World Breastfeeding Week: Addressing barriers to nursing could support healthy weight in childhood

05 Aug 2024 --- This year’s annual world breastfeeding week (August 1–7), supported by the WHO, UNICEF and ministries of health around the world, centers around the theme “Closing the gap: Breastfeeding support for all.” UK-based charity The Food Foundation argues that removing barriers to breastfeeding could play a role in addressing the nation’s childhood overweight and obesity problem.

In its report titled “Breaking down the barriers to breastfeeding to support healthy weight in childhood” The Food Foundation highlights: “Breastfeeding reduces the risk of childhood overweight and obesity and therefore can play an important role in supporting healthy weight in childhood.”

“The UK has some of the lowest rates of exclusive breastfeeding in the world, with less than half of infants breastfed exclusively at one week old, and just 1% of infants being exclusively breastfed for six months, with rates lower in deprived communities.”

Meanwhile, more than a fifth of children in England are living with overweight and obesity by the time they reach their first year of school.

The Food Foundation report considers the current breastfeeding practices in the UK and potential barriers to those who would like to breastfeed their infants. It identifies key areas of policy intervention that could improve breastfeeding rates and reduce childhood overweight and obesity. 

The UK has some of the lowest rates of exclusive breastfeeding in the world.Breastfeeding for healthy weight
The charity highlights that there is “a huge body of evidence” showing that breastfeeding reduces the risk of childhood obesity even when a range of other potential factors are taken into consideration. 

The WHO’s 2022 European Childhood Obesity Surveillance Initiative reveals that exclusive breastfeeding for six months can decrease the likelihood of a child developing obesity by up to 25%. Exclusive breastfeeding allows for oral rehydration salts, vitamins, minerals and medicines as drops and symptoms, but no other food or drink, including water.

The report also asserts that “bottle feeding may promote weight gain and formula fed babies are likely to gain weight more rapidly than infants who are breastfed.” The Food Foundation links this to factors related to the gut microbiome, hormones, appetite regulation and gene moderation. 

“Human breast milk is high in bifidobacteria, which positively influence the development of the baby’s gut microbiome. Bifidobacteria have been shown to be present to a lesser extent in the gut of children with obesity.”

Breastfeeding supports appetite regulations as infants are better able to judge when they are full, in comparison to when they are bottle-fed and the carer is in control. It is significant to the moderation of genes associated with fat mass and obesity.

Natural infant feeding results in different hormonal responses when compared to formula, as the latter causes greater insulin release. 

Breastfeeding is linked to healthier diets in childhood, with breastfed children showing a greater preference for fruit and vegetables. 

The Food Foundation reports: “Exclusive breastfeeding was highest in England compared to the other nations of the UK, starting at over 70% at birth and falling below 20% at three months, with the lowest exclusive breastfeeding in Northern Ireland, starting at just over 50% at birth and falling below 10% by three months.” 

Meanwhile, 21,4% of children in the first year of school in England suffer from overweight or obesity. The same is true for 25.4% of all children in Northern Ireland, 27% of four- and five-year-olds in Wales and 33% of two- to 15-year-olds in Scotland.

Policy recommendations
The document presents nine policy recommendations to UK policymakers on how to ensure all who want and are physically able to breastfeed their infant are able to do so without the interference of other potential barriers. 

Breastfeeding is linked to healthier diets in childhood.The Food Foundation calls on policymakers to provide funding to local authorities to ensure the provision of breastfeeding support services for all. This should include “family hubs” and children’s centers in areas of high deprivation.

The organization asserts the need for health visitors to be increased. It proposes statutory recommendations for workplaces to provide support to breastfeeding women.

“Baby Friendly Initiative (BFI) accredited facilities should be increased. BFI is UNICEF’s accreditation program to support maternity, neonatal, health visiting and children’s services by providing training and assessing progress.” 

Another policy recommendation concerns the strengthening of protections for women breastfeeding in public. It also proposes the increase of the statutory maternity pay to align with the living wage and extend the Sure Start Maternity Grant to second and subsequent children.

The charity asks policymakers to broaden the eligibility for the Healthy Start and Best Start benefit schemes, to introduce auto-enrolment, expand value in line with inflation and to ensure “nutritional safety net” for breastfeeding as well as formula feeding mothers.

UK law on the marketing of breastmilk substitutes should be strengthened in line with WHO’s International Code of Marketing of Breastmilk Substitutes.

Lastly, the report recommends the dedication of a specific government team to breastfeeding to integrate breastfeeding within the government’s obesity strategy. 

By Milana Nikolova