The CPHVA perspective – May 2003

The government’s announcement that mothers should feed their babies only breast milk for the first six months - which marked the start of National Breastfeeding Awareness Week on 12 May – is obviously a matter of intense interest for our members.

Therefore, it is important for the Community Practitioners’ and Health Visitors’ Association to make clear where it stands on this most emotive of issues.

First of all, the CPHVA is pleased to note that for the first time the Department of Health is providing clarity regarding exclusive breastfeeding in the first six months.

Since the World Health Organisation resolution many professionals have been awaiting more detailed guidance on this issue to support them in practice. This week’s announcement

(12 May, 2003) will now assist them in reinforcing the message of exclusive breast feeding when supporting and advising mothers.

The success of these recommendations is reliant on many factors:

  • the overall policy supporting mothers with infants

  • professional knowledge

  • access to training and resources

  • clear health messages

  • nutritional support

  • maternity leave

  • support within the work environment.

It almost goes without saying that all these elements are inter-linked; the better they gell together, the more confident will mothers feel in adopting the ‘breast is best’ philosophy, not just intellectually, but as a daily - and beneficial - reality for their babies and themselves.

To facilitate the uptake and sustainability of these recommendations, we hope to see further legislative changes in national policy to support women who currently wish to follow this advice.

Many of you will be wondering as to why the CPHVA, your professional body, did not flag up this announcement in advance. All information was embargoed until 12 May - most government policy change is handled in this way. It is aimed at getting the maximum media impact on a certain day.

You and your colleagues must reinforce to mothers that these are recommendations. The need is to support and encourage women to achieve this, if they wish to, after weighing up all the evidence. Professionals should not be prescriptive, but informative.

This knowledge has been around for some time, but the government has been slow to make any statement about it. Just as you would not make a mother, who bottle-feeds rather than breast feeds feel inadequate, so you would not make a mother, who starts complementary feeding before six months, feel that she is failing in some fashion.

Mothers who have started complementary feeding from four months should be reassured and given up to date nutritional information. Every day that breast feeding is sustained is of benefit to both mother and baby. We know that early weaning causes health problems and that later weaning has the best nutritional health gain.

Concern has been expressed by some members that this policy change may lead to unhappy, underweight babies. And while this concern is understandable, if there is proper service provision, there should be no increase in these occurrences.

Health visitors and other professionals should monitor the healthy growth and development of all infants and children – in the same way, as you would support mothers with feeding problems.

Some mothers do not want to exclusively breast feed, or bottle feed past four months, because they find the frequency of feeding and/or pressure from society or peers unacceptable.

We are pleased that this information is being made available and we hope it will be used appropriately and sensitively in practice.

Evidence shows that some professionals do not have up to date knowledge on nutrition. We hope that work around the Healthy Start initiative will address this. The information to support this will be changed in documentation over the next few months.

I will be meeting with the Department of Health on this subject within the next month to plan how this information is best disseminated.

Lead Professional Officer, Health Visiting
40 Bermondsey Street
London SE1 3UD
Tel: 020 7939 7046
Fax: 020 7403 2976