Guest Blog: No Such Thing As A Free Lunch?

As life has been a tad chaotic recently (did I mention my book is out soon?), it unfortunately hasn't left as much time as I would like to blog. I would therefore like to introduce and thank Ayala Ochert for this great guest entry:

What if I told you that there’s a vaccine that could save the lives of 1 million children worldwide each year? And that this same vaccine also helps prevents diabetes, heart disease, breast cancer and depression in adults? As if that were not enough, this remarkable vaccine also helps reduce health inequality and antisocial behaviour while also boosting intelligence.

Yet, even though it would save the lives of at least 200 under 1s in the UK and prevent the hospitalisation of many more, most babies in the UK are not getting their “shot”. Perhaps you are thinking that this vaccine is too expensive for our beleaguered NHS, yet in fact it costs very little and would save – at a very conservative estimate – around £2 billion each year*.

So while politicians are clambering to tell us how they would protect the NHS if we give them our vote, why aren’t they talking about this incredible biological product? Perhaps because it’s not manufactured by any pharmaceutical company but is produced by ordinary women. This “vaccine” I’m referring to is in fact the act of breastfeeding.

No politician wants to tell women that they should breastfeed – they know that would win them no votes. But informing mothers about the health protection afforded by breastfeeding is just a small part of what they can do to increase the number of babies and mothers that receive this vital “inoculation”. Most mothers in the UK start off with the intention of breastfeeding, and most stop before they want to.

So what can policymakers do? In 2007, over 30 health organisations created the UK’s first Breastfeeding Manifesto, setting out the policies that the government would need to put in place to ensure that more mothers breastfeed and for longer. The seven principles outlined in the manifesto are yet to be realised in the UK.

1. Implement the Global Strategy for Infant and Young Child Feeding
   The World Health Organisation and UNICEF developed this document to focus world attention on the fact that 1 million babies die each year because of inadequate breastfeeding. While most of these babies are born in the developing world, some of them will be born in rich countries with good healthcare systems.
2. Implement best practice into the health service across the UK
   All maternity hospitals should implement the Baby Friendly Initiative, developed by UNICEF to ensure that babies get off to the right start with breastfeeding as soon as they are born.
3. Improve training for health professionals
   Sadly, those who are meant support mothers to breastfeed – midwives, health visitors, GPs – often lack the expertise they need. In many parts of the country, qualified breastfeeding support is hard to access and there is an over-reliance on volunteers.
4. Work with employers to create a supportive environment for breastfeeding mothers
   While other European countries require employers to provide breastfeeding breaks for mothers, there is no such protection in the UK.
5. Develop policy and practice to support breastfeeding in public places
   While it is illegal to discriminate against mothers breastfeeding in public in the UK, only the Scottish government has made it an actual criminal offence.
6. Include breastfeeding education in the curriculum
   To begin to counter the bottle-feeding culture in this country, children need to be taught from a young age that breastfeeding is normal, as well as about the importance of breastfeeding for health.
7. Adopt the World Health Organization International Code of Marketing of Breast Milk Substitutes and subsequent relevant Resolutions
   Despite the fact that it is well known that formula marketing undermines breastfeeding, several attempts to fully implement the WHO code have failed in parliament. Formula manufacturers know that their slick television commercials for “follow-on milk” (intended for babies over the age of six months) also hook in mothers of much younger babies.

Instead of putting this issue at the forefront of policymaking, the government decided to cancel the 2015 Infant Feeding Survey, which collects data on how many babies across the country are breastfed and for how long.

So what are the political parties promising at this election when it comes to improving breastfeeding rates in the UK?

Conservatives – They don’t specifically mention breastfeeding in their manifesto, but they say: “Building on our success in training thousands of nurses and midwives to become health visitors, we will ensure that women have access to mental health support during and after pregnancy, while strengthening the health visiting programme for new mothers.”

Labour – In their main manifesto they say they will recruit 3,000 more midwives. Their maternity policy states that this will “allow us to guarantee all women one-to-one care from a midwife during labour”, adding that “benefits of one-to-one may care include increased take-up of breastfeeding”.

Liberal Democrats – They are the only party to specifically refer to breastfeeding in their main manifesto, stating that they will “review the support and advice available for parents on early child nutrition and breastfeeding”.

Green Party – although the party has a very detailed breastfeeding policy, which largely mirrors the commitments in the Breastfeeding Manifesto, in their 2015 manifesto they simply state that they would “give special attention to the well-being of children from conception to 2 years old – the first 1001 days”.

You can read more about the parties plans in relation to breastfeeding here.

*How did I arrive at this figure? The article published in Pediatrics in 2010 "The Burden of Suboptimal Breastfeeding in the United States: A Pediatric Cost Analysis" states that “if 90% of US families could comply with medical recommendations to breastfeed exclusively for 6 months, the United States would save $13 billion per year and prevent an excess 911 deaths". The UK population is 64 million and the US population is 319 million – one fifth. Extrapolating to the UK we would get around 200 excess deaths and $2.7 billion (£1.8 billion). However, the study only looked at 10 childhood diseases (breastfeeding prevents many more than this) and it completely excluded the diseases that breastfeeding helps to prevent in mothers - like breast cancer, diabetes, heart disease and osteoporosis - so I rounded up to £2 billion. This is a very conservative estimate because those diseases cost the economy much more than £200 million.

Ayala Ochert is a freelance science journalist and a breastfeeding support volunteer.