The problem with breastfeeding

Jenni Pratt

First Minister Eluned Morgan took part in one of Mumsnet’s web chats last week, with questions suggested by some of the site’s 8 million, mainly female users.

It was no surprise on a parenting website to see questions raised about early years and breastfeeding, and a real positive that the First Minister mentioned the First 1000 Days – the critical phase between conception and a child’s second birthday – as a priority.

However, it was worrying that she got some key facts on breastfeeding wrong, suggesting misunderstanding in government about how things are going on the ground.

The First Minister noted that breastfeeding rates in Wales are the highest on record, quoting the percentage starting breastfeeding as 65%. While this is technically correct, it is among the world’s lowest rates – not something to be proud of.

Over a third of Welsh babies are not receiving even one breastfeed. And amongst those who start breastfeeding, there is a steep drop in the first days of life with over a quarter stopping breastfeeding before their baby is two weeks old.

World Health Organization

Only about one in five Welsh babies receive the World Health Organization recommended six months of exclusive breastfeeding, and there is plenty of research showing that many mothers who stop breastfeeding would have liked to continue for longer.

Why should this matter to the Welsh Government?

Improving breastfeeding rates has potential to influence a wide range of health conditions for mothers and babies. To name just a few: breastfed babies get fewer infections leading to fewer GP appointments and hospital admissions.

They are much less likely to develop allergies requiring expensive prescription milk.

Breastfeeding lowers the risk of obesity and diabetes for mother and child; two significant challenges for the Welsh NHS. In its Child Poverty Strategy, the Government itself described breastfeeding as “the most accessible and cost-effective activity available to public health”.

But this rhetoric has not led to meaningful action.

Breastfeeding Action Plan

In 2019 Welsh Government published the All Wales Five Year Breastfeeding Action Plan, which included plans to create a Strategic Infant Feeding Lead post in every health board.

The First Minister cited this action as evidence of the government’s work in this area, but there’s one huge problem: it hasn’t actually happened.

These posts don’t exist and no funding has been provided for them. The five year period ended in 2024 with many actions still outstanding, and as yet no indication of whether there will be further work to implement them.

One aim of the Action Plan was to address inequalities in infant feeding, but this has not been achieved.

Breastfeeding rates remain very low for babies in more deprived cohorts. Only a little over half of babies in the most deprived quintile according to the Welsh Index of Multiple Deprivation (WIMD) receive any breastmilk at all, compared to over three quarters in the least deprived.

Flying Start programme

The First Minister mentioned the Flying Start programme as an example of targeted intervention in the First 1000 Days, but the programme’s statistics do not demonstrate any success in narrowing the gap.

This is doubly concerning as formula costs have rocketed over the last few years, putting huge pressure on family budgets.

As a breastfeeding peer support volunteer, I have heard many women share their experiences which shine a light on the challenge of breastfeeding in a society where it is not the norm.

Mothers often receive poor advice from health professionals who have not received any training on infant feeding.

Many women find that their employers are not supportive of breastfeeding on their return to work, despite legal obligations.

Mothers feel worried and intimidated about breastfeeding in public. They receive well meaning advice from friends and family which reinforces formula marketing. Perhaps it is more surprising that so many continue despite all of this.

Formula feeding

Generations of formula feeding, along with powerful and effective marketing, have led to a situation where breastfeeding is not the social norm in Wales.

Strategic leadership is needed to understand the barriers to successful breastfeeding and make an impact on them, beyond what clinical infant feeding teams and volunteers like me can do.

It’s not about pressuring individual mothers to breastfeed if it’s not for them, but taking action to make sure that Wales is an environment where breastfeeding is visible, understood and supported, and continuing to breastfeed feels like a viable option.

Support for breastfeeding is an integral part of action on the First 1000 Days, and a vital component of many of the Welsh Government’s priorities, from public health to child poverty.

But the First Minister’s comments last week have not given advocates confidence that Welsh Government truly grasps this.