Becoming breastfeeding friendly in Wales: Recommendations for scaling up breastfeeding support

Abstract

Breastfeeding and the provision of human milk is established as protecting infant and maternal health. However, breastfeeding rates in many countries, including Wales, are low. Given the significant health, economic and environmental impacts of this, the need to strengthen breastfeeding promotion, protection and support is paramount. As part of this, the becoming breastfeeding friendly: a guide to global scale‐up (BBF) initiative sets out a methodology to enable countries to assess their readiness to scale up breastfeeding protection, promotion and support by gathering data and scoring progress under eight areas, termed ‘gears’, shown to be essential for large‐scale change. Recently, Wales took part in the BBF initiative. A cross‐sector committee, including stakeholders from Universities, Welsh Government, Public Health Wales and Health Boards alongside critical friends scored Wales’ support for breastfeeding across the eight gears. The overall score for Wales was 1.1 out of a possible 0–3, representing a moderate scaling up the environment for breastfeeding. Six gears were rated in the moderate gear strength category and two (‘Promotion’ and ‘Advocacy’) in the weak gear strength category. Gaps in breastfeeding support were identified and 31 recommendations covering six themes for change were put forward. These included a strategic action plan, consistent and long‐term funding, a nuanced, cocreated engagement and promotion framework, strengthened education and training, robust monitoring and evaluation mechanisms and ensuring maternity rights and the International Code of Marketing of Breastmilk Substitute are upheld. Taken together, the analysis and recommendations present a clear vision for protecting and not merely promoting breastfeeding in Wales.

Abstract

The Breastfeeding Gear Model

Highlights

• Wales is a small nation with devolved health legislation that should take advantage of its power to enact countrywide, universal breastfeeding policy and strategy.

• Policy, promotion and support should be nuanced and cocreated by communities to meet the needs of the diverse Welsh population.

• Policy must be supported by sustainable investment and political, positional and operational buy‐in across government, health and social services.

• Strategy must be evidence‐based with an emphasis on women's experiences and voices. Robust monitoring and evaluation mechanisms must be put in place so that data are up to date and meaningful.