While breastfeeding has increased, this is attributed to outside cultural influences, writes DR MUIRIS HOUSTON
WE MAY have got used to being among the poor relations of Europe when it comes to banking, but we have been the dunces of the Continent for breastfeeding since well before the financial crisis erupted.
Just over half of mothers currently initiate breastfeeding in Ireland compared with 81 per cent in the UK and in the region of 98 per cent in Nordic states such as Sweden, Norway and Denmark.
It seems that when you lose the culture of breastfeeding as a nation it’s hard to reverse the trend. The fall-off in breastfeeding of the 1950s and 1960s was sharper here than among other European states. And while there has been a rise of 7 per cent in the number of mothers breastfeeding in the Republic between 2005 and 2010, research presented yesterday at the Economic and Social Research Institute (ESRI) conference in Dublin suggests a significant part of the trend is down to the influence of mothers who are not born here.
According to Prof Richard Layte, women resident for less than five years here are 10 times more likely to breastfeed than Irish women but this falls to six times more likely after six to 10 years and 2.4 times more likely after 11 or more years. His analysis of data from the Growing Up in Ireland study also shows non-Irish male partners increase the chance that Irish women will breastfeed. Women with a non-Irish partner are 1.4 times more likely to breastfeed than women with an Irish partner.
Women born in eastern European states and parts of Africa are bringing their cultural norms with them when they settle in Ireland. The ESRI’s Aoife Brick and Anna Nolan told the conference about 60 per cent of the increase in breastfeeding from 2004 to 2010 can be explained by the changing characteristics of mothers over this period.
The most important factors are increasing maternal age (which accounted for 13.8 per cent of the increase over time), and the increasing share of mothers from eastern Europe (which accounted for 38.8 per cent).
What does this say about our national policy on breastfeeding? Since 1994 two government policy documents have been published which have set breastfeeding targets. The first of these published in 1994 had a target of reaching 50 per cent initiation by 2000 – this level was not reached until 2007.
The latest of these was published in 2005 and had the goal of achieving a sustained increase in the national breastfeeding initiation rate of at least 2 per cent per year (4 per cent for lower socioeconomic groups). It managed a 7 per cent rise in five years, most of which can be explained by cultural factors. All of which suggests the initiatives underlying both policy documents have largely failed.
The finding that after just one month, women who gave birth in hospitals where there is a particular breastfeeding culture are no more likely to breastfeed than other women, may be a sign that putting more resources into the community may be the way to go.
Another key point to emerge from yesterday’s conference is that one of the most important determinants of how long a woman will breastfeed is the length of maternity leave. Returning to work part-time increases the risk of stopping breastfeeding by 150 per cent; returning full-time increases the risk by 230 per cent. Again, targeted support around a woman’s return to work may help increase the number of women who breastfeed for longer.
The benefits of breastfeeding are well documented (see panel) which is why the World Health Organisation, the Department of Health and the HSE recommend that children are exclusively breastfed for six months. Thereafter they should continue to be breastfed in combination with appropriate complementary foods until they are at least two years of age.
Maybe it’s time we learnt from our recent immigrants. Has anyone asked mothers from other cultures what is it that makes breastfeeding their babies something they prioritise? And why is it that older mothers, no matter where they were born, breastfeed more? A research focus on both of these groups is likely to provide some valuable points with which to target a more general public health campaign on breastfeeding.
As is the case with many preventive medicine initiatives, breastfeeding among lower socioeconomic groups is especially low. This is the reason for the higher target set in the last policy document for this group of mothers; specific programmes targeted at working class women must continue to be resourced. We can undoubtedly do better as a breastfeeding nation.
BREASTFEEDING EVENTS
National Breastfeeding Week, which began yesterday, runs until Sunday. The theme this year is “Good Health begins with Breastfeeding”.
Breastfeeding information from the Health Service Executive is available at breastfeeding.ieand tel: 1850-24 1850.
La Leche League, Tivoli Estate, Lovers Walk, Cork. Tel: 021-4552357.
Cuidiú, Carmichael House, North Brunswick Street, Dublin. Tel: 01-8724501.
BREASTFEEDING: THE BENEFITS
During the first year of life, breastfed infants have lower rates of otitis media (ear infection), pneumonia, meningitis and diarrhoea.
Antibodies present in breast milk provide a natural immunity against infection.
Breast milk contains all the necessary nutrients for a baby. Breastfed infants over six months require additional dietary iron.
Breastfeeding is associated with a lower incidence of asthma, eczema, high cholesterol and high blood pressure in later life. The incidence of obesity and insulin-dependent diabetes is also reduced.
Breastfeeding also has health benefits for the mother; it reduces the risk of breast and ovarian cancer later in life. The risks of osteoporosis and arthritis are also lessened and a mother who breastfeeds has less chance of a haemorrhage after birth.
There are psychological benefits for both mother and child.
