The APPG on Infant Feeding Inequalities was formed in 2015 to raise awareness of infant feeding. It brings together MPs, Peers, external organisations, policy stakeholders and interested individuals, and gives them the opportunity to work together, discuss important issues related to infant feeding, including areas where support is needed. It is chaired by Alison Thewliss MP and its aim is to make sure infant feeding remains a priority for HM Government with a view to reducing inequalities and improving health.
LLLGB has attended meetings since they began in 2015. Meetings were suspended during last year’s General Election but were resumed in July 2017. The latest meeting, which took place in London at the end of January, is summarised below.
30 January 2018 meeting – Portcullis House, London
The meeting was chaired by Alison Thewliss MP, who started by reviewing correspondence and Parliamentary questions since the previous meeting, held on 14 November 2017.
Alison said that, following a lot of discussions on human milk sharing, which had featured heavily in the media, she had urged the UK Government to offer guidance on this topic. She was keen for them to work with the UK Association of Milk Banks to invest in services allowing the donation of breastmilk locally in a safe and regulated way, and for those requiring breastmilk to be able to access it easily. She had raised these questions with the Secretary of State for Health and had received responses from Jackie Doyle-Price, Under-secretary at Department of Health, who said that breastmilk sharing is not a recommended practice unless done through official NHS milk banks which adhere to National Institute for Health and Care Excellence (NICE) guidance. This is due to be reviewed in 2019.
Presentation: Professor Mary Renfrew FRSE, University of Dundee, “New approaches to enabling women to breastfeed, and tackling inequalities”
Professor Mary Renfrew said, “I cannot think of a single public health intervention that would have a bigger impact than raising breastfeeding rates.” She said with regards to public health that breastfeeding is the solution, not the problem, and she stressed that we should be working towards enabling all women to breastfeed and all babies to be breastfed – irrespective of their backgrounds and specific challenges – offering support starting in pregnancy.
She said that innovative approaches were needed to support mothers to breastfeed and to change societal attitudes. She pointed out that local authority figures showed the inequality of breastfeeding prevalence rates across England, with rates varying from 16% to 74%.
Professor Renfrew said that formula sales were higher in upper income countries: sales in Asia had grown by 40% between 2008 and 2014. She also mentioned that we should be monitoring NOT breastfeeding rather than breastfeeding.
Talking about the NOSH (Nourishing Start for Health) study[i] which offered mothers vouchers for breastfeeding, she said that using financial incentives to change behaviour was not new. The scheme had been based in areas which had UNICEF Baby Friendly Initiative (BFI) accreditation and offered peer support. It had achieved a 6% increase in breastfeeding rates at 6-8 weeks, in itself a better result than many other interventions. As the study went on, the size of the effect increased and when the scheme stopped the areas involved had slightly higher breastfeeding rates than before. It was felt that if the scheme had continued this would have continued to increase.
It was agreed during the meeting that there is no bigger intervention for health than breastfeeding and that Parliament needs to give out the message that it is hugely important. Social barriers have to be tackled, women need more support if they return to paid work, and more needs to be done to monitor market and advertising of formula. Breastfeeding has to be “normalised” and women need to feel safe to feed in public spaces.
Presentation: Clare Meynell RM (rtd) IBCLC and Helen Gray M Phil IBCLC, World Breastfeeding Trends Initiative, “Update on latest WBTi report”.
Helen Gray, an LLL Leader in London, and Clare Meynell, a former LLLGB Peer Counsellor Programme Administrator, said that copies of the UK WBTi Report 2016 [ii] had been sent to MPs involved in the area of breastfeeding. The report asks “Why does breastfeeding matter in Public Health?” and looks at ten key policies and programmes. It identifies gaps and gives recommendations. The report had been well received, with several ministers in the area of public health saying that the WBTi recommendations needed to be implemented.
Helen and Clare also stressed that information about infant feeding and HIV needs to be up-to-date and they mentioned that work is ongoing in terms of Infant Feeding During Emergencies, with guidance needed on the care of pregnant and breastfeeding mothers, and young children in emergencies.
They said that a multi-agency policy forum was due to meet and a report would be produced soon after.
Presentation of Breastfeeding posters: Liz Stacey and Caroline Baddiley, Breastfeeding Advisory Team, Forset Healthcare (NHS)
Liz and Caroline explained that they had identified a need for posters with a new message, moving from the emphasis on the health benefits of breastfeeding towards a more relaxed and realistic attitude to breastfeeding uptake. As part of this effort, they had produced posters acknowledging that breastfeeding, although natural, is a learned process.
The posters showed mothers feeding “naturally” at home or out and about, not demonstrating “classic” position and attachment.
A range of posters from LLLGB can be found here:
Update from Dr. Helen Crawley, First Steps Nutrition Trust
Dr. Crawley explained that First Steps Nutrition is looking into the marketing of specialist formulas on shelves. She expressed concerns about one formula company claiming that their formula is “nutritionally closer to breastmilk than ever before” and she mentioned the challenges related to formula labelling and the claims regarding added probiotics, some of which are not even in the formula. She pointed out the “Surviving and thriving” campaign, specifically aimed at premature babies despite the fact that it is known that formula is a risk to them.
Dr. Crawley also explained that, unlike other countries, the UK has good recommendations for making up formula, using water over 70 degrees C.
Written by Anna Burbidge who attended the meeting on behalf of LLLGB