practice, particularly in countries with entrenched bottle feeding cultures, is complex and challenging and the Baby Friendly Initiative provides a roadmap for services to follow. This supports them to develop policies and guidance, train their staff, improve standards of care and monitor and evaluate progress over time.[7],[8]

In the UK, the Baby Friendly programme has evolved to reflect the current evidence base and cultural context.[9] It is a holistic, parent-centred programme which includes care for breast and bottle feeding mothers and support for parents to build close and loving relationships with their baby.[10] The programme does not ban the use of formula milk as suggested, but rather supports health professionals to understand when formula is clinically required and how to provide appropriate, sensitive care to those parents who choose to bottle feed. Since its inception the programme has improved breastfeeding initiation rates[11] and is recommended in numerous national policy and guidance documents.[12],[13],[14],[15]

Extensive evidence indicates that the largest improvements in breastfeeding rates come when a multi-faceted approach is taken which considers the parents’ whole journey from pregnancy into parenthood. The Baby Friendly Initiative ensures that this journey has the best possible start.[16] Concerted and co-ordinated action at national, local and societal level is also required to support breastfeeding in the longer term.[17],[18]

Further reading

The New Scientist article refers to an American review published in JAMA. Read a full response to this review.

Read the original JAMA review.

Read the original New Scientist article.

Download

Protecting Health and Saving Lives: A Call to Action

Download

References

[1] Victora CG, Bahl R, Barros AJD, Franca GVA, Horton S, Krasevec J, Murch S, Sankar MJ, Walker N, Rollins NC (2016) Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet Breastfeeding Series, Volume 387, No. 10017, pp.475–490, 30 January.

[2] Rollins NC, Bhandari N, Hajeebhoy N, Horton S, Lutter CK, Martines JC, Piwoz EG, Richter LM, Victora CG (2016) Why invest, and what it will take to improve breastfeeding practices?  Lancet Breastfeeding Series, Volume 387, No. 10017, pp. 491–504, 30 January.

[3] Acta Paediatrica (2015) Special Issue: Impact of Breastfeeding on Maternal and Child Health, December, Volume 104, Issue Supplement S467, pp. 1–134.

[4] Kramer MS, Kakuma R (2009) Optimal duration of exclusive breastfeeding (Review), The Cochrane Library, Issue 4 www.http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD003517.pub2/abstract.

[5] NICE (2011a) NICE Public Health Guidance 11: Improving the nutrition of pregnant and breastfeeding mothers and children in low-income households, Quick Reference Guide: Maternal and child nutrition (http://guidance.nice.org.uk/PH11), Issued March 2008 (updated 2014).

[6] WHO (2011) Exclusive breastfeeding for six months best for babies everywhere, Statement, January http://www.who.int/mediacentre/news/statements/2011/breastfeeding_20110115/en/index.html.

[7] WHO (2009) Baby-friendly Hospital Initiative: Revised, Updated and Expanded for Integrated Care http://www.who.int/nutrition/publications/infantfeeding/9789241594967_s1/en/index.html.

[8] WHO (2003) Global Strategy for Infant and Young Child Feeding, Geneva, WHO/UNICEF.

[9] Unicef UK (2012) The evidence and rationale for the Unicef UK Baby Friendly Initiative Standards https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/advocacy/the-evidence-and-rationale-for-the-unicef-uk-baby-friendly-initiative-standards/.

[10] UNICEF UK (2012) Guide to the Baby Friendly Initiative standards https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/guidance-for-health-professionals/implementing-the-baby-friendly-standards/guide-to-the-baby-friendly-initiative-standards/.

[11] McAndrew F, Thompson J, Fellows L, Large A, Speed M, Renfrew MJ (2012) Infant Feeding Survey 2010, Health and Social Care Information Centre http://content.digital.nhs.uk/catalogue/PUB08694/Infant-Feeding-Survey-2010-Consolidated-Report.pdf.

[12] NICE (2013) Postnatal Care. NICE quality standard 37, July https://www.nice.org.uk/guidance/qs37.

[13] NICE (2014) NICE Public Health Guidance 11: Improving the nutrition of pregnant and breastfeeding mothers and children in low-income households, Quick Reference Guide: Maternal and child nutrition (http://guidance.nice.org.uk/PH11), Issued March 2008 (updated 2014).

[14] PHE (2015) Healthy Child Programme: Rapid Evidence Review. https://www.gov.uk/government/publications/healthy-child-programme-rapid-review-to-update-evidence.

[15] Davies, S (2013) Chief Medical Officer’s annual report 2012: Our Children Deserve Better https://www.gov.uk/government/publications/chief-medical-officers-annual-report-2012-our-children-deserve-better-prevention-pays.

[16] Unicef UK (2012) The evidence and rationale for the Unicef UK Baby Friendly Initiative Standards https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/advocacy/the-evidence-and-rationale-for-the-unicef-uk-baby-friendly-initiative-standards/.

[17] PHE/Unicef (2016) Commissioning local infant feeding services https://www.gov.uk/government/publications/infant-feeding-commissioning-services.

[18] Unicef UK (2016) Protecting Health and Saving Lives: A Call to Action. https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/advocacy/call-to-action/.