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Breastfeeding

Last Modified 22/03/2023 13:39:10 Share this page

Introduction

Breastfeeding is good for babies and is recommended for about the first 6 months of a baby's life. The health benefits of breastfeeding babies are considered to be; reduced chance of diarrhoea and vomiting, fewer chest and ear infections, not as much chance of being constipated or developing eczema and less likelihood of becoming obese. The health benefits of breastfeeding babies for mothers are; reduced risk of developing certain ovarian and breast cancers, a lower risk of developing diabetes and hip problems in later life1.

Mothers who are young, white, from routine and manual professions and who left education early are the least likely to breastfeed2.

Facts and Figures

Breastfeeding data focuses on two main areas: the initiation of breastfeeding, or first feed of breastmilk, and whether breastfeeding has been maintained after six to eight weeks. Both of these measures have undergone changes over recent years, and some data may be less reliable due to these changes and the challenge of obtaining a reliable level of completed data. Because of these factors, trend data should be read with caution.

Breastfeeding Initiation / First Feed

Figure 1 measures the percentage of newborn babies who commence breastfeeding.  Until the end of 2016/17 this was measured by whether the mother gives their baby breastmilk within the first 48 hours after delivery. From 2017/18 this measurement changed to the number of babies whose first feed is known to be breastmilk. The changes shown in Figure 1 from 2017/18 reflect this. A national rate for the first year of the new measurement was not published due to data quality concerns.

The chart compares the rate of breastfeeding initiation in Blackpool and England. The breastfeeding initiation rate was relatively stable between 2013/14 and 2016/17, significantly lower than the England rate. In Blackpool in 2016/17, 1,068 new mothers began breastfeeding, a rate of 59.1% compared to 74.6% across England as a whole. The new measurement from 2017/18 shows a lower proportion of babies receiving breastmilk as their first feed both nationally and locally. Blackpool's rate remains significantly lower than the England average, with 910 babies in 2018/19 receiving breast milk as their first feed, a rate of 52.4% compared to 67.4% across England. 

The Office for Health Improvement and Disparities (OHID) have not published first feed breastmilk data at national or local levels since 2018/19, so further comparisons are not available at this time. However, monthly first feed statistics for Blackpool Teaching Hospitals NHS Foundation Trust are available via the NHS England National Maternity Dashboard.

Figure 1 - Breastfeeding Initiation / First Feed 2011/12 - 2018/19

Chart showing trends in breastfeeding initiation and first feed of breastmilk for England and Blackpool CCG. Proportions of breastfed infants are significantly lower in Blackpool than across England
Source: NHS England, Maternity and breastfeeding / Maternity Services Dataset

Breastfeeding at 6 to 8 weeks

This is the number and proportion of infants that are totally or partially breastfed at 6 to 8 weeks of age. Totally breastfed is defined as infants who are exclusively receiving breast milk at 6-8 weeks of age - that is, they are not receiving formula milk, any other liquids or food. Partially breastfed is defined as infants who are currently receiving breast milk at 6-8 weeks of age and who are also receiving formula milk or other liquids or food.

In 2021/22 in Blackpool, 354 infants were known to be still breastfeeding at 6-8 weeks. This equates to 25.7% of all infants due a 6 to 8 week check, compared to 49.3% in England as a whole3. Due to recording and reporting issues, recent levels of the known breastfeeding status of infants in Blackpool have been lower than the validation threshold for OHID reporting (84.8% in 2021/22 compared to a threshold of 95%). This means that the actual numbers may be higher than reported, though proportions are still likely to be significantly lower than the national average. For 2021/22, the proportion of breastfeeding among those infants reported as receiving a check at 6 to 8 weeks was 30.3%, compared to 54.3% in England as a whole.

Figure 2 compares the rate of breastfeeding at 6-8 weeks after birth in Blackpool with England. Proportions of breastfeeding among all infants due a 6 to 8 week check AND those with known breastfeeding status are shown for comparison purposes.

Figure 2 - Breastfeeding at 6-8 weeks after birth 2015/16 - 2021/22 (all infants due 6-8 week check and those with a known breastfeeding status)

 Chart showing trend in recorded breastfeeding at 6 to 8 weeks to 2021/22. The proportion of infants breastfeeding in Blackpool at 6 to 8 weeks are considerably below national levels.
Source: OHID, Breastfeeding at 6 to 8 weeks after birth

Breastfeeding Drop-Off

The drop off rate is the difference between breastfeeding initiation from birth, and the number of mothers that continue to breastfeed at 6-8 weeks. Figure 3 shows that the approximate 2018/19 breastfeeding drop-off rate for Blackpool mothers is 31.7% which is higher than the England rate of 21.2%4.

Figure 3 - Breastfeeding drop-off rate, Blackpool and England, 2015/16 to 2018/19

Chart showing breastfeeding drop-off rates across Blackpool and England from 2015/16 to 2018/19. Drop of rates in Blackpool are consistently higher than national levels with 31.7% of mothers ceasing breastfeeding by 6 to 8 weeks, compared to 21.2% nationally
Source: Calculated from NHS England and PHE breastfeeding data

Barriers to Breastfeeding

Public Health England and Unicef UK have developed guidance to support the commissioning of evidence-based interventions to improve breastfeeding rates. The guidance highlights reasons why mothers in England don't breastfeed.

Infographic explainer as to why mothers in England don't breastfeed. Identifies that many mothers find breastfeeding difficult, not acceptable in public and difficult to combine with work and lifestyles. Some families also live in a culture where formula feeding is considered normal.
Source: PHE, Commissioning infant feeding services: infographics, July 2016

The US Surgeon General's report Call to Action to Support Breastfeeding also identifies a number of barriers to breastfeeding:

    • Lack of knowledge
    • Social norms
    • Poor family and social support
    • Embarrassment
    • Lactation problems
    • Employment and child care

National and local strategies

    • The Healthy Child Programme (HCP) (Department of Health, 2009) - Aims to increased rates of breastfeeding initiation and continuation, which will contribute specifically to improving breastfeeding and obesity outcomes.
    • NICE Guidance [PH11] Maternal and child nutrition (November 2014) covers advice and information regarding breastfeeding.
    • The NHS Long Term Plan (January 2019) recommends Unicef UK Baby Friendly accreditation across all maternity services and includes a focus on improved support for families with infants in neonatal care.
    • PHE, Infant feeding: commissioning services.  Evidence-based good practice prompts for planning local comprehensive breastfeeding support interventions. Public Health England and Unicef UK have developed the guidance to support the commissioning of interventions to improve breastfeeding rates across England. July 2016


[1] NHS, Benefits of breastfeeding [Accessed January 2019]

[2] Davies, S (2014) Annual Report of the Chief Medical Officer 2014, The Health of the 51%: Women, December 2015

[3] Data note: These values should be viewed with caution due to data quality issues. High levels of reported 'unknown' breastfeeding status can affect data reliability.

[4] Data note: This data is approximated due to the changes to the initiation measure and data quality issues for 6-8 week breastfeeding.