Category: Cuts

Cuts to breastfeeding support reported in 44% of English council areas

Resulting “postcode lottery” to be reported in Channel 4 Dispatches documentary, Breastfeeding Uncovered, which airs 30 July at 8pm

Campaigners in over 140 council areas in England say mothers are not getting the help they need to breastfeed as local services are being reduced or shut down altogether. This represents 44% of the 326 local authority areas in the country that have experienced cuts to breastfeeding support.

The survey of campaigners and mothers was conducted by the campaign group Better Breastfeeding. “We’ve been hearing from mums who say their local breastfeeding support has been significantly reduced, or in many cases cut altogether. So far we know of 142 local authority areas in England that are affected, but these are just the ones we’ve heard about. The actual number is likely to be even higher,” said Ayala Ochert, founder and co-chair of the campaign, which is pushing for better support for mothers who want to breastfeed.

“All over the UK – and especially in England – councils and health boards are trying to save money by closing peer support and specialist breastfeeding support services, which are essential in helping mothers to continue breastfeeding. It’s a totally false economy because these services are not only very cheap, but they also save the NHS money as breastfed babies get sick less often,” she added.

On 30 July – ahead of World Breastfeeding Week – Channel 4 will broadcast a Dispatches documentary, Breastfeeding Uncovered, on the state of breastfeeding in the UK and the impact of the cuts to support services. The documentary features an interview with Professor Amy Brown, professor of child public health at Swansea University and co-chair of the Better Breastfeeding campaign, who highlights the impact of a lack of breastfeeding support on mothers’ mental health.

“This isn’t about telling mums they should breastfeed – most people already know about the benefits. Most mothers in the UK begin breastfeeding, but of those who give up in the early weeks around 80 percent of those say they would have liked to continue,” says Professor Brown. “When you consider that there are over 750,000 births each year, that means there are literally millions of women out there who have been affected by the lack of practical and societal support to breastfeed. For many women, the pain of having struggled with breastfeeding can last for decades. We hear of grandmothers breaking down in tears in breastfeeding support groups, recalling the lack of help when they were new mothers themselves.”

Postcode lottery
The Better Breastfeeding survey on the extent of the cuts gives details of the cuts experienced in each area. In some places – like Blackpool – the entire service has been closed down, while in others – such as Kent – high-quality services have been pared down, leaving some mothers without the help they need.

Previous surveys have indicated similar results. Last year, Unicef UK’s Baby Friendly Initiative asked infant feeding leads about cuts in their areas. Many of these posts have been cut but of those responding, 40% reported cuts to one-to-one breastfeeding support and 47% reported closures of breastfeeding support groups in their areas. In April 2018, the Institute of Health Visiting conducted a similar survey of its members. Of those who responded, 50% reported recent cuts to breastfeeding support groups; 54% reported cuts to breastfeeding support specialist services; and 51% reported cuts to peer support programmes.

The NCT has also reported that its Baby Cafés – groups where mothers can get skilled help from breastfeeding counsellors and peer supporters – have been closing. The numbers have nearly halved in the last three years, falling from 97 in 2014 to just 46 at the end of 2017.

Survey of mothers’ experiences
In addition to its survey on the extent of the cuts, Better Breastfeeding also teamed up with the popular website Can I Breastfeed In It? to conduct a complementary survey of mothers’ experiences of cuts to breastfeeding support. The survey, which had over 1500 responses, reveals a postcode lottery of breastfeeding support, with some mothers getting all the help they needed locally while others found themselves struggling alone.

One mum in Hartlepool said the three support groups in her area had been cut to just one and funding for peer supporters had also ended. As a result, she had to travel 50 miles to get the help she needed. Another mother in Brent wrote: “I struggled with breastfeeding in the beginning and couldn’t find support anywhere in my area. Can you imagine what it is like as a new mother with a very unhappy baby to find the courage and energy to go out to seek support, only to be told that there’s no one there to help because of short staffing?! In the end my daughter and I were admitted to hospital in another borough [Harrow] and finally got some help.”

A mother from Hampshire wrote: “Since the closure of all but about 11 children’s centres in Hampshire, where most of the breastfeeding clinics were held, there is now no longer regular and wide ranging support… The support is even more difficult to find than it was 3 years ago when I had my first child.” She praised the support that she had previously received at the clinics. “It pretty much saved me from descending into postnatal depression. If it wasn’t for me regularly attending a local breastfeeding support group (that has now had to close), my daughter would never have been diagnosed with a severe tongue tie and there is no way that I would have been able to carry on breastfeeding for as long as I did. I went almost every week, in floods of tears usually, and always received warm, friendly and dedicated support. I was, and remain, devastated that the services have been slashed so wantonly.”

Mothers’ mental health
Breastfeeding rates in the UK are among the lowest in the world, with just 1% of mothers exclusively breastfeeding for six months. Around 80% of mothers begin breastfeeding, but by 6 weeks half of them have stopped breastfeeding. Around 8 out of 10 of these mothers say they stopped breastfeeding before they wanted to. Many cite lack of support as their reason for stopping or problems such as sore nipples, which can almost always be solved with skilled breastfeeding support. A report last year from the NCT on women’s experiences of maternity care, Support Overdue, found that two thirds of mothers said their midwife was too busy to help them with feeding their baby.

“We’re sleepwalking our way from a crisis to a total disaster with the present cuts to breastfeeding support. There had been steady gains in breastfeeding rates in recent decades, but these are about to start falling back down again. And that translates into hundreds of thousands of mothers every year being let down,” Professor Brown warned.

When women plan to breastfeed but it doesn’t work out, their risk of postnatal depression doubles, according to research from Cambridge University. “Antenatal education is very important, but it’s not enough to just tell women about the benefits of breastfeeding. They need practical, one-to-one, skilled help once their baby is born so that they can actually do it. Many people are surprised to discover that it’s not always completely straightforward. Mothers also need to hear when things are going well and their baby is feeding normally, especially those who don’t have any family and friends who have breastfed,” said Ayala Ochert.

Government guidance being ignored
Guidance from NICE (National Institute for Health and Care Excellence) and from Public Health England (PHE) says that local authorities should ensure that all mothers have access “local, easily accessible breastfeeding peer support programmes” and that peer supporters should be part of a multidisciplinary team, including midwives, health visitors and others. It also says all new mothers should be contacted directly by peer supporters within 48 hours of their transfer home from hospital (or within 48 hours of a home birth). The guidance also says that when there are more complex breastfeeding problems – for example, if the baby has a tongue tie that is affecting their ability to suck – mothers should be seen by a specialist, such as a lactation consultant. Only a small handful of places in the country now remain where all these NICE guidelines on breastfeeding support are followed.

Last year, Chief Medical Officer, Professor Dame Sally Davies, wrote to local authorities about the importance of breastfeeding: “Improving breastfeeding rates is not the responsibility of individual women struggling alone in a culture that can be hostile towards breastfeeding – rather this is a public health challenge for which we all share responsibility. We must find a way to meet this challenge; failure to invest in breastfeeding leads to poorer health outcomes for children and women today and for generations to come.”

She singled out peer support as a success story, but local authorities appear to be ignoring her advice. A study from Cardiff University in 2017 reported that mothers have access to peer support in just 56% of the UK. (The actual number is now even lower, following cuts since the study was conducted.) Many councils wrongly assume that breastfeeding support can be provided by midwives and health visitors alone, but this goes against PHE and NICE guidance. In practice, most midwives and health visitors will have far less training on how to support breastfeeding mothers – typically just two days’ worth of training compared with two years for breastfeeding counsellors and even longer for lactation consultants.

NHS England’s new Maternity Transformation Programme, which is currently being implemented across the country, includes the aim of increasing breastfeeding rates. Baroness Cumberlege wrote in her report Better Births: “Women told us that [breastfeeding] care was poor. There needs to be much better support for breastfeeding focused on practical help that supports and empowers women.” Yet very few Local Maternity Systems have plans in place to improve breastfeeding rates – instead, breastfeeding support is being cut.

The government has been criticised for failing to include breastfeeding as part of its Childhood Obesity Strategy, despite evidence that breastfeeding could reduce obesity in later life by as much as 13%.

In 2016, over 30 organisations, including medical royal colleges and charities supporting new families, wrote an open letter on the crisis in breastfeeding support. They wrote: “The breastfeeding crisis in the UK is in fact a crisis of lack of support for those mothers who choose to breastfeed.”

Better Breastfeeding’s campaign co-chair Ayala Ochert concluded: “Just at the time when we should be investing in breastfeeding support as a matter of urgency, local councils and health boards across the UK are disinvesting. It makes no sense, and parents across the country are demanding that skilled breastfeeding support is available to all who need it. This must be made a national priority that gets translated into real support locally.”

The campaign’s petition against the cuts gained has over 18,500 signatures.

Three things to do during National Breastfeeding Week

This National Breastfeeding Week 2018, most breastfeeding campaigners are not feeling much like celebrating. The swingeing cuts to breastfeeding support we’ve seen recently have left us angry, but we must not be despondent.

 

Here are three simple things you can do to help the Better Breastfeeding campaign:

  1. SIGN  and SHARE our petition against the cuts
  2. Write to your MP telling them why breastfeeding support is important to you, and asking what the government is doing about it. (There’s a template below to help you write it.)
  3. Respond to this survey telling us about your experience of cuts to breastfeeding support

These three things should only take you a few minutes. If you can only do one thing – make it the MP letter. You don’t need to wax lyrical. Write as much or as little as you like, but do write. (I’ve just written mine using the template below and it took 5 mins). If you manage something more detailed then you can copy and paste it into the short survey (2 mins), and signing and sharing the petition is even quicker (1 min).

Suggestions for MP letter

It’s best to put the letter in your own words, but here are some suggestions for what to include. (The numbers are just there for clarity – obviously don’t include them in your actual letter!)

Dear [Local MP]

  1. I am very concerned about the provision of breastfeeding support in [my constituency] and I want to know what can be done about this.
  2. There have been cuts to breastfeeding support [describe them in your own words]

OR

There is very little practical support for mums who want to breastfeed [describe what’s available]

  1. Whereas in [neighbouring area] there is much more support [describe what’s available if you know]
  2. This has affected me [describe your personal experience]

OR

I’ve seen how this is affecting mums in [my constituency – describe how they’re affected]

  1. I know that the government say that it’s the responsibility of councils to provide breastfeeding support to mothers in their local areas. But I’d like to know what the government is doing to make sure that councils actually deliver this and hold them to account. Please could you ask the minister responsible what they are doing? Please include this paragraph or something similar
  2. This week is supposed to be National Breastfeeding Week but I see very little emphasis on from government on this important public health issue. Mothers in [my constituency] are feeling let down, and our low breastfeeding rates show that babies are missing out too.

Yours sincerely,

[My name
Full address
Postcode
Contact telephone number]
MPs will not respond unless they have these full details to show that you’re their constituent

 

Better Breastfeeding – a new campaign is launched

“The success or failure of breastfeeding should not be seen solely as the responsibility of the woman. Her ability to breastfeed is very much shaped by the support and the environment in which she lives. There is a broader responsibility of governments and society to support women through policies and programmes in the community.”

Dr Nigel Rollins (WHO) in The Lancet

Last January, The Lancet produced its most definitive analysis of breastfeeding to date. It confirmed the importance of breastfeeding – in both rich and poor countries – to the health of babies, mothers and to the economy. It also reported that the UK has the lowest breastfeeding rates in the world.

You might imagine that the shock of finding itself at the very bottom of the world table would have prompted some action from our government, but so far there has been stony silence. In the meantime, breastfeeding rates are about to fall even further. Across the whole of the UK, but especially in England, there have been deep cuts to breastfeeding support services in the last two years and these continue apace.

In June, Blackpool Council ended its highly acclaimed and well-liked breastfeeding peer support service. Kent County Council has just announced that it wants to get rid of its breastfeeding service too. They join a long and growing list.

What is breastfeeding support?

Supporting mothers to breastfeed is not the same as telling mothers that breastfeeding is good for them and their babies. Governments do have a legitimate role in promoting healthy behaviours, like exercising, eating fruit and vegetables, avoiding cigarettes and too much alcohol – and encouraging breastfeeding.

But the fact is that most mothers in the UK already want to breastfeed. The last Infant Feeding Survey found that 81% of mothers began breastfeeding – by 8 weeks, half of them had stopped altogether. Of those who did, 80% said that they stopped breastfeeding before they wanted to. With over 700,000 births annually, that means almost a quarter of a million mothers are being let down ever year.

What on earth is going on? What is it in our society that is holding so many women back from reaching their own breastfeeding goals? (By comparison, in Norway, 70% of mothers are still breastfeeding at 6 months.) Broadly speaking, the answer is that we just don’t have a supportive environment for breastfeeding mothers in UK.

This lack of support takes many forms – telling mothers to stop breastfeeding in public or simply making them feel unwelcome when they do. It’s well-meaning family members who urge mothers to “just give some formula”. It’s the seductive advertising that lures us into the belief that infant formula is basically equivalent to breastmilk. It’s those midwives, doctors and health visitors who say “breast is best” but are unable to offer help when breastfeeding difficulties arise. And it’s reducing access to the practical help and emotional support that mothers should be receiving from trained peer supporters, breastfeeding counsellors and lactation consultants.

In many parts of the country, mothers have never had access to good quality peer support and specialist breastfeeding help. But now, even those places with exemplary services are seeing them cut. Breastfeeding peer supporters, breastfeeding counsellors, lactation consultants – these are the very people who are able to help mothers achieve their goals. When breastfeeding is painful, they offer ways to make it comfortable; when mothers don’t produce enough milk, they suggest ways to increase their supply. They also offer reassurance and an empathetic ear when mothers are struggling with normal baby behaviour.

The Better Breastfeeding campaign will be lobbying local and national governments, getting them to  recognise their responsibility to ensure that all mothers have access to high-quality, timely breastfeeding support in their area. We’ll be talking to politicians of all parties, encouraging them to work together to do the right thing for those millions of mothers who are currently being let down.

If we’re going to create an environment in which mothers feel supported to breastfeed, we’re also going to have to change the way we talk about the subject. Right now, we hear the same stories rehashed in different ways. “Breast versus bottle – which is best?” “Breastfeeding in public – what do you think?” “Pressure to breastfeed – were you made to feel guilty?” We need to move on from these tired old subjects that keep us stuck right here with the lowest breastfeeding rates in the world.

So, as well as pushing for access to good quality breastfeeding support for all mothers, the Better Breastfeeding campaign will be sparking new conversations about breastfeeding. We’ll be encouraging the media to broaden their horizons and start talking about breastfeeding in a new and better way.

We hope you agree that the Better Breastfeeding campaign is very much needed at this time. You can support our campaign in a number of ways.

  • Add your name to our change.org statement and show you share our mission
  • Sign up at the bottom of the page to receive updates about our campaign
  • Donate to our campaign – we plan to produce high-quality infographics and briefings to get our message across, and these are not cheap to make