Ignore Farage and worry about the real breastfeeding scandal

Breastfeeding rates are low in Britain and the mothers who are least likely to breastfeed are the poorest and least supported.

Breastfeeding rates are low in Britain and the mothers who are least likely to breastfeed are the poorest and least supported

The papers have given lots of coverage to Nigel Farage’s views that breastfeeding women should sit in a corner. His comments on LBC follow the request by Claridges’ staff that a mother hide behind a napkin to feed her baby.

But the debate about this issue has skipped over some shocking facts about breastfeeding in Britain. Compared with many other developed countries, breastfeeding rates are low in the UK and the mothers who are least likely to breastfeed are the poorest and least supported. The real breastfeeding story is what these statistics say about inequality, family life and NHS funding in this country.

A word about breastfeeding for readers who have not done it. Although formula milk provides adequate nutrition for babies, breast milk is free and is associated with better health and developmental outcomes in children. It also helps a mother lose weight after pregnancy and protects against a number of female cancers.

But breastfeeding is not as easy as it looks. The baby has to ‘latch on’ correctly and someone has to teach a mother this technique. As many of our mothers did not breastfeed themselves, this advice is usually provided by a midwife or a volunteer mentor from an organisation such as La Leche League.

Breastfeeding is also takes longer than a bottle. When a mother is stressed, tired or unsupported or has other small, demanding children, formula milk is a welcome convenience.

Improvements in formula milk and its aggressive marketing led to breastfeeding rates falling to an all-time low by 1970. Since then, the government and health professionals have recognised that more needs to be done to support breastfeeding. There are national breastfeeding strategies in all parts of the UK. Midwives are now better trained and breastfeeding is covered in ante-natal classes. There is also much more drop-in advice and a national helpline for mothers encountering problems.

Breastfeeding rates are monitored in quarterly statistics in England. The most recent data shows that 74 per cent of mothers initiated breastfeeding, up from 66 per cent in 2005-06, although this figure is collected in hospital and includes those whose babies were only fed once or twice. By the time babies receive their 6-8 week development check, just 46 per cent of mothers are breastfeeding, exclusively or partially.

But there are marked local differences in breastfeeding rates, with mothers in the City and Hackney Clinical Commissioning Group (CCG) area having the highest rates of breastfeeding at 6-8 weeks at 82 per cent. Rotherham CCG has the lowest prevalence at 6-8 weeks, at 13 per cent.

In Scotland and Wales rates are lower than England, with 38 per cent of babies breastfed at 6-8 weeks in Scotland. Here, too, rates of breastfeeding are not increasing and in some – mostly deprived areas – they are falling. In East Ayrshire, for example, 27 per cent of babies were breastfed at 6-8 weeks in 2003-04, but in 2012-13 this had fallen to 20 per cent.

The five-yearly Infant Feeding Survey unpacks these statistics, showing that the least well-qualified women and those living in the poorest areas are those least likely to breastfeed. Younger mothers and those of white British ethnicity are also less likely to breastfeed compared with older mothers and those from minority ethnic groups.

But there are deprived areas where breastfeeding rates are higher and have increased in recent years, in Leeds, Birmingham and Sheffield, for example. This is usually down to local strategy and the hard work of midwives and health visitors.

Yet breastfeeding rates are lower in the UK than in many other developed countries. In Norway, for example, 99 per cent of mothers start breastfeeding and 63 per cent are doing so exclusively at 12 weeks after birth. Of developed countries, only the US, Malta, Belgium, France and Ireland have lower breastfeeding rates than the UK.

Those countries that have achieved high levels of breastfeeding have factors in common. Poverty does not force women to go back to work early. There is often better breastfeeding support for mothers in hospital and at home. Post-natal wards are properly staff. Crucially, there is less income and educational inequality than in the UK.

In England, targets to recruit more health visitors that have not been met and there are persistent shortages of midwives. Public spending cuts have reduced breast-feeding advice in children’s centres. Deep-rooted inequalities also compromise breastfeeding. This is the real story, not one politician’s crass remarks and events in a luxury hotel in London.

Jill Rutter is a contributing editor and mother of two sons

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