How do we improve breastfeeding rates in the UK?

The UK has traditionally ranked as a world leader in many areas, such as education and medical research. However, the same cannot be said when it comes to breastfeeding.  

In fact, studies have shown the UK to be amongst the lowest in the world. According to the last UK-wide Infant Feeding Survey in 2010 [1], only 0.5% of babies are still consuming breastmilk when they reach 12 months. This pales in comparison to the likes of Germany (23%), The United States (27%), Brazil (56%) and Senegal (99%).  

UK breastfeeding rates

In addition to trailing behind other countries, the UK’s low breastfeeding rates also fall below the NHS and World Health Organisation’s advice. Both organisations recommend exclusively breastfeeding (breast milk only) for the first six months of the baby’s life. Breastfeeding alongside solid food is recommended for babies from six months on. 

While breastfeeding has infinite benefits for babies (immune-boosting, healthy weight gain, brain development, etc), there is also an equally long list of benefits for mothers. This is especially true when it comes to breast cancer prevention. A large study found that breastfeeding could decrease the risk of breast cancer by 4.3% for every 12 months of breastfeeding.  

Read our resources on breastfeeding and breast cancer for more interesting facts and advice. 

So, with all that being said, why are breastfeeding rates in the UK so low and what can be done to fix this? We sat down with Lucy Webber IBCLC (International Board Certified Lactation Consultant) and cancer researcher Dr Britta Stordal to find out more. 

‘It’s a generational Issue’ 

“We are lagging behind other countries with our low breastfeeding rates. Only 72.7% of babies in England have breastmilk as their first feed [2] and the breastfeeding rate then drops very quickly. Breastfeeding rates are even lower in Scotland and Northern Ireland as well as in younger mothers and more deprived areas [3–6],” says Britta. 

The cancer researcher added: “The reason for low uptake in the UK is complex, but a lot has to do with much lower rates of breastfeeding and increased use of formula milk in previous generations. In 1990, only 62% of babies were breastfed. This means that today’s grandmothers have less experience of breastfeeding compared to their daughters. This is important because women are more likely to breastfeed if they were breastfed as a baby and if their friends also breastfeed [1]. 

Breastfeeding is very important in reducing the risk of breast cancer. I don’t think the link between lack of breastfeeding and breast cancer is widely known by the everyday person. The benefits of breastfeeding to children are more widely understood. I chose to breastfeed my children but didn’t know about the breast cancer link until I became a trustee of Breast Cancer UK, and had a background as a cancer researcher.” 

‘There’s a stigma around breastfeeding’ 

“Breastfeeding can be quite an emotionally charged topic because of the wide range of experiences. The societal messages around breastfeeding are still incredibly mixed up. These include outdated views on breastfeeding in public and misinformation that breastfeeding will make your baby ‘extra clingy’. 

“The media has played a role in creating these polarising views as there is an overpromotion of breastfeeding stories centred around struggle. And little about people who have had pleasant experiences,” said Lucy. 

Lack of regulations 

“The WHO launched an International Code of Marketing Breastmilk Substitutes in 1981, which explicitly banned the advertising and promotion of formula milk to the general public.[7] It is illegal in the UK to promote formula milk for infants < 6 months old, but the advertising of milk for older infants is permitted.[8]  

Formula milk marketing, and not the product itself, alters informed decision-making and undermines breastfeeding and public health.[9] Banning the advertising of formula milk, including the introduction of plain packaging, will allow new mothers to make healthier choices,” said Britta. 

Lucy added: “In countries where they have the appropriate marketing around formula milk, their breastfeeding rates are much better. In the UK, the breastfeeding rates aren’t as high and I don’t think this is a coincidence. Stricter marketing regulations on formula marketing would help mothers to cut through the noise and make a more informed choice. 

It’s not about shaming or banning anyone from formula feeding. It’s about making sure that breastfeeding resources are as easily accessible and widely promoted.” 

How do we fix this? 

“Every breastfeeding journey is different. As a result, every mother will have their own needs. However, some measures will help to make breastfeeding more achievable and sustainable for mothers who wish to breastfeed their children,” says Lucy. 

“It’s normal for mothers to experience some uncertainty around their approach to breastfeeding. Many of these issues can be resolved easily with the right support. The problem is it can be difficult to find the right place to go. This is why more needs to be done in terms of education and training of support services. While GPs are well-intentioned, a lot of them lack the necessary specialist training to help mothers with breastfeeding.  

As the training isn’t mandatory, it falls on the GP to make time for independent learning outside of working hours. Most of them simply don’t have the time. This isn’t to disparage GPs and doctors, but more so to emphasise the difference that can be made if they’re given the right training.” 

Similarly, Britta also believes that outside intervention is needed to help improve the UK’s breastfeeding rates. 

“UK law requires an employer to provide a space to rest for lactating mothers, including the ability to lie down [10]. However, the law doesn’t cover paid breaks from work to express milk or breastfeed or provide facilities for storing expressed milk. 

This lack of legislation is a barrier to breastfeeding, particularly for women who work in complex environments such as the armed forces [11]. In contrast, 121 other countries provide paid or unpaid breaks [12].  The introduction of paid breaks for lactating mothers will allow women to continue to breastfeed on their return to work.” 

References

1. McAndrew F, Thompson J, Fellows L, et al (2010) Infant Feeding Survey 2010. The Information Centre for Health and Social Care
2. (2021) NHS Maternity Statistics, England – 2020-21. Community and Mental Health Team, NHS Digital
3. Public Health Scotland (2021) Infant Feeding Statistics Scotland. Public Health Scotland
4. Health and Social Care Northern Ireland (2018) Health Intelligence Briefing: Breastfeeding in Northern Ireland. Public Health Agency – Health and Social Care Northern Irelan
5. Oakley LL, Renfrew MJ, Kurinczuk JJ, Quigley MA (2013) Factors associated with breastfeeding in England: an analysis by primary care trust. BMJ Open 3:e https://doi.org/10.1136/bmjopen-2013-00276 
6. (2021) Maternity and birth statistics: 2020. Welsh Government
7. (1981) International Code of Marketing of Breast-Milk Substitutes. World Health Organisation
8. (2007) The Infant Formula and Follow-on Formula (England) Regulations 2007. UK Statutory Instrument
9. WHO (2022) How the marketing of formula milk influences our decisions on infant feeding. WHO
10. ACAS (2014) Accommodating breastfeeding employees  in the workplace. Advisory, Conciliation and Arbitration Service
11. Taylor H (2021) Enablers and barriers to workplace breastfeeding in the Armed Forces: a systematic review. BMJ Mil Health bmjmilitary-2020-001724. https://doi.org/10.1136/bmjmilitary-2020-001724
12. Laura Addati NC and KG (2014) Maternity and paternity at work: Law and practice across the world

For more information on breastfeeding and breast cancer visit our key facts sheet here.

• awareness
• Breast cancer
• breast cancer prevention
• Breast Cancer UK
• cancer
• prevention
• reduce your risk