Reporter 431, 15 February 1999

Targeting the new mothers to show the best feeding is breastfeeding

Breastfeeding offers many benefits to both mother and baby. It can reduce childhood diabetes, adult heart disease and the risk of early breast cancer for the mother. However, despite national initiatives the Government is struggling to increase the number of mothers doing it. To help it promote breastfeeding, three University departments have joined forces to launch a ground-breaking survey of expectant mothers.

Like blood, breast milk is a living fluid. It contains thousands of cells, growth factors, enzymes and chemicals that not only nourish the baby, but switch on and regulate many of its functions and systems. This makes it very difficult to mimic and means the health benefits cannot be conferred by artificial preparations.

Benefits of breastfeeding to the child include reduced risk of infections and long-term illnesses, including respiratory conditions. Breastfeeding mothers can be protected from the early onset of breast cancer, certain forms of ovarian cancer and the risk of bone fractures when elderly.

Despite these benefits, one in three women choose not to breastfeed their newborn baby, and another one in three stops within six weeks. One reason for this could be that the message is failing to reach many women. Working mothers returning to their jobs is another, but University researchers believe many other factors can play a role - cultural and social, as well as economic.

There are also distinct groups of new mothers in whom the initiation of breastfeeding is lower than average. Teenage mothers, unsupported and unpartnered women and those on income support are twice as likely to feed their babies with synthetic, bottled milk. Mike Woolridge, of the School of Healthcare Studies is co-ordinating the project, and is working closely with several professional and voluntary groups. The research within the Mother and Infant Research Unit will seek to understand and address these sources of variation.

"Addressing the inequalities in health is a Government priority and we have recently focused our efforts on the promotion of breastfeeding as a way to address these inequalities," said Dr Woolridge.

Research indicates that women from ethnic minorities need to be targeted separately. "There is a very high initiation rate among mothers from Asian communities. As many as eight out of every ten women begin breastfeeding, but then this drops away very quickly," he said.

The research team will target expectant mothers in these groups to see what factors influence their decision, and to assess the most appropriate method of trying to promote breastfeeding to them.

"There are many reasons why women do not begin to breastfeed their newborn babies, or begin and then are forced to stop. These economic, cultural and practical factors can vary considerably across different sectors of society," said Dr Woolridge.

"Each of these reasons may require a different intervention strategy if the Department of Health is to try and address them. For example, the welfare food scheme provides mothers on income support with tokens that can be exchanged for 'doorstep' milk or infant formula milk.

"The financial benefit is much greater, however, with infant formula which can be a strong incentive for mothers to bottle feed. In that case, alternative financial inducements would be needed to encourage them to consider breastfeeding," he said.

Dr Woolridge has enlisted the help of the psychology and geography departments in the research. Psychologist Mark Conner will adapt a model that predicts the choices people make about their own health to analyse the decisions that women make about breastfeeding.

Graham Clarke of the School of Geography will identify regions across the country with a high number of women in the target groups.

Up to 750 pregnant women will be surveyed about their infant feeding decision, and the factors affecting it. After birth the team will see whether the model has predicted the women's decision and post-natal behaviour accurately.

"The results will help refine the generic approach that the Department of Health currently takes," said Dr Woolridge.

"They will show us the key issues affecting each group of mothers, which the Government will then integrate into its future policy."

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