Breastfeeding in Ireland 2012

Breastfeeding in Ireland 2012: Consequences and Policy Responses Rates of breastfeeding in Ireland are very low by international standards.

Just over half of mothers (56 per cent) currently initiate breastfeeding in Ireland compared to 81 per cent in the UK and over 90 per cent in Scandinavian states. Breastfeeding has been proven to reduce the risk of respiratory, ear and gastrointestinal infection in infants and evidence is accumulating of longer term health benefits such as a lower risk of obesity and cardiovascular disease. Conservative estimates suggest that exclusive formula feeding currently costs €12 million a year in extra health care costs for the treatment of infections in infancy alone. At this joint ESRI/HSE conference as part of National Breastfeeding week 2012 (1st to 7th October), researchers from the ESRI will present new findings on trends in breastfeeding in Ireland and the factors that explain the distribution of breastfeeding across the population. Speakers from the HSE, Department of Health and the World Health Organisation will then discuss potential policy options for raising breastfeeding rates in Ireland. The 2005 Five-Year Strategic Breastfeeding Action Plan recommended policy changes to increase rates of breastfeeding in Ireland and established a target to increase rates of breastfeeding initiation by 2 per cent per year. Since the publication of the report rates of breastfeeding at hospital discharge in Ireland have increased by nearly 7 percentage points (from 48.9 per cent in 2005 to 55.7 per cent in 2010), suggesting substantial progress. In a new study using data on a sample of mothers of singleton, healthy babies from the National Perinatal Reporting System (NPRS) from 2004 to 2010, ESRI researchers Dr Aoife Brick and Dr Anne Nolan analyse the factors driving this increase. They found that:

• The average age and social class of mothers is increasing, they have fewer children and they are more likely to be born outside the Republic of Ireland.
• All these characteristics are associated with a higher likelihood of breastfeeding.
• Analyses show that around 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).
• These results suggest a limited role for existing policy initiatives in explaining the change over the period 2004-2010.
• Much of the increase has occurred simply because the characteristics of mothers are changing in ways that made them more likely to breastfeed over time.

ESRI researcher Richard Layte presents new findings from the Growing Up in Ireland Study on the characteristics of women who breastfeed and the role of hospitals in promoting breastfeeding initiation. The analyses show that:

• Non-Irish women are much more likely to breastfeed but the longer the woman is resident in Ireland, the lower the chance she will breastfeed. Women resident for less than five years are 10 times more likely to breastfeed than Irish women but this falls to 6 times more likely after six to ten years and 2.4 times more likely after eleven or more years.
• Non-Irish male partners increase the chance that Irish women will breastfeed. Women with a non-Irish partner are 40 per cent more likely to breastfeed than women with an Irish partner.
• Older mothers are significantly more likely to breastfeed even adjusting for their education, income and other characteristics. A woman of 35 to 39 is 50 per cent more likely to breastfeed than a woman aged 25 to 29.
• A woman’s mental health is important. Women being treated for depression or anxiety are 28 per cent less likely to breastfeed adjusting for other factors.
• Hospital practices make a difference. Women who give birth in Irish hospitals which are accredited under the World Health Organisation’s ‘Baby Friendly Hospital Initiative’ (BFHI) are 11 per cent more likely to initiate breastfeeding adjusting for the woman’s characteristics.
• Unfortunately, the ‘hospital effect’ is short lived. After one month, women who gave birth in BFHI hospitals are no more likely to breastfeed than other women.
• 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.

Policy Implications

• This research suggests that extension of accreditation under the Baby Friendly Hospital Initiative to more hospitals in Ireland could significantly increase initiation (around one-third of children are born in BFHI accredited hospitals).
• The temporary effect of the BFHI suggests that women need more support, advice and encouragement once they leave hospital if breastfeeding is to be sustained. This is particularly true of younger mothers with lower levels of education.
• However, increases in both the initiation rate and average duration of breastfeeding will be dependent on changing the beliefs and attitudes towards breastfeeding of Irish women, their partners, family and friends.

The keynote speaker at the conference, Dr Adriano Cattaneo from the Institute of Child Health, Trieste, commented that: "International experience shows that the right policies and actions by government and health authorities can increase rates of breastfeeding but this requires political will and financial resources. Given the economic costs of not doing so however, this is a good investment" Minister for Children and Youth Affairs, Frances Fitzgerald TD said "'Efforts to improve Irish breastfeeding rates need to address two main issues: The need to empower and build the confidence of more Irish women in their innate ability to breastfeed their children. Of equal importance is the need to offer the right kinds of support to mothers so that they can breastfeed for as long as they wish. I would like to commend the WHO/UNICEF Baby Friendly Hospital Initiative which has made a major contribution to breastfeeding and forms an integral part of Ireland’s policies and strategies to better promote, protect and support breastfeeding"

Note to Editors: 1. Members of the media are invited to attend the half-day ESRI Conference "Breastfeeding in Ireland 2012: Consequences and Policy Responses", which will take place on Monday 1 October at the ESRI, Whitaker Square, Sir John Rogerson's Quay, Dublin 2, from 8.30am - 1pm. 5 papers will be presented. Visit our website for details and programme. 2. The Conference will be opened by the Minister for Children and Youth Affairs, Frances Fitzgerald TD. 3. The Conference presentations will be published on our website during the Conference.