More Thoughts on the Infant Feeding Survey 2010

The Infant Feeding Survey 2010 came out last week and has been discussed in the media and in other places (see also my previous blog post). The survey is completed every five years and “the main aim of the survey was to provide estimates on the incidence, prevalence, and duration of breastfeeding and other feeding practices adopted by mothers in the first eight to ten months after their baby was born.” Over 10,000 mothers were surveyed when their babies were between certain ages. Overall, the survey showed that mothers are continuing to breastfeed for longer and more mothers starting breastfeeding. Breastfeeding initiation was higher for mothers and babies that shared skin-to-skin contact after the baby was born. It was reported that only 1 in 100 babies are still exclusively breastfed at six months as per government recommendations.

So what are the statistics that stood out to me?

– At six months, just over a third of mothers (34%) were still breastfeeding. That means that 66% of babies were on formula (and possible solids) by the age of six months. These surveys are so hard to interpret in a way. You could conclude that of the 34 from 100 babies that only one is still exclusively breastfed, but that doesn’t mean that the other 33 are mixed formula feeding or are giving solids before six months along with breastmilk. It could mean that some or all of the 33 babies were given something other than breastmilk at an early age and from then until six months have remained solely breastfeeding. The limitations of surveys and reporting data…

– Across the UK, 69% of mothers were exclusively breastfeeding at birth in 2010. At one week, less than half of all mothers (46%) were exclusively breastfeeding, while this had fallen to around a quarter (23%) by six weeks. So by six weeks of age 77% of babies were receiving or had received something that wasn’t breastmilk, up from 33% at birth. That is a huge increase. What happens in that six weeks? Do mothers doubt themselves? Do they supplement just once with formula and still get counted as not exclusively breastfeeding? Do they give formula once a day? I wish these numbers could really give us a clear picture so that we knew how to support mothers to continue with breastfeeding.

– Two in five mothers (41%) were taught how to position their baby for breastfeeding and how to attach their baby to the breast during their pregnancy. I remember in my own antenatal class reviewing breastfeeding and thinking that it was not enough information and there was not enough time spent on the topic. I was glad that I had other information about breastfeeding from my work to supplement what I was being taught as I don’t think that I would have had confidence in my abilities from this antenatal session alone. I wonder what the other mothers on the course felt? Was it better than nothing? Did they think it was adequate? There were six mothers on the course. Besides me, I know that one mother exclusively breastfed until just before six months before introducing solids and continues to breastfeed her toddler and another mum intended to breastfeed but was fully formula feeding within a couple of weeks. I do not know about the others. I feel that our society is not open enough for breastfeeding and it is not common enough to see our sisters, friends, or fellow mothers in a cafe breastfeeding. In a society that is able to learn from others experiences by being exposed to breastfeeding as a norm and seeing what a breastfeeding baby looks like, it may not be necessary to purposefully teach breastfeeding antenatally. However, in our society, it is possible that a pregnant mother has never seen someone breastfeed. Do we expect her to know what to do with her baby when it is born? Some mothers and babies do know how to breastfeed instinctively, but again, in a society where a woman’s natural instincts may have been diminished through medicalised birth, would the instincts kick in afterwards? I believe that antenatal education is important and more than 4 in 10 mothers should have opportunities to learn about breastfeeding. This leads into the next figure:

– Mothers who recalled receiving information were more likely than mothers who had not, to intend to breastfeed (77% compared with 66% respectively) and were more likely to actually initiate breastfeeding (83% compared with 73% of those who did not recall receiving information).

– Nearly seven in ten mothers breastfeeding in the hospital, birth centre or unit (69%) had been shown how to put their baby to the breast in the first few days (84% of first-time mothers and 50% of mothers of second or later babies). The thing that surprised me here is the support for second-time mothers. Why did only half get shown? Are 50% of second time mothers confident in their abilities or do health care professionals assume that they are confident as they may have done it before? I don’t know the answer to that, I am just as curious as the next person. I know from experience that some second or third time mothers do just get on with it and others find that it is a different experience. It would be interesting to know if more than 50% were offered the opportunity to be shown.

– Just under half of mothers breastfeeding in the hospital, birth centre or unit (48%) were informed about how to recognise that their baby was getting enough milk. This I found staggering. As a nurse, I always discussed this with clients out in the community. One of things that mothers often raised as a concern was knowing how a breastfed baby was getting enough as you can’t see the breastmilk the baby is taking. They would tell me that formula for that reason is a lot easier. Why would mothers not get taught the simple signs of recognising a baby is getting enough when they need to feel confident in their abilities from the beginning?! I know there were times I doubted myself and how well I was breastfeeding and had to rely on knowing this information to reassure myself.

– Nearly seven in ten mothers (69%) had been given the contact details of a voluntary organisation or community group which helps new mothers with infant feeding. All mothers should leave hospital or leave the care of their midwife knowing where they can get help. This is important no matter how a baby is being fed. I know that I have answered feeding questions for both breastfed and formula fed babies in the community. Mothers need to know where to go and not feel alone.

Overall, it seems that the figures reported were more positive in 2010 than in 2005 which is great. There are amazing people doing amazing things, be this health professionals, mothers, or the community supports. It just seems that there is so much more that could be done.