Research on infant feeding routines and disincentives to breastfeeding have influenced policy, strategy and clinical guidelines in the UK and around the world.

About the research

The UK has one of the lowest breastfeeding rates in the world, with up to 80% of mothers stopping breastfeeding prematurely. Research by Professor Amy Brown at Swansea University is exploring why so many women experience problems with breastfeeding, and what can be done to help them.

Professor Brown's ESRC-funded PhD showed that the main factor governing whether breastfeeding was successful or not was the feeding routine the mother adopted. Women who breastfed 'responsively' – in response to whenever the baby wants to be fed, typically every two hours including through the night – were much more likely to continue breastfeeding for longer. Feeding in this way led to a good milk supply and reduced the likelihood of pain, difficulty or poor weight gain.

Mothers that fed to a set routine were much more likely to experience breastfeeding difficulties, leading to them stopping breastfeeding. Reasons for feeding to a set routine included worrying that a baby was feeding too often, as well as the belief that a baby should be established in a set routine and sleep through the night from an early age. This belief was also tied into wider pressures on women to ‘get their lives back’ and return to work, lose weight and socialise.

Further ESRC research by Professor Brown has shown that there are many societal barriers to responsive feeding: a lack of knowledge, lack of acceptance about normal baby behaviour and a lack of support for new mothers. Through her extensive outreach and campaign work, including media articles, a book and a range of animations, Dr Brown aims to educate the wider public about how breastfeeding works and why we need to support it.

“I am seeing a real difference in the way my students are starting to interact with new parents when talking about the importance of breastfeeding and how infant sleep really is. I can see how rewarding new families are finding this support and I truly believe it will help them in breastfeeding for longer.” (Vicky Thomas, Consultant Paediatrician, Great North Children's Hospital)

Impact

  • Professor Amy Brown's research animations have been used as a staff training tool in 200 health boards across the UK, helping health professionals engage with breastfeeding mothers. They are played on TVs in hospital waiting rooms, and have been translated into Spanish, Serbian and Russian. To date they have been viewed 15 million times on Facebook, and have been shared 65,000 times.
  • Professor Brown worked with for Abertawe Bro Morgannwg University Health Board in Swansea to design their breastfeeding strategy. She is currently working with the Welsh Government and Public Health Wales to update the breastfeeding strategy for Wales.
  • Her work underpins the Royal College of General Practitioners’ Perinatal Mental Health Toolkit, which is given to primary care teams across the UK to help them deliver the highest quality care to women with mental health problems in the weeks surrounding birth.
  • The research contributed to the Scientific Advisory Committee on Nutrition (SACN)'s Feeding in the First Year of Life report, the first comprehensive UK government scientific review on infant feeding since 1994
  • Her research was also cited by UNICEF and the World Health Organization’s Baby Friendly Initiative in their national infant feeding strategy for the UK, and to revise their standards so that they continue to support public services to implement the best possible care for mothers and babies in the UK.
  • UNICEF and Public Health England also used the research to produce their ‘Commissioning infant feeding services’, a toolkit providing guidance to local authorities to help them promote, protect and support breastfeeding.
  • In Australia, Professor Brown's research has been used by the Department of Health to produce clinical antenatal guidelines given to health workers, to ensure all pregnant women attending hospital receive appropriate information about the benefits and management of breastfeeding.
  • In Canada, the research informed guidelines issued to health professionals about what advice to give to mothers wishing to introduce solid foods to infants.
  • The research was also cited in the US Surgeon General's 2011 call to action to support breastfeeding. As a result of the call, the US Department of Labor enforced the ‘Break Time for Nursing Mothers’ provision of the Fair Labor Standards.