Statement on the Unicef UK Baby Friendly Initiative

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Our response to Madeleine Morris’s blog in Huff Post Parents, 21 October 2015:

Madeleine Morris makes a good point in her blog (Huff Post Parents, 21st October 2015) with her assertion that all mothers and pregnant women need access to helpful and accurate information on feeding and nurturing their baby, and that there should be open discussion and debate around these themes.

The Unicef UK Baby Friendly Initiative works with health services to give every baby the best possible start in life, regardless of feeding method, through helping build strong loving relationships between mother and child, supporting breastfeeding, and ensuring mothers who bottle-feed are given accurate information and trained support with both feeding and nurturing.

Effective, empathetic communication between health professionals and mothers is key to achieving our standards, as is a holistic, mother-centred approach. Information about the well documented benefits of breastfeeding needs to be available for families, but where a mother needs or wants to bottle-feed, extra support and advice is provided to ensure that nurturing behaviours that occur naturally with breastfeeding (such as skin contact, responsive baby-led feeding, eye contact, closeness with the mother as the primary care giver) are understood and take place as much as possible. Indeed, one of our specific standards is that skin to skin contact for mothers and babies takes place straight after birth, or as soon as possible thereafter. Another standard is that the first feed (whether breast or bottle) takes place in skin contact.

We disagree with Madeleine that implementing Baby Friendly standards stifles debate. We encourage open discussion and accurate information sharing about breastfeeding, bottle-feeding and nurturing. However, we believe there is a crucial difference between unbiased evidence-based information and promotion or marketing, where a commercial company has an ulterior motive of selling their product. Therefore, we insist that Baby Friendly accredited units abide by the International Code on the Marketing of Breastmilk Substitutes. This ensures that women are given accurate information on feeding, and not advertising or promotion.

The Baby Friendly Initiative unifies evidence, policy and practice by working collaboratively across governments, public services, the voluntary sector and families. We work within maternity, health visiting, neonatal and early years services, as well as in universities, supporting these services to implement our standards around care for mothers and babies.

Breastfeeding has irrefutable benefits for mothers and babies. However, research shows that nine out of 10 mothers in the UK stop breastfeeding earlier than they would like to. The UK has some of the lowest breastfeeding rates in Europe, and it is widely recognised that mothers are likely to encounter difficulties and challenges with breastfeeding. It is thus our responsibility to improve conditions for breastfeeding women, in order to improve breastfeeding rates as recommended by the WHO.

The Baby Friendly Initiative has been shown to be effective at helping women initiate and continue breastfeeding – mothers giving birth in hospitals where Baby Friendly policies are fully implemented, are 14.6 per cent more likely to initiate breastfeeding and 6.6 per cent more likely to continue to breastfeed exclusively at four weeks of age, in comparison to similar mothers in other hospitals. These effects are stronger for less educated and more economically disadvantaged mothers. Since Baby Friendly started in the UK, breastfeeding initiation rates have increased from 62 per cent to 81 per cent (ISER, 2011).

We hope that accurate debate and discussion around infant feeding continues to take place, in an evidence-based and non-judgmental way, so that all mothers can make informed decisions that are right for them, and then receive the support they need to make good on that decision. Every baby deserves this.