BREASTFEEDING/CHESTFEEDING IN THE UK
Up until 2010 there was a national survey of infant feeding practices every 4 years, which showed that initiation of breastfeeding was slowly climbing and had reached around 85%. Smaller National Maternity Surveys since then, and the Infant Feeding Survey 2024 have shown static initiation rates (86% in 2024 maternity and infant feeding surveys). These are still low relative to many other countries. Breastfeeding figures from the Department of Health and Social Care have always been lower than the national surveys (around 70-75%) - both ways of estimating have their weaknesses so the true figure may lie between the two. The figures above are from the 2018 National Maternity Survey and the 2024 Infant Feeding Survey.
There has been major improvement in prevalence of any breastfeeding over the first six months after birth since 2000. Estimates for 2024 (from the National Maternity Survey and the Infant Feeding Survey) are 70% at six weeks and 53-58% at six months of age. Scottish routinely collected data suggests that around 20% of infants still receive breastmilk into toddlerhood (13-15 months). The figures below are from the 2024 National Maternity Survey. The Covid-19 pandemic did not seem to have a major effect on breastfeeding rates nationally, although there was a small reduction in exclusive breastfeeding at six weeks after birth, a sharp rise in parents reporting inadequate feeding support, increased attendance at ED with feeding issues and a rise in postnatal depression and anxiety.
When defined as never having any infant formula or complementary food, the rate of exclusive breastfeeding in 2024 was estimated as 56% at one week after birth and 26% at six month of age. There is no directly comparable data for exclusive breastfeeding over time. However, age at introduction of solid/complementary food has had dramatic change in the last 20 years. The figures below are from the 2024 Infant Feeding Survey and 2024 National Maternity Survey.
Certain factors are associated with lower initiation and continuation rates - mothers who are more economically deprived are most at risk - for example those in the most deprived quintile had an adjusted odds ratio of 0.68 for breastfeeding initiation. Younger people and smokers also show reduced breastfeeding rates. In general, people from black and minority ethnic groups have higher initiation and continuation rates for breastfeeding, but this may hide significant differences among specific ethnic groups with different historical and cultural attitudes to breastfeeding. Rates are lower in the devolved nations than in England but show rapid improvement in Scotland.
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There are many reasons for the poor state of breastfeeding in the UK, compared to other high income countries. The UK World Breastfeeding Trends Initiative Report in 2016 identified insufficient training for health professionals as one of seven key gaps.
Figure from WBTi UK, click on the picture to go to the site
What do families say?
The 2017 Scottish Infant Feeding Survey reported that:
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Two thirds of those who had initiated breastfeeding/chestfeeding reported experiencing some problems
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Half had difficulty with attachment to the breast/chest in the early days
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65% were concerned about their milk supply in the first few weeks
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A quarter said that they had been made to feel uncomfortable when breastfeeding/chestfeeding their baby
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Three quarters of those who stopped breastfeeding/chestfeeding wanted to continue
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Of those who stopped breastfeeding/chestfeeding, 77% had problems with attachment to the breast/chest and 86% were concerned about their milk supply
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The 2018 National Maternity Survey in England showed that a third of respondents wanted more help with breastfeeding/chestfeeding than they received.
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It is also important to note the mental health impact of this steep drop off in breastfeeding/chestfeeding rates. Those who plan to breastfeed/chestfeed and don't succeed have a 50% higher rate of postnatal depression than those who plan to breastfeed/chestfeed and do so. This is a useful website for families and health professionals to work through their feelings about feeding.
