Breastfeeding by NHS Board, Council Area and Community Health Partnership

This feature presents 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, 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 babies who are exclusively breastfed and babies who are mixed breast and formula fed.  Overall breastfeeding rates and exclusive breastfeeding rates are presented for the 12 NHS Boards in Scotland using the CHSP-PS system.

Data are presented for calendar years 2001 to 2009 and financial years 2001/02 to 2008/09.

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.  The 12 NHS board areas now using the system account for approximately 89 percent of Scotland 's pre-school population. The boards that are not included are NHS Grampian and NHS Orkney.

The CHSP-PS system is dynamic, with ongoing updating of records.  Each year's release is based on the latest available data from the CHSP-PS to allow for additions and amendments to the review data. However this means, where a child's postcode of residence has changed, in some instances the derived NHS Board, Community Health Partnership and Council Area may not reflect where the child lived at the time of their First Visit/ 6-8 week review.  Along with updates to postcode reference data, this may result in slight changes to the figures previously published.  However, this is not considered to have a significant effect on the rates reported for each area.

Breastfeeding rates for calendar year 2009 are provisional as data are extracted from CHSP-PS in February 2010 and at this point children born near the end of calendar year 2009 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 presented for 2009 from the First Visit review are around 99% complete and data from the 6-8 week review are around 90% complete. Past experience indicates any differences between the breastfeeding rates based on provisional data and complete data are minor, though slightly larger differences may be seen for the Island Boards where the rates are based on a small number of reviews.

Among participating NHS Boards, the majority of 6-8 week reviews are carried out before babies are 9 weeks old.  The maximum age limit for the 6-8 week review is recommended as 12 weeks.  Variation in the timing of the 6-8 week review may affect the reported rates as there is a known drop-off in breastfeeding rates with time.

There may be some variation between public health nurses in terms of how they define whether a mother is exclusively breastfeeding, mixed feeding or if the baby is being fed formula milk only. In order to improve consistency, recent guidance for public health nurses specifies that the feeding method recorded on CHSP-PS should relate to the type of milk feeding in the last 24 hours. This differs from the World Health Organization (WHO) definition of exclusive breastfeeding where the baby has only ever been given breast milk and has never been fed formula milk, solid foods, or any other liquids.

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 Infant Feeding Survey is based on a sample of mothers in Scotland and uses the WHO definition of exclusive breastfeeding. Results of the survey tend to give a higher breastfeeding rate compared with data from CHSP-PS; however the trends demonstrated are similar.


Tables and charts are available for:

Breastfeeding by NHS Board of Residence:
Calendar Years 2001-2009 ( 149KB)
Financial Years 2001/02-2008/09 ( 162KB)

Breastfeeding by Council Area:
 Calendar Years 2001-2009 ( 258KB)
 Financial Years 2001/02-2008/09 ( 210KB)

Breastfeeding by Community Health Partnership:
 Calendar Years 2001-2009  ( 264KB)
 Financial Years 2001/02-2008/09  ( 239KB)


Tables and charts are also available by maternal age, deprivation and smoking status for calendar years 2001-2008.

Key points for the 12 participating NHS Boards (calendar year figures)

• In 2009, a total of 45.9% of babies were breastfed at the First Visit review, which takes place at around 10 days.   This comprises 36.7% of babies who were exclusively breastfed and 9.3% of babies who were fed both breast milk and formula milk (mixed feeding).  This compares with a breastfeeding rate in 2008 of 44.9% (37.0% of babies exclusively breastfed and 8.0% mixed breast and formula fed).
  
• At the 6-8 week review, the overall breastfeeding rate was 36.4% in 2009.  A total of 26.5% of babies were exclusively breastfed and 9.9% were mixed breast and formula fed. In 2008, the breastfeeding rate was 35.8% (26.4% exclusive breastfeeding and 9.5% mixed feeding).
  
• The overall breastfeeding rate and exclusive breastfeeding rate have remained relatively stable since 2001.
  
• Breastfeeding rates vary by geographical area. For example, at the 6-8 week review, exclusive breastfeeding rates in 2009 range from 18.6% in NHS Lanarkshire to 38.4% in NHS Shetland. A small proportion of this variation may be accounted for by differences in the timing of the 6-8 week review.