Benefits of Breastfeeding for Mother and Newborn
Discuss about the Perceptions and Experiences of Breastfeeding.
Breastfeeding is an unequalled nutrition a mother provides for her baby which contains the baby with the needed nourishment it needs for growth (WHO, 2018). It also enables both mother and baby to have an emotional and physical attachment. A person’s breastmilk cannot be exchanged for an animal’s milk, and it is irreplaceable. Breast milk contains colostrum which the breasts produce after childbirth. Colostrum is also known as the first immunization for the baby which transfers minerals and vitamins, antibodies and growth factors to the babies which helps to guard it against some childhood illnesses such as diarrhea, rashes, asthma, skin infections, respiratory diseases among others. It also enhances intellectual development of the baby Breastfeeding and is profitable to the mothers by supporting quick recovery from childbirth, minimizing the possibility of breast and ovarian cancers in future, and lower the risk of maternal depression (Department of health, 2017). The promotion of breastfeeding is an international public health priority and the recommendation to exclusively breastfeed until around six months of age has been adopted by many countries around the world including Australia (Daly, Pollard, Phillips, & Binns, 2014). The government of Australia and some private healthcare sectors are responsible for the formulation and implementation of public health policies. Healthcare policies are a set of decisions, plans and actions taken to arrive at healthcare goals within a society (“WHO | Health policy,” 2018). Such programs can be viewed as deliberations of the government’s intent outlining the vision, priorities and their establishment (Althaus, Bridgeman & Davis, 2013). The success of a government in providing excellent healthcare services to its population depends on the kind of the healthcare policy and its implementation. A useful plan factors in social, political, economic and environmental factors. Australia is a country that posts an advanced healthcare system and so is its maternity services. Among the public health policies that have received much attention both nationally and internationally is the maternity services in the form of the exclusive breastfeeding (EBF) plan. EBF is a widely accepted component of public health as the best option for infant feeding (Eidelman et al., 2012). The World Health Organization (WHO) recommends six-month continuous breastfeeding of newborns followed by a gradual introduction of complementary food as breastfeeding continues up to two years or beyond (World Health Organization & UNICEF, 2003). Many countries including Australia have incorporated the EBF into their health policies (Binns, Lee, & Low, 2016). This paper will analyses the critical points for the implementation process of the national breastfeeding policy in Australia and evaluate its achievements and failures thus far.
In 2001 the WHO provided guidelines for comprehensive breastfeeding as well as its benefits (World Health Organization & UNICEF, 2003). For example, EBF is both a long-term and short-term beneficial factor to a good relationship between the mother and the infant (Victoria et al., 2016). Also, breast milk is crucial to the initial activation of immunological and epigenetic roles in the infant as well as controlling microbial changes of the gut (Fujita, Lo & Brindle, 2017). Furthermore, well-breastfed children are less likely to have diarrhea (Ogbo et al., 2016), obesity, otitis media and reduced chances of mortality (Lamberti et al., 2011). Breastfeeding mothers lower their chances of developing breast and ovarian cancer as well as type II diabetes when they breastfeed their infants to the recommendation duration (Victoria et al., 2016). An adequately breastfed child has a higher likelihood of developing a better intellectual functioning (Horta, Loret de Mola & Victoria, 2015). The benefits mentioned above and other documented benefits of breastfeeding compelled the WHO member states in 2002 to adopt a global strategy for infant and young child feeding. The comprehensive approach enhances the implementation of national policies aimed at promoting, protecting and supporting appropriate infant and young children feeding practices. The intention of the global strategy advocated for infant breastfeeding from birth through four to six months which extends to two years with appropriate weaning foods at six months. A Baby Friendly Hospital Initiative (BFHI) campaign was launched to support the goal. The BFHI offered guidelines and recommendation to foster maternity services that encouraged and incorporated breastfeeding support systems. Many hospitals advanced their maternity services to acquire a BHI accreditation as the strategy expanded to other healthcare providing facilities as well as into the community (Cai, Wardlaw & Brown, 2012; Daly et al., 2014).
Global Strategy for Infant and Young Child Feeding
Furthermore, besides the benefits of breastfeeding and it is being accepted as the ideal way to feed babies, there have been some barriers which deter women from practicing breastfeeding. Among these are inadequate family support, inadequate knowledge of the importance of breastfeeding, short paid maternal leave, insufficient breastmilk, the age of the mother, maternal beliefs and perceptions (Ogbuanu, Glover, Probst, Liu, & Hussey, 2011). Evidence shows that commencing and sustaining EBF among postpartum women through education and support, will have an enormous impact in tackling some of the barriers to EBF (Bevan & Brown, 2014). In Australia by 2006, there were still few facilities (19%) that were Baby-Friendly Hospital Accredited (BFHA) (Bartington, Griffiths, Tate & Dezateux, 2006). The government then initiated breastfeeding research to facilitate implementation of the plan. The study came up with recommendations of mandating the federal department of Health and Aging to provide finances for the Australian College of Midwives to control BFHI efforts and be responsible for accrediting maternity facilities (Lum, Todd & Porter, 2016). Later, a strategy requiring every state and Territory governments to adhere to the policy was launched after the Australian Health Ministers endorsed the “Breastfeeding strategy 2010-2015”.
The goals of the system are; to create awareness for breastfeeding as a natural and socially ethical act for the infant feeding, to fully inform those involved in raising children of breastfeeding value and increase the number of babies that undergo complete breastfeeding. Another aim of breastfeeding according to the Australian Health Ministers conference (2015) is to enhance the wellbeing, nourishment and welfare of babies and young children and the health as well as the well-being of the mothers by promoting and overseeing breastfeeding. The objective of breastfeeding is to raise the ratio of infants who are breastfed from birth to six months of age, with continued breastfeeding and complementary foods to twelve months and beyond (Australian Health Ministers conference, 2015).
Some strategies to achieve the aims and objectives of breastfeeding is to advocate for breastfeeding friendly organizations and environments, provide relevant and sufficient information to mothers and carers of babies regarding breastfeeding. Further promote paid parental leave, education to raise community acceptance of breastfeeding as a public norm and practice (Australian Health Ministers conference, 2015).
In 2001, an organization of 1,100 women was formed comprising of volunteers in counselling and educating other women about benefits of breastfeeding. The organization was called Australian Breastfeeding Association (ABA), and it instructed the community on the importance of full breastfeeding practices to both the mother and the infant.
The implementation of the breastfeeding policy in New South Wales (NSW) commenced in 2002 due to an NSW Childhood Obesity Summit that recognized breastfeeding as a remedy for the obesity pandemic. Due to the policy, many midwives and Nurses undertook training which supported breastfeeding women and its practices. Further, the plan saw the establishment of BFHI in many health facilities due to public health funding for the maternity facilities (Sheehan & Schmied, 2011). Another version of the NSW Breastfeeding policy was in 2011 by the Department of Health which outlined the integral part the midwives, children and family health practitioners could play to meeting the policy’s objectives (wales, 2006). In the NSW state, the plan has been propagated by the Breastfeeding Working Group as well as the BFHI NSW committee. One of the challenges to the success of the policy is limited funding to the policy’s initiatives since there are still very few, about eight, hospitals that have BFHI accreditation in NSW. Also, the NSW Aboriginal Maternal and Infant Health Strategy (AMIHS) is another initiative aimed at advancing the health of the Australian indigenous mothers during pregnancy to reduce perinatal mortality and morbidity (Murphy & Best, 2012). Moreover, the implementation of strategies that enhance policies depends on financial empowerment as well as other factors, such as, social, environmental and political factors for the breastfeeding system.
Barriers to Breastfeeding
Breastfeeding has cost benefits to the individual, community and nation at large. Breastfeeding exclusively for six months and above goes a long way to provide immunologic protection against different types of childhood illnesses. This decreases hospitalization rate for both mothers and babies. Mothers have good mental health from breastfeeding. Also, there will be reduced or no cost of buying formula for the first six to twelve months of the infant’s life. Indirect cost such as wage and time spent looking after the baby while sick with diarrhea, respiratory illness, gastrointestinal disorders etc. could be saved by actively breastfeeding (Breastfeeding Coalition Tasmania’, 2015). The government has utilized the training of midwives as a way of reaching to the aboriginal mothers who have a less tendency of seeking professional maternal services due to low socio-economic status (Lording, 2009). Research has shown that the number of indigenous infants that are exclusively breastfed after leaving the hospital is small as compared to non-indigenous (Australian Institute of Health, & Welfare, 2012). When about 90% of mothers are encouraged to breastfeed exclusively, 13 billion health care dollars would be saved (Bartick & Reinhold, 2010).
Breastfeeding is also beneficial to the environment in a way that it is a sustainable essential resource that is the most environmental-friendly sources of food. Breastmilk does not cause pollution in its preparation, storage, shipping or refrigeration; it generates no waste and is a renewable resource (Save the Children, 2012). Women who breastfeed exclusively have high tendency to experience natural contraception associated with lactation, and this helps to control unplanned pregnancies that will pose stress on the family, environment and nation at large (Brown & Sear, 2017). According to the United States Breastfeeding Committee (USBC), 2013, employers who support breastfeeding are likely to reduce absenteeism by mothers calling in sick to look after their babies. Bosses are at a higher risk to lose money due to training new staffs to take over maternity leave positions.
The social environment for breastfeeding mothers such as her partner, family, and allies play a role in forming a positive attitude towards initiating and sustaining the policy (York & Hoban, 2013). The experiences other women relatives have undergone through while breastfeeding their infants are significant in influencing breastfeeding behaviors of other mothers especially the new mothers (Rollins et al., 2016). Grandmothers in specific have been found to be vital in shaping young mothers to perform exclusive breastfeeding (Negin, Coffman, Vizintin & Raynes-Greenow, 2016). The social network is essential to the breastfeeding mothers as it means availing oneself to a reality that transforms biological aspects associated in the breastfeeding process, which is not narrowed to the regular counselling about the convenience of breastfeeding, but that is infused by essence and intentions (Souza et al., 2016). Indigenous people benefit more from social support due to their lower socioeconomic status. About Seventy per cent of Indigenous children from age 0- 3 years residing in homes with lower socioeconomic ratio were breastfed 90% more than those in a higher socioeconomic proportion (Australian Health Ministers conference, 2015).
Implementing the National Breastfeeding Policy
According to the Australian Health Ministers conference, (2015), the objectives and goals of breastfeeding are to increase the breastfeeding rate of infants from birth to six months of age, while gradually introducing supplementary foods up to twelve months and beyond. Also, develop universal acceptability and advocacy of breastfeeding. According to the NSW Breastfeeding policy, the objectives are to maintain the current percentage of infants who are ever breastfed, to raise the rate of babies exclusively breastfed to six months and lastly to increase the period of breastfeeding.
Furthermore, the goal is to give pertinent information and training of staffs to enable them to promote, protect and reinforce breastfeeding. According to the Australian National Breastfeeding Strategy (2015), the goals identified were to raise the community compliance of breastfeeding as a cultural rule. Also, to encourage policymakers in the community to see the relevance in breastfeeding and to serve as mentors to motivate mothers and families and to empower breastfeeding mothers to make use of reserved public places, to enable them to continue with their breastfeeding when out and about. What needs to be achieved is that according to the international code of marketing of Breastmilk substitutes, it recommended that Breastfeeding must be severely guarded and advocated in all countries and the government taking measures to ensure that everyone has information on the merits of breastfeeding and is supported in the use of this information. This can be achieved by law enforcement, training and education of mothers, nurses etc., advocacy and appropriate support to those involved.
The priority group noticed for the breastfeeding policy is the indigenous women and babies between six months to one year and beyond. Right from the initial stages of pregnancy, the women qualify as a priority to this policy. Prior information about the infant breastfeeding will enhance the successful implementation of the system for the benefits associated with the adoption of the plan will persuade the women into adhering to it.
The source of funding the implementation of the policy is the national government through public funding by allocating some budget to the department of health. Besides the finances, the other resources will be the midwives, children and family healthcare practitioners who will disseminate the policy informant as well as facilitate its implementation. Creating awareness among the Australian women and funding activities that promote the policy should utilise these funds. Also, in the maternity facilities, the programs that enhance the implementation of the procedure such as BFHI is to be supported by the government as well.
The women and children that enroll in the program require a minimum of two years to enhance the comprehensiveness for infant breastfeeding as the policy postulates. The maternity services are to incorporate the breastfeeding strategies to ensure that the mother and the infant experience many steps during their stay in the hospital to enhance exclusive breastfeeding.
There is numerous evidence-based practice that amplifies the benefits of the breastfeeding policy. The policy initiates a quality life for the infants and benefits the mother, family and the society. Quality hospital maternity has been found to be critical in the successful implementation of the breastfeeding policy (Wen et al., 2009). The information and services provided at the initial stages of the postpartum period have a positive impact on breastfeeding in the long term. Also, the WHO and UNICEF have devised ten guidelines for successful feeding based on best evidence-based hospital practices which have been adopted by most maternity facilities. Research has shown that the more the steps the mother is taken through, the higher the possibility of leaving the facility after having exclusively breastfed. Furthermore, the experience increases the duration and intensity of breastfeeding after discharge (DiGirolamo, Grummer-Strawn & Fein, 2008).
Goals of the National Breastfeeding Policy
However, the success of this policy in the contemporary world depends on the quality of information available on the internet. A professor of Pediatrics at the University of Colorado, Maya Bunik, reiterates that many women that especially the new parents that go online to sources for information are often misled. The misinformation affects the initiation and successful continuation of breastfeeding (Bunik, 2017). Further, Bunik noted that there are 20.7 million articles on breastfeeding whereby about 50% discredit the importance of the policy. She highlighted the ten step private maternity practice as an evidence-based practice that should extensively make available on this platform. Therefore, the internet is an excellent platform to enhance the implementation of the policy only if agencies and organizations overseeing the strategy regulate the information available.
Conclusion
The benefits of the breastfeeding policy cannot be overestimated. As highlighted above its economic, social and environmental importance are tremendous. Channeling more efforts by increasing resources and advancing the implementation frameworks will be pivotal to the success of this policy. More importantly exclusive breastfeeding that is endorsed and propagated by the NSW breastfeeding policy. The plan requires the participation of all the stakeholders since it is for the overall well-being of the society. The BFHI enhances the implementation of this policy through the maternity services offered in the healthcare facilities. Furthermore, the ten steps formulated by the WHO and the UNICEF have proved to be one of the best evidence-based practices that increase changes of exclusive feeding among women. Among the challenges faced in the establishment of the policy are the inadequacy of quality information and its effective dissemination. In this technologically advanced world where information is easy to access, the type of information obtained is crucial in determining the steps the mother is to take regarding this policy. More research on the benefits of breastfeeding will be appropriate to complement the already available benefits. Also, this information should be used to create awareness among the public and not only the women. More groups in the society should be educated about the policy to increase chances of the correct information being accessed. To speed the implementation of the procedure the informal sector and their contributions should be acknowledged. For this reason, their efforts can be complimented and be viewed as one of the critical agencies of the policy. The breastfeeding system in the NSW has achieved great success so far through incorporating various agents in both the informal and formal sector. However, there is still more to be executed.
References
Althaus, C., Bridgman, P., & Davis, G. (2013). The Australian policy handbook. Allen & Unwin.
Australian Institute of Health, & Welfare. (2012). Australia’s Health 2012: In Brief. AIHW.
Bandura, A. (2006). Guide for constructing self-efficacy scales. Self-efficacy beliefs of adolescents, 5(1), 307-337.
Barclay, L., Longman, J., Schmied, V., Sheehan, A., Rolfe, M., Burns, E., & Fenwick, J. (2013). The professionalising of breast feeding—Where are we a decade on?. Midwifery, 29(5), e32-e33.
Binns, C., Lee, M., & Low, W. Y. (2016). The long-term public health benefits of breastfeeding. Asia Pacific Journal of Public Health, 28(1), 7-14.
Evaluation of the Achievements and Failures of the National Breastfeeding Policy
Brodribb, W., Kruske, S., & Miller, Y. D. (2013). Baby-friendly hospital accreditation, in-hospital care practices, and breastfeeding. Pediatrics, peds-2012.
Brown, A., Raynor, P., & Lee, M. (2011). Healthcare professionals’ and mothers’ perceptions of factors that influence decisions to breastfeed or formula feed infants: a comparative study. Journal of advanced nursing, 67(9), 1993-2003.
Bunik, M. (2017). Debunking Breastfeeding Myths for New Mothers. Retrieved May 29, 2018, from https://www.aap.org/en-us/aap-voices/Pages/Debunking-Breastfeeding-Myths-for-New-Mothers.aspx
Cai, X., Wardlaw, T., & Brown, D. W. (2012). Global trends in exclusive breastfeeding. International breastfeeding journal, 7(1), 12.
DiGirolamo, A. M., Grummer-Strawn, L. M., & Fein, S. B. (2008). Effect of maternity-care practices on breastfeeding. Paediatrics, 122(Supplement 2), S43-S49.
Eidelman, A. I., Schanler, R. J., Johnston, M., Landers, S., Noble, L., Szucs, K., & Viehmann, L. (2012). Breastfeeding and the use of human milk. Pediatrics, 129(3), e827-e841.
Faircloth, C., & Hoffman, D. M. (2013). Introduction. In Parenting in Global Perspective (pp. 19-36). Routledge.
Forde, K. A., & Miller, L. J. (2010). 2006-07 north metropolitan Perth breastfeeding cohort study: how long are mothers breastfeeding?. Breastfeeding Review, 18(2), 14.
Fu, I. C. Y., Fong, D. Y. T., Heys, M., Lee, I. L. Y., Sham, A., & Tarrant, M. (2014). Professional breastfeeding support for first?time mothers: a multicentre cluster randomised controlled trial. BJOG: An International Journal of Obstetrics & Gynaecology, 121(13), 1673-1683.
Fujita, M., Lo, Y. J., & Brindle, E. (2017). Nutritional, inflammatory, and ecological correlates of maternal retinol allocation to breast milk in agro?pastoral Ariaal communities of northern Kenya. American Journal of Human Biology, 29(4).
Gallegos, D., Russell-Bennett, R., Previte, J., & Parkinson, J. (2014). Can a text message a week improve breastfeeding?. BMC pregnancy and childbirth, 14(1), 374.
Hansen, K. (2016). Breastfeeding: a smart investment in people and in economies. Lancet, 387, 416.
Lamberti, L. M., Walker, C. L. F., Noiman, A., Victora, C., & Black, R. E. (2011). Breastfeeding and the risk for diarrhea morbidity and mortality. BMC public health, 11(3), S15.
Lee, E. J. (2014). Living with risk in the age of ‘intensive motherhood: maternal Identity and infant feeding. . Health Risk and Society.
Lording, R. (2009). Socioeconomic status and rates of breastfeeding in Australia: evidence from three recent national health surveys. Breastfeeding Review, 17(1), 33-34.
Lum, M. N., Todd, A. L., & Porter, M. (2016). Breastfeeding issues-Initiating and sustaining breastfeeding: a literature summary.
Murphy, E., & Best, E. (2012). The Aboriginal Maternal and Infant Health Service: a decade of achievement in the health of women and babies in NSW. New South Wales public health bulletin, 23(4), 68-72.
Negin, J., Coffman, J., Vizintin, P., & Raynes-Greenow, C. (2016). The influence of grandmothers on breastfeeding rates: a systematic review. BMC pregnancy and childbirth, 16(1), 91.
Ogbo, F. A., Page, A., Idoko, J., Claudio, F., & Agho, K. E. (2016). Diarrhoea and suboptimal feeding practices in Nigeria: evidence from the national household surveys. Paediatric and perinatal epidemiology, 30(4), 346-355.
Schmied, V., & Lupton, D. (2001). Blurring the boundaries: breastfeeding and maternal subjectivity. Sociology of health & illness, 23(2), 234-250.
Schmied, V., Beake, S., Sheehan, A., McCourt, C., & Dykes, F. (2011). Women’s perceptions and experiences of breastfeeding support: a metasynthesis. Birth, 38(1), 49-60.
Sheehan, A., & Schmied, V. (2011). The imperative to breastfeed: an Australian perspective. In Infant Feeding Practices (pp. 55-76). Springer, New York, NY.
Victora, C. G., Bahl, R., Barros, A. J., França, G. V., Horton, S., Krasevec, J., … & Rollins, N. C. (2016). Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), 475-490.
Wales, N. S. (2006). Breastfeeding in NSW: Promotion, Protection and Support. Sydney: NSW Department of Health.
Wen, L. M., Baur, L. A., Rissel, C., Alperstein, G., & Simpson, J. M. (2009). Intention to breastfeed and awareness of health recommendations: findings from first-time mothers in southwest Sydney, Australia. International Breastfeeding Journal, 4(1), 9.
WHO | Health policy. (2018). Retrieved May 29, 2018 from https://www.who.int/topics/health_policy/en/
World Health Organization, & UNICEF. (2003). Global strategy for infant and young child feeding. World Health Organization.