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Using breastfeeding data to inform service development locally - Coleen Milligan

We know the importance of understanding what’s happening locally and how this compares to other areas. Without it how do we know where we need to focus our efforts to have the most impact on improving the health of the local populations we serve? Data about breastfeeding rates at 6 to 8 weeks after birth is a particularly important example of where understanding the data can help us ensure that all children get a healthy start, the impact of which may be felt throughout their lives.

World Health Organisation recommends that babies are exclusively breastfed for the first six months and after that given a combination of breast milk and other food. But latest annual statistics for 2016/17 show that in England only 44.4% of babies are still being breastfed when they are approaching 2 months old.  We can see that this figure is low particularly when we compare it to countries like Norway where 71% of mothers are still breastfeeding 6 to 8 weeks after they have given birth. This is disappointing when typically the number of women who start breastfeeding in the UK was 74% in February 2018 (Maternity Services data set)

There is also considerable variation between local authorities with 75.6% of babies being breastfed in the area with the highest rates compared to 19.3% (breastfeeding at 6-8 weeks annual statistics 2016/17) in the area with the lowest. Improving breastfeeding rates, particularly in those areas where it is significantly lower than the average, offers real opportunities for improvement in the overall health of children.

Public Health England has published data on breastfeeding at 6 to 8 weeks after birth on a quarterly and annual basis since 2015. These publications give a breastfeeding rate for England and are based on the local authorities which submit a return with data of suitable completeness and quality for meaningful comparison with that of others. In the longer run, when the Maternity Services Data Set and Community Services Data Set have become established, national and local data on breastfeeding will be published by NHS Digital.

Making sure that good quality data for a local area is submitted to Public Health England and NHS Digital means that, in turn, a local area can use national reports to compare how they are doing at promoting and supporting breastfeeding with what’s happening elsewhere, both in their region and with similar populations in other parts of England – it’s a really good way to look at the impact of local maternity and early years services and how yours compares to others. It also creates opportunities to learn from similar areas elsewhere which might have higher rates: what are they doing differently which we might be able to adopt here? Understanding the differences in breastfeeding rates helps us target our work towards those areas with the greatest need for improvement.

There is clear evidence of the advantages of breastfeeding  so we need to work across the health and social care system in a coordinated way to make sure that as many mothers and babies as possible benefit.  There are two pieces of the jigsaw which will help you do this. By looking at breastfeeding statistics you can understand the local picture and potential aspects on which you need to focus. Then by reading PHE’s commissioning guidance for infant feeding  you can get ideas about how to commission services more effectively, ensuring that ever greater numbers of mothers and babies benefit from breastfeeding.

Coleen Milligan is Programme Manager for Child and Maternal Intelligence Network, Public Health England



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