Staying Healthy

Breastfeeding

Health Professionals

All newborn babies and children up to four years old will now have their growth measurements plotted on new charts, based on the World Health Organization (WHO) Child Growth Standards which describe the optimal growth of healthy breast-fed children. Research shows that breast-fed babies tend to gain weight at a healthier pace and are less likely to become obese in later life.

The new charts will play an important role in establishing breastfeeding as the norm and will be included in the Personal Child Health Records, which parents of every newborn are given. They will help parents and healthcare professionals identify children at early risk of obesity and provide important reassurance for parents of breast-fed babies, who are likely to gain weight more slowly.

The charts and further information are available to view on the Royal College of Paediatrics and Child Health website.

Evidence shows that breastfeeding has a major role to play in public health as it promotes health and prevents disease in both the short and long-term for both infant and mother.  As well as providing complete nutrition for the development of healthy infants, human breast milk has an important role to play in protection against gastroenteritis and respiratory infections.  There are also strong indications that breastfeeding has an important role to play in the prevention of otitis media, urinary tract infection, atopic disease, juvenile onset insulin-dependent diabetes, raised blood pressure and obesity1. 

Concern has been raised that breastfeeding and its duration may increase the risk of early childhood dental caries.  A study was planned in the United States to assess the potential risk factors for dental caries in a group of 1,576 children aged 2-5 years old.  The results demonstrated that there is no evidence to suggest that breastfeeding or its duration are risk factors for early childhood caries, severe early childhood caries, or decayed and filled surfaces on primary teeth2.  To access the study, click here.

In addition to the nutritional and immunological superiority of breast milk over formula milk, artificial feeding is associated with a number of specific health hazards to which breastfed babies are not exposed.  These include the possibility of over or under concentrating formula milk during reconstitution, and the potential for infection introduced by substitute milk products, bottles, teats and other vessels1. 

Despite the overwhelming health benefits and cost savings of breastfeeding, breastfeeding initiation rates in the UK are around the lowest in Europe, and worldwide, with rapid discontinuation rates for those who do start.

In England and Wales the breastfeeding rate for 2005 was 77%, in NHS North Yorkshire and York it is 70.2%. However some areas fall well below this figure, for example Scarborough has a rate of 57.6% and York a rate of 66.4%

For more information on the long term effects of breastfeeding, promotion of initiation and duration and evidenced based practice please refer to the documents listed under ‘Key documents’ above.

For more information on breastfeeding policy and practice, click here and our Local Initiatives page.

Vitamin D Deficiency

Vitamin D deficiency impairs the absorption of dietary calcium and phosphorus, which can give rise to bone problems such as rickets in children.

The following groups of people are at risk of vitamin D deficiency:

• All pregnant and breastfeeding women, especially teenagers and young women.

• Infants and young children under 5 years of age.

• Older people aged 65 years and over.

• People who have low or no exposure to the sun, for example those who cover their skin for cultural reasons, who are housebound or confined indoors for long periods.

• People who have darker skin, for example people of African, African-Caribbean and South Asian origin, because their bodies are not able to make as much vitamin D.

The Department of Health recommends that ALL pregnant and breastfeeding women should take a daily supplement containing 10 micrograms of vitamin D.  Babies born with low levels of vitamin D can sometimes develop softened bones, which can lead to rickets.  Taking vitamin D during pregnancy will ensure that your baby has enough stored in their body for the first few months of their life.

Women and children from families who are eligible for the Government’s Healthy Start scheme can get free vitamin supplements which include vitamin D, in the form of tablets for women and drops for children.

Helping a baby with tongue tie - help for health professionals.

Lactation consultants/breastfeeding counsellors in your area are available by contacting:

Encouraging mums to breastfeed

Recent research carried out with young women by Claro, marketing research company, for North Halifax PCT noted that the following had a strong impact when encouraging women to breastfed and to continue to feed and made the following recommendations for health professionals, especially midwives and health visitors:

• Always praise any attempt to breastfeed.

• Don’t overwhelm with long targets, e.g. 6 months, or even 6 weeks – adopt an every feed is a benefit/day by day approach.

• Recognition that breastfeeding is difficult, including less weight gain in baby.

• Don’t under estimate the amount of wavering that can go on.

• Use all opportunities to discuss the benefits of breastfeeding in detail.

For more information on the interventions which enable and encourage women to breastfeed for longer, go to: Breastfeeding for longer – what works?  Health Development Agency, 2005.

References

1  Promotion of breastfeeding initiation and duration – Evidence into action, HDA, July 2006).

2  Iida H, Auinger P, Billings RJ et al (2007).  Association between infant breastfeeding and early childhood caries in the United States.  Pediatrics; 120(5): e9440-52.

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