I know these points of view and circumstances, they are reflected in my friends and family and therefore I’m very wary of causing offence when talking about feeding babies because I recognise that all family circumstances are different.
Sometimes it is difficult to talk about a topic as personal as breastfeeding or formula feeding without someone feeling judged. Every parent I know is doing their very best and if that is the basis of our conversations around feeding babies perhaps we can find ways of better protecting all babies, regardless of how they are fed.
This week is National Breastfeeding Week and the theme is ‘Feeding the Future’. In Ireland in 2020 62.3% of mothers initiated breastfeeding in maternity hospitals compared to initiation rates of 90% in Australia, 81% in the UK and 79% in the USA .
The WHO global target for 2025 is at least 50% of babies to be exclusively breastfed for the first six months of life after which mothers are recommended to continue breastfeeding, in combination with solid foods, until their children are two years of age or older.
Ireland has much to do to achieve those rates and mothers who intend and wish to breastfeed are often let down by an overstretched maternity system where overworked staff simply don’t have time to give the hands-on support and guidance that is needed to successfully establish feeding in the hours and days after birth. Mothers are often discharged without feeding well established and if a mother doesn’t have a GP or public health nurse knowledgeable about breastfeeding then the mother’s best laid breastfeeding plans can unravel quickly.
Ireland doesn’t have a strong breastfeeding culture so knowing where to turn for help is half the battle. Voluntary organisations like La Leche League, Cuidiu and Friends of Breastfeeding offer breastfeeding support and information but these organisations are run by overstretched busy voluntary mums.
This week the National Women’s Council of Ireland and Baby Feeding Law Group Ireland are calling on the government to adequately fund the Maternity Strategy and Breastfeeding Action Plan in Budget 2022 to ensure all women get the maternity care they deserve and properly support women who want to breastfeed. It would be a prudent health investment in the future.
Another action that would protect all babies, breast or formula fed, would be an end to marketing and advertising of infant formula, follow-on milks, toddler milks to the general public and healthcare staff.
Formulae would still be on the supermarket shelves but parents would be basing their choices on factual information from public health resources not marketing messages.
No emotive TV ads, no special “Baby Club” offers, no free “helplines” - all marketing tactics to get parents to choose one brand over another. I know a dietitian when asked “what is the best infant formula?’ she replies ‘the cheapest’. The ingredients of infant formula are strictly regulated which means there is little difference between the brands. Infant formula companies spend millions annually trying to convince parents otherwise. Baby milks could conceivably be cheaper if the industry didn’t spend so much on advertising.
Follow-on milks and toddler milks are “unnecessary and inappropriate” according to the WHO and were created by the industry to circumvent advertising rules around first infant milks. Cow milk after 12 months is just fine.
Even healthcare workers are susceptible to influence.
The HSE has just introduced a new staff policy which recognises that healthcare staff must keep the HSE a marketing free zone ensuring that instead families can get unbiased information from healthcare workers and websites like www.mychild.ie.
The HSE policy ‘Working within the Code’ refers to the WHO’s International Code of Marketing of Breast-milk Substitutes. Known as ‘the Code’, it is a set of recommendations to regulate the marketing of breast milk substitutes, feeding bottles and teats. The HSE staff policy explains; “Marketing has been proven to encourage formula consumption and sales are increasing 8% year-on-year. Companies spend this money because advertising works. None of us are immune to the influence of advertising.”
The HSE says that parents “should have access to accurate and effective information free from the influence of marketing campaigns that are designed to protect profits rather than families and babies.”
All parents will agree that babies come before profits and the new HSE policy is a big step in removing industry from the healthcare arena and conversations about how we feed our babies.
Government can go further and fully legislate for the Code, shielding us from all infant formula marketing. Now that would be a bold leap!