PRESENT: Jenny Rathbone MS (Chair); Julie Morgan MS; Lee Gonzalez – Senedd; Rachel Evans – PHW; Sharon Breward – NHS Wales; Prof Amy Brown – Swansea University; Clare Murphy – Feed UK; Lara Stevens – FTWW; Bronni Preston-Williams – FTWW; Eliza Wide – FTWW; Rhiannon Carmichael – MoMa Breastfeeding; Emma Thomas – Breastfeeding Network; Isabel Linton – FTWW; Debbie Shaffer – FTWW; Ruth Lewis – MoMa Breastfeeding; Ali Morris – Merched Cymru; Cathy Larkman – WRN Wales; Viv Rose – BPAS; Diana Dobrzynska – BPAS; Lucy Ward – BPAS
APOLOGIES: Sioned Williams MS; Julie Richards – RCM; Heatherjane Dangerfield – Endometriosis UK; Andrew McMullan - BPAS
1. Welcome, minutes, and MATTERS ARISING
Minutes: Minutes not accepted as no one from previous meeting was present in the call.
2. BREASTFEEDING – WHY A NATIONAL APPROACH IS NEEDED
Presentation by Rachel Evans, Public Health Wales
· Breastfeeding, and the importance for the health and development of infants and their mothers, was mentioned in the Welsh Government’s Child Poverty Strategy in 2024
· Breastfeeding is a key focus of Public Health Wales as a way to prevent major health inequalities and reduce the worst effects of poverty
· New figures show that at 6 months old, babies worldwide are exclusively breastfed at a rate of 48% compared to 21% in Wales. In regards to any breastfeeding, the rate in Norway is 78% but in Wales is only 29%
3. Female lactation – ‘orphan’ status in health systems
Presentation by Sharon Breward, Chair of The Welsh Infant Feeding Network
· The presentation started with the history of lactation, and highlights ‘institutionalised blindness’ to lactation physiology and care needs in the structures of health care
· There have been multiple reports of lactating women suffering significant harm (including post-partum haemorrhage, mastitis, breast abscess, and sepsis) due to healthcare practitioner ignorance of lactation physiology and care needs which is why there needs to be a renewed focus on improving standards of care
· Calls to ensure that lactation care is included in all clinical networks and guideline groups and workstreams. The Welsh Government should invest in equitable, operationally effective infant feeding/lactation specialist-led care teams as a priority, and there needs to be a full implementation of the government’s own Breastfeeding-Infant Feeding Action Plan
4. why the uk remains such a hostile environment for breastfeeding
Presentation by Prof Amy Brown, Programme Director for Child Public Health at Swansea University
· Professor Brown underpinned her presentation with the premise that women and families need to be respected, valued, and supported in caring for their babies and one major factor of this is breastfeeding
· Research has found that the UK has some of the lowest breastfeeding rates in the world and that there needs to be a cultural change in public, and institutional, attitudes towards breastfeeding
· Professor Brown’s research has indicated that the NHS could save £40 million per year if breastfeeding rates were increased and would have numerous other benefits for the health of both mothers and their babies
5. Open DISCUSSION
A question was asked about if there was any Welsh Government app-based support for new mothers that they can access to help overcome feelings of isolation or lack of support.
· There is no app-based support available, but there is the National Breastfeeding Helpline which is available to women in Wales 24/7 365 days per year both over the phone and on social media
· There should also be three support sessions a week in health board areas to encourage women to breastfeed together
Someone asked about the impact of domestic violence and trauma on a woman’s ability to breastfeed. They also raised this issue around the ‘sexualisation’ of women with regards to breastfeeding and how that could be overcome.
· Some lactation specialists in the NHS are trauma-informed and can support women who face a wide range of barriers to breastfeeding
· Cultural impacts are also needed to be looked at, as well as the role of misogyny within society as a way to overcome the inherent sexualisation of women’s bodies
Partners are an important influence in how women choose to food their baby, but it is really important to consider language as the phrase ‘breastfeeding families’ gives credence to the idea that it is the choice of men too.
· This was acknowledged by the panel and they know that partners have a massive influence on the decision. However, the impact of partners is bigger than individual health services and this is another example of how we need to work to change cultural norms
There was a question about the impact of birth trauma on breastfeeding rates. One of the clinicians on the call stated that may of the women that they see with breastfeeding-related concerns have had a traumatic birth which was resulting in poor mental health amongst mothers
· There was recognition of the impact of birth trauma and how mindful HCPs need to be when speaking with new mothers about their experience and how it relates to breastfeeding
The CEO of Feed UK was at the meeting and encouraged everyone to read their new report ‘Set Up To Fail’, which reflects women’s lived experience of the current breastfeeding policy in Wales. The report highlights that more funding is needed to provide the support and evidence that women need to fulfil their infant feeding goals.
· A number of participants resonated with the report by Feed UK, with one noting that the messaging around breastfeeding being the biological norm is hugely offensive and stigmatising and that because they had issues breastfeeding, they were made to feel inferior and ashamed which resulted in postnatal depression.
· Some participants, and members of the panel, did not agree with the premise of the report saying that it undermined all breastfeeding policy. They acknowledged that whilst some women have difficulties, they don’t speak for all women and the report sounded like a publicity drive from the formula industry.
· Public Health Wales have produced comms on key messages around formula feeding, and that safe and responsive bottle feeding is a key part of the Baby Friendly Initiative
Participants spoke about the ‘postcode lottery’ of breastfeeding support, an example of this being the outcomes of areas that have Flying Start and those that do not.
· Significant work is being undertaken to make sure that there are specialist teams in all health board areas
6. AOB
Next meeting: TBC