The UK has a breastfeeding rate at 12 months of 0.5% apparently - worst in the world.

[minifingerz]

Whereas 99.4% of women in Senegal, where there is widespread poverty, double the UK average family size, no maternity leave and minimal medical or midwifery support for postnatal mothers, are still going.

Those statistics are mind-boggling, given that most of the 82% of women who start off breastfeeding in the UK state medical reasons for not being able to continue breastfeeding.

Does beg the question - how is this possible?

here

Thank you for the link.

It talks about the widely accepted benefits of breastfeeding to four months.

Please can you let me know if there is similar information on breastfeeding beyond 12 months in a western culture.

Also do you have any links giving information on rates of breastfeeding and pnd?

"Which may explain why I had zero postnatal ward support at 19"

I think health professionals do make assumptions about young mothers, and they shouldn't. I can understand it though if you've cared for hundreds of teenagers of whom the vast majority don't want to breastfeed, and who don't want to be encouraged to try, you get a bit complacent about it and stop treating people as individuals. Not saying that's right, just saying I can see how it happens!

Isnt it quite obvious that in a developed country, women have more choice?

Isn't a lot of it about cultural norms? If pretty much everyone in Senegal is breastfeeding then every mother would be surrounded by peer support to get breastfeeding established and there would be no snide comments or assumptions about "when you are going to give up" When the vast majority formula feed the peer support is pretty lacking unless you are motivated enough to go seek it out and formula is the first option as soon as there's a problem.
Within my NCT group of 7 (small sample, and from the hippy yoghurt knitter breastfeeding end of the spectrum of mothers) everyone BF to 6 months, then 4 of 7 gave up. It seemed that they'd taken in the message "it's important to BF for 6 months" and assumed there was no benefit beyond that. The WHO statement about BF exclusively for 6 months and alongside other foods for 2 years or beyond is so removed from the UK cultural norms as to seem faintly ridiculous.

I think the uk cultural norm for bf is that you don't have to bother

"Please can you let me know if there is similar information on breastfeeding beyond 12 months in a western culture."

My understanding is that there's a dearth of research into the impact of prolonged breastfeeding in Western culture - basically because breastfeeding beyond a year is so rare, particularly breastfeeding where the baby is getting nothing but breastmilk as a drink in addition to solids, that it's impossible to construct studies with large enough groups of participants to get valid findings.

The recent Chinese study of reduction in breast cancer risk among breastfeeding mothers flagged this up. It found a much higher protective benefit from prolonged breastfeeding (50%) than other studies have done in the West. This was because the protective effect of breastfeeding is 'dose dependent' - ie it's not just about how long you breastfeed, but how much. Even mothers in the UK who continue to breastfeed beyond 6 months are mostly also using formula, and so few continue beyond the end of the first year. Vanishingly few beyond 2. Not so in China (although the formula companies are now making massive inroads in that market so that will change in the forthcoming years)

here

for mini for hosting an interesting debate about breastfeeding and managing to keep buns from flying freely! It's good to see everyone discussing these issues with a level of objectivity.

I tend to agree that it's a cultural view that limits feeding beyond a certain age in this country. It is frowned upon by some in the older generation (think MIL/FIL sitting with puckered expressions and curt "suggestions" about the baby needing "proper" milk now as breast milk won't be satisfying anymore ), other mums at toddler groups, society as a whole doesn't look favourably on it.

Hypothetically - I'd happily sit in a cafe breastfeeding a baby of 2, 4, 6 months old. 9 months at a push. After that I think I'd feel uncomfortable. Why? I don't honestly know, I think I'd be judged. (That leaves whether I'd be able to or want to out of the equation completely)

mini I had pain despite being told my latch was fine. It wasn't, my baby was pulling off screaming and fussing and couldn't get a good chunk of the breast. But I also had pain expressing, as well as feeling sick, so I think it might just be me.

I wasn't particularly attached to either feeding method, I could see advantaged for both but I did want to try bf and continue for 3 months. I switched though because to me it was such a hassle and after a difficult birth I didn't want more stress.

I agree about young mothers. I was young and single and when I asked for support they just shoved my boob in his mouth and walked off, when more time was spent with more "typical" breast feeders.

My point is that I think the lack of support in hospitals contributes

DS1 was toe curlingly painful to feed and took ages. Latch etc were fine, but he has coordination issues, now, which I suspect aren't unrelated. (Could have done with a laceration consultant, in hindsight. Holy mincemeat nipples!)

DS2 was lovely to feed, despite having a small tongue tie.

I knew no one in real life who was breastfeeding when the boys were babies. HV said she only knew of a handful of us in her area. over the years, I've met a few local mums who have all breastfed, but all have stopped when they've gone back to work.

I've not read the article mentioned, but I remember seeing one that gave rates at 6 weeks and 6 months, as well as a year. I expect that would be a lot more informative. I know when the boys were babies, it was the case that plenty of mums would start feeding at birth, but would then be convinced that their milk wasn't enough when they hit a difficult patch like an early growth spurt. Just look at how many mums we get on here absolutely panicked when their 3 week old wants to nurse constantly and so many of them aren't helped by their mothers or friends who aren't culturally used to breastfeeding as the norm who try to convince them that they need to give something else - and thus starts the slow decline. It's just counter-intuitive to an inexperienced breastfeeding mother, to go with the flow for a day or two, then realise that baby then has a good long sleep and outgrows all their clothes, pretty much overnight.

"Isnt it quite obvious that in a developed country, women have more choice?"

Yes - but it's not the case that in all developed countries where women have choices this results in very low rates of breastfeeding, as it does in the UK.

Norweigan women also have the choice not to breastfeed, but far fewer choose to exercise it.

Why?

Lol Ouryve obviously lactation;)

Not saying that's right, just saying I can see how it happens!

No I totally agree, I can see why they'd make the assumption. I'm part of a group that does a lot of advocacy for young parents and I'm hoping that's something we can work on in the future is a double-education - making sure that young women are aware of the benefits of BF, as there is a lot of "breastmilk and formula are basically the same thing" in my age group, and making HCPs aware that young women are just as capable of wanting to breastfeed, and just as deserving of support!

I don't think we emphasise some of the practical benefits of BF enough. Of course the health benefits are proven and important - but I know that one of the biggest draws for me, as a student parent with no intention of taking a year out, was that breastmilk was free (which was why I resented paying into the pockets of the formula companies every ten days!) and any BF paraphernalia is a one-off payment.

Probably just the culture of the UK? Working rather than being at home with the baby seems more valued these days than being off work breastfeeding. I don't think expressing milk is the same. Average family of one mum and one dad can't afford for mum to be at home for months on end unless they're a very high earner.

Also the stats are likely wrong (nobody asked me) and it's probably not a choice there like it is here.

Apart from all that, I chose not to breastfeed beyond 3 weeks with both my children because I didn't enjoy it and formula is readily available and 'easier' in my mind. I'm pregnant again and can't see my breastfeeding beyond a few weeks. Personal preference no medical reason

Interesting summary of the study. Difficult to extrapolate to western cultures for lots of reasons and can see why it would be difficult to replicate in a western culture.

I appreciate your level of concern but am afraid I don't share the view that low levels of breastfeeding beyond 12 months is a public health issue in the uk. That kind of statement needs proper evidence.

I had a look on the who website which talks about ebf to 6 months and continuing some bf to 24 months. Talks about babies who might not die if this were universal. Horrendous numbers of babies. But it doesn't say why they die or why bf to 24 months can help. Is it all down to hygiene or lack of hygiene?

I agree there should be choice and an informed choice. I don't think comparing breastfeeding rates in Senegal to the UK helps with this.

Fwiw I felt no cultural pressure to stop breastfeeding any of mine. Quite the contrary. All were ebf to 6 months and completely weaned from me by 18 months. I felt cultural pressure to breastfeed, not the other way round.

What this study brings home to me is that we shouldn't accept the status quo of very low continued breastfeeding rates in the UK as being 'natural' and unremarkable.

I do feel on mumsnet that the dominant view is that it doesn't matter if most babies aren't breastfed.

I would like to see really big cultural changes: breastfeeding being covered in PSHE at school along with other aspects of reproductive education; a massive drive to publicise women's right to breastfeed in public and to properly penalise those people who attempt to interfere with this; for breastfeeding to become more visible, and for formula promotion to be severely reined in, as it is in Norway.

"My point is that I think the lack of support in hospitals contributes"

I think some health professionals actively sabotage women's attempts at breastfeeding. God knows why.

mini I agree that some people seem to make it more complicated. I think in my case I'm just crap at pregnancy and birth related stuff but more support could have helped me bf longer.

Not sure I agree bf should be in PSHE, no other form of parenting is is it?

The figure doesn't surprise me. 12 months is quite a long time to breastfeed. My DM breastfed for 9 and 7 months and I thought that was pretty good going and something to aim for... though I myself carried on well into taboo territory.

Surely it's better to encourage women to breast feed up to introducing solids in the first instance rather than scare them off by suggesting they do it for a year.

When I embarked on breastfeeding peer supporter training, I liked the fact that all the women were treated equally as suitable advocates for breastfeeding, however, long their personal experience. The only requirement was that you had breastfed at least once.

That approach... that its not the length of time, it's the fact that you had considered it as an option would be a good starting point.

I would think in Senegal, if there are so many mothers who bf until 12 months, then you think it is normal and do so. You will know how to do it, when and how to mix it with the solid foods.

When I had DS in 1991, follow on milk was a new thing, and the idea that you needed formula beyond 6 months was a new thing.

Both my parents (born just before the beginning of the second world war) were bottle fed and it seemed the norm. One GM used to tell me about the cow and gate milk, and the banana shaped bottles. I think there had been a lot of change in the milk available and equipment and sterilising, and that combined with the problems of getting extra food in war time, it was quite the thing. Also, it was probably easier to get the baby milk from the clinic than extra food for the mother on rations. People did not have lots of spare money either. DFIL, born earlier in the 1930s, on a farm, had watered down cows milk (dairy farm, of course). They were quite set in the way of feeding every 4 hours (3 hours up to 6 weeks) to make sure that their babies were being properly fed, and babies had routines so that the rest of the housework could be done.

My own mother bf (1960s and 70s), then moved onto bottles (6 weeks to 12 weeks). Some of her friends went on until the baby was weaned at about 6 months, when they could have cows milk in a cup. Bedtime bottles usually continued, but bottles were usually dispensed with by 12 months. Some hippy types fed bigger babies, and a lot of people started with bottles. My mother used to work in a childcare environment, so there were lots of posters about breast is best around there.

I fed DS until 8 months and DTDs until 10 months. There were all the problems of going out etc which I never felt comfortable about (lots in the press of people having to feed DC in toilets etc) DS fed badly after about 4months, would not have bottles, did not like solids and I was desperate for some sleep and normality. We finally got him to take some formula at 7 months in a cup. DTDs were a dream and I would have fed them longer only I was underweight by 6 months.

I found it very confusing as to what to do once they were taking solid food; books were directed at bottle feeding every 4 hours. Anything bf related was an afterthought and usually written for people who were totally demand bf, which I was not doing with twins. BLW sounds a good thing, and I would probably have given it a go if I had known about it, and the HV was not telling me I should give 12 week old 1 month prem twins babyrice. or that DS should have been on 3 meals a day at 20 weeks.

Re: public health issue, I think the difficulty comes with the fact that research into this area is so difficult, as you have acknowledged tilder We have studies showing a huge number of benefits of breastfeeding though for many the benefits don't seem to be massively pronounced. But then these are studies done in and on populations with vanishingly small numbers of babies who are exclusively breastfed for more than a few weeks, and on vanishingly few babies who experience prolonged breastfeeding. In other words - it's like a giant, poorly controlled experiment. We can't really see the full picture because we can't create studies with decent controls.

I have to say - and this is a personal stance which I appreciate many people won't share - I think that when as a society we choose to depart from the physiological and evolutionary norm in such a radical way (and the almost universal switch to feeding babies on non-human synthesised milk is the fastest and most radical change in the whole history of human nutrition) we really shouldn't adopt the 'no proof of harm is proof of no harm' stance. Not if the subject of this change is babies, who have no choice in how they're fed.

I too would like to see breastfeeding as a normal thing with proper support in place.

But I would like to see it supported by proper evidence. That acknowledges differences between cultures in terms of the benefits. That properly acknowledges the real difficulties a lot of women have with breastfeeding.

Maybe a study that genuinely looks at women who try to breastfeed but don't. Is there a physiological issue? Is it unrealistic expectations of breastfeeding? If there is a link to pnd, what is the cause of the link?

I actually agree with a lot you say minifingerz. I just think promoting breastfeeding after 6-12 months in the uk should be done to enable choice and not as a comparison to other countries. Or seen as a public health issue when the evidence does not support that.

"Not sure I agree bf should be in PSHE, no other form of parenting is is it?"

I know that culturally we like to think of it as an adult lifestyle choice, but it's actually just part of normal physiology of reproduction, which is something which is covered on the school curriculum.

TheCats we're campaigning for honesty about parenting to be taught in schools more, so I think breastfeeding should form a part of this.

I've recently signed up to volunteer with a group called Straight Talking Peer Education, which involves young parents going to schools and talking to pupils about the honest truth of being a young parent. I think the more we talk about parenting to school pupils, including breastfeeding, the more we'll see it as normal rather than something "special", and the more women who attempt breastfeeding and request support will show the NHS that their current provision isn't enough, and kickstart them into improving their support offered to new parents.

"I just think promoting breastfeeding after 6-12 months in the uk should be done to enable choice and not as a comparison to other countries. Or seen as a public health issue when the evidence does not support that"

I'm sure the promotion will always focus on the initiation and establishment of breastfeeding. Then maybe the focus should be on protecting breastfeeding by supporting women to continue by reducing the cultural pressure on women to stop.

"Maybe a study that genuinely looks at women who try to breastfeed but don't. Is there a physiological issue? Is it unrealistic expectations of breastfeeding? If there is a link to pnd, what is the cause of the link?"

Have you had a look at the Infant Feeding Survey? The last one was 2010, as the government has decided they no longer wish to support it. It used to be done every five years, and looked at infant feeding choices and what influences them: here

There's a debate going on the Good Morning Britain Facebook page at the moment and someone mentioned that they are breastfeeding their 17 month old. The immediate reply was "17?!?!". It shows the public perception of extended breastfeeding. It's really sad, and especially disheartening to see that it's coming from mums who FF.

If we want our feeding choices (whether it was a willing choice or one we were forced to make) to be respected and not criticised, the least we can do is return the favour and not judge others for breastfeeding for longer than six months.