Breastfeeding
Statistical Publication Notice
12 May 2008
Breastfeeding Statistics
INTRODUCTION
Encouraging and supporting breastfeeding is recognised as an important public health activity. There is good evidence that breastfeeding in infancy has a protective effect against many childhood illnesses. Breastfed infants are likely to have a reduced risk of infection, particularly those affecting the ear, respiratory tract and gastro-intestinal tract. This protective effect is particularly marked in low birth weight infants. Other probable benefits include improved cognitive and psychological developments, and a reduced risk of childhood obesity. There is evidence that women who breastfed have lower risks of pre-menopausal breast cancer, epithelial ovarian cancer and hip fracture later in life.
A key section of the 2007 Scottish Government action plan 'Better Health, Better Care' lays out the benefits of giving children the 'best possible start'. These actions include targeting NHS Boards to increase the proportion of newborn children who are exclusively breastfed. A health improvement target has been set to increase the proportion of newborn children exclusively breastfed at 6-8 weeks in Scotland from 26.2% in 2006/07 to 32.7% in 2010/11 (an increase of 25%).
Support and encouragement for breastfeeding can be provided at many levels. For example: health promotion adverts at a national level; policies in maternity hospitals at NHS board level and primary care teams working with individual women and groups within the community. While these can support and encourage mothers to initiate and continue breastfeeding, there are a wide range of other factors that influence mothers. Maternal age and deprivation are known to be strongly associated with the likelihood of breastfeeding.
This release provides an annual update of breastfeeding statistics for NHS Boards that participate in the Child Health Systems Programme - Pre-School (CHSP-PS) system. All NHS Boards in Scotland provide a Child Health Surveillance Programme where children are offered reviews at various stages of their life. In NHS Boards that use the CHSP-PS system (11 NHS Boards in Scotland), information on breastfeeding is recorded at the public health nurse/health visitor First Visit review (at around 10 days old) and the 6-8 week review. At these reviews, the health professional (normally a public health nurse/health visitor) records whether a mother is exclusively breastfeeding (baby is fed breast milk only), mixed feeding (baby is fed both breast and formula milk), or if the baby is being fed formula milk only. The overall breastfeeding rate includes mothers who are exclusively breastfeeding and mothers who are mixed breast and formula feeding. In addition to the overall breastfeeding rates, exclusive breastfeeding rates are shown separately in this release for the first time.
This publication has traditionally focussed on calendar year data as these are the most up-to-date figures which are available to allow publication to coincide with Breastfeeding Awareness Week. This year's publication also includes financial year data (year ending 31st March) to aid monitoring of the new breastfeeding target, although the majority of the analysis focuses on the calendar year data (year ending 31st December). Data are presented for calendar years 2001 to 2007 and financial years 2001/02 to 2006/07.
KEY POINTS
Among the 11 participating NHS Boards in Scotland (calendar year figures):
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In 2007, 44.6% of mothers were breastfeeding at the First Visit review, which takes place at around 10 days, up slightly from the 2006 level (44.1%). This includes 37.5% of mothers who were exclusively breastfeeding (the same percentage as 2006).
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At the 6-8 week review, the overall breastfeeding rate was 36.0% in 2007 (35.9% in 2006). This includes 26.4% of mothers who were exclusively breastfeeding (26.6% in 2006).
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The overall breastfeeding rate and exclusive breastfeeding rate have remained relatively stable since 2001.
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Breastfeeding rates vary across NHS Board areas. For example, at the 6-8 week review, exclusive breastfeeding rates in 2007 range from 18.8% in NHS Ayrshire & Arran to 35.0% in NHS Lothian.
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Younger mothers who smoke and live in the most deprived areas are the least likely to breastfeed their babies.
INTERPRETATION
The CHSP-PS system, from which these statistics are derived, was introduced in 1991 and the number of participating boards has increased over the years. Data are now available for 11 of Scotland's 14 NHS Boards areas. These board areas account for approximately 89 percent of Scotland's pre-school population. The boards that are not included are: NHS Grampian, NHS Orkney and NHS Shetland.
Breastfeeding rates for calendar year 2007 are provisional. Data are extracted from CHSP-PS in February 2008; at this point children born near the end of calendar year 2007 may not have had their 6-8 week review or the data from their review may not have been entered on to CHSP-PS. It is estimated that data for 2007 from the First Visit review are around 99% complete and data from the 6-8 week review are around 90% complete.
Breastfeeding rates from child health surveillance data are often compared to breastfeeding rates from the UK wide Infant Feeding Survey, which has been carried out every five years since 1975. The results of the Infant Feeding Survey are based on a sample of mothers in Scotland and tend to give a higher breastfeeding rate compared with the data from child health surveillance reviews, however the trends demonstrated tend to be similar.
DETAILED FINDINGS
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In 2007, a total of 44.6% of mothers were breastfeeding at the First Visit review, which takes place at around 10 days. This comprises 37.5% of mothers who were exclusively breastfeeding and 7.0% who fed their babies both breast milk and formula milk (mixed feeding). This compares with a breastfeeding rate in 2006 of 44.1% (37.5% of mothers exclusively breastfeeding and 6.6% mixed feeding).
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At the 6-8 week review, the overall breastfeeding rate was 36.0% in 2007. A total of 26.4% of mothers were exclusively breastfeeding and 9.6% were mixed breast and formula feeding. In 2006, the breastfeeding rate was 35.9% (26.6% exclusive breastfeeding and 9.3% mixed feeding).
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The overall breastfeeding rate and exclusive breastfeeding rate have remained relatively stable since 2001.
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Breastfeeding rates vary across NHS Board areas. For example, at the 6-8 week review, exclusive breastfeeding rates in 2007 range from 18.8% in NHS Ayrshire & Arran to 35.0% in NHS Lothian.
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There is a strong association between breastfeeding and the age of the mother. Older mothers are more likely to breastfeed than younger mothers, however the differences in breastfeeding rates above the 30-34 age group is less apparent. In 2007 only 5.9% of mothers aged under 20 were exclusively breastfeeding at 6-8 weeks, compared with 37.7% of mothers aged 40 and over. A similar pattern is seen in the overall breastfeeding rate.
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There is a clear association between breastfeeding and deprivation. In 2007, 42.3% of mothers in the least deprived areas were exclusively breastfeeding at the 6-8 review, compared with 13.9% of mothers in the most deprived areas. This means mothers in the least deprived areas were three times more likely to exclusively breastfeed at 6-8 weeks compared with mothers in the most deprived areas. A similar pattern is seen in the overall breastfeeding rate. However, the gap between the most and least deprived areas has narrowed slightly. Between 2001 and 2007 exclusive breastfeeding rates increased by 16.1% (from 12.0% to 13.9%) in the most deprived areas whilst rates fell slightly in the least deprived areas (down 2.5% from 43.4% to 42.3%).
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Older mothers are more likely to breastfeed but the effect of age is less pronounced in the more deprived areas. The combined effect of the age of the mother and deprivation on breastfeeding rates is such that for children born between 2001 and 2007 only 5.0% of younger mothers (under 20 years of age) in the most deprived areas were exclusively breastfeeding at 6-8 weeks compared with 18.9% of mothers aged 40 and over. In comparison, 12.4% of younger mothers in the least deprived areas were exclusively breastfeeding at 6-8 weeks compared with 50.9% of mothers aged 40 and over.
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Non-smoking mothers are nearly three times as likely to exclusively breastfeed as mothers who smoke. The smoking status of mothers is recorded at the First Visit Review at around 10 days. In 2007, 43.3% of non-smoking mothers exclusively breastfed their babies, compared with 15.3% of mothers who smoked. A similar pattern is seen in the overall breastfeeding rate. It is worth noting that maternal smoking data from the First Visit demonstrates a fall in the proportion of mothers who smoke in recent years.
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MAIN CONTACT:
Judith Tait
Child Health Team Information Manager
Tel: 0131 275 6833
Judith.Tait@isd.csa.scot.nhs.uk
GLOSSARY:
PRE-RELEASE ACCESS TO THIS PUBLICATION WAS GIVEN TO:
Directors of Public Health
Chairs of the Child Health Systems Programme National User Groups
NHS Board Chief Executives
HISTORY OF THIS PUBLICATION:
Last Published: 14/05/2007
Next Due: May 2009
Data Avaliable Since: Data available back to 2001. Due to phased implementation of CHSP-PS system, data are available for some NHS boards for earlier years.
Judith Tait
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