Breastfeeding In NSW: Promotion, Protection And Support Policy

Background and Vision

Discuss about the Prevalence and Determinants of Cessation.

This policy paper aims to deliver a framework for activities and responsibilities to enhance the protection, support and promotion of breastfeeding within the New South Wales health system. Breastfeeding in NSW: Promotion, Protection and Support was first released in year 2006. It was main initiative that has arisen from 2002 policy called Childhood Obesity Summit. It was the first ever complete, evidence-based regulation with particular action to support and promote the importance of breastfeeding within a state health system in Australia. It has been then reviewed by considering recent changes in state and national policy contexts, especially the National Breastfeeding Strategy 2010-2015.   

In march 2009, when the Australian health minister affirmed on collaboration of implementing and developing the Australian national breastfeeding strategy under the Australian Government (Lutter & Morrow, 2013). The department of Health and Ageing commissioned to give rise to Allen Consulting group for the expansion of the Australian National Breastfeeding Strategy along with a consultation process for the key stakeholders in 2009.

This policy publishes a framework for the action and priorities for all governments to address the support, promotion, protection and monitoring of breastfeeding throughout the country.

Vision: It is evident that, Australia is a country in which breastfeeding is promoted, protected and supported and respected by whole community (Breastfeeding, 2017). The issue of breastfeeding is seen as a social and biological norm for children and infants. Even families, mothers, health professionals and other care givers are aware about the importance of breastfeeding.

The aim of this policy is to layout a framework for activities to enhance the protection, support and promotion of breast-feeding in the NSW health system. There are other several factors that affect the rates of breastfeeding (Breastfeeding – Protection, Promotion and Support, 2012). So, this policy is established to contribute to population groups living in NSW in ways: to maintain present percentage of constantly breastfed infants; to enhance the percentage of exclusively breastfed infants for 6 months and to expand breastfeeding duration.

The factors like social, cultural, family and environmental factors greatly influence breastfeeding continuum.

Child and mother: it is well understood that, mother and child relationship is vital of all maternal and breastfeeding activities.

Access: Every member of the group or community has the accessibility to all the services and information that can support, protect and encourage breastfeeding continuum.

Factors Influencing Breastfeeding Continuum

Diversity: The diversity in Australian society is identified over various support and promotional activities which are sensitive and approachable to distinct conditions (Innocenti declaration: On the protection, promotion and support of breastfeeding, 2010).

Collaborative care: the health care providers in partnerships with services provide holistic care to the women and their relatives which helps in strengthen and maintain support services.

Evidence based promotion, support and protection activities are regularly checked by the available evidence, number of breastfeed babies are regularly checked and all the activities are examined.

Continuity care: the continuity of care: the continuous support to the women during the transition period to community services is vital from the final perspectives (Greiner, 2008).

The reason behind selecting the Breastfeeding in NSW: Promotion, Protection and Support policy as the topic because of increasing health issues of the infants, young children due to poor nutrition collectively affecting the health and wellbeing of mother as well. This paper will analyses all the factors influencing the health of mother and children by protecting, promoting, monitoring and supporting breastfeeding.

The Australian policy Breastfeeding in NSW: Promotion, Protection and Support aims in boosting the health, wellbeing and nutrition in young children and infants along with good health of mothers by promoting, supporting, protecting, and monitoring the breastfeeding within the New South Wales Health System. The central government and state government in collaboration, are concerned and committed towards promoting the value of breastfeeding and improving the rates of breastfeeding in NSW population (Breastfeeding protection, promotion and support, 2010).

This policy also clarifies the responsibilities in order to help in a synchronized and steady approach across the New South Wales health system. The policy is committed towards keeping the existing proportion of infants breastfed to 6 months and easily increasing the period of breastfeeding.

Breastfeeding is considered as an important population health measures. It is apparent that breastfeeding protects mothers and infants from a wide range of long-term and short-term health problems. Therefore, breastfeeding is invariably considered as one of the best and most beneficial for the infants, as per WHO, Royal Australasian College of physics, NHMRC, Royal Australian College of General practitioner Australian Medical Association (Esterik, Blystad, & Leshabari, 2010).

The breastfeeding is one of the major health issue existing in New South Wales, Australia. The rates of breastfeeding are well below the rates recommended by the Australia’s National Health a Medical research Council (NHMRC). The evidences verify the low rates of breastfeeding, especially in regards to period and exclusivity, larger number of mothers and infants at added risk of obesity or overweight with ill health (Pérez-Escamilla & DJ, 2012). All these health risks combined with all other health factors affect the formula of feeding and can lead to considerable cost to individual, health system, society and government.

Government Initiatives and Legislation

According to the Australian National infant factor affecting breastfeeding in women varied as most of the women were interested while others were not interested in breastfeeding. The most common causes for the women who breastfed are healthier for child (94%) helps in establishing mother- infant bonding (64%) and convenient (64%). Similarly, the reason for not breastfeeding are because of prior unsuccessful attempts (38%), so partner can share feeding (29%) and other infant formula is good as breast milk (26%).

The social barriers also influence the physical and mental wellbeing of the mother and health of the children who are forced to join work due to inadequate maternity leaves have insufficient or no support for breastfeed at workplace. Although there is law which allows women to exercise her right but the fellow employers pressurize on women breastfeeding making them feel bad. The other issue is there is no support for bringing babies at workplace. Due to insufficient breaks, women often find themselves pumping milk by sitting on a toilet seat to maintain milk supply discourages women in joining such places (Smith, McIntyre, Craig, Javanparast, & Strazdins, 2013).

It is also observed that, people only breastfeed if they see others doing the same. The peer pressure, behaving normal in front of others and having role models also influences or discourages women from breast feeding. Some women get influenced by magazines, advertisements, movies, televisions showing bottles to feed, which compels them to believe it.

Lack of milk banks is also one of the factor which affects women’s health. There are very few milk banks which gives them advantage of exploiting the market and earning more profit.

The poor access to specialist and breast pumps also affects of heath of the women. The women experiencing problems in breastfeeding needs specialist like lactation professionals and also are in need of double electric breast pump in order to increase or maintain supply (Mangasaryan & Martin, 2012). Most of the workplace or offices do not provide sufficient maternity leaves which affects the breastfeeding period and poses risk to health of the women. These insufficient maternity leaves act as a significant barrier to breastfeeding.

Therefore, the government should consider all these issues at social level and develop plans and policies according.

Another important factor influencing the breast feeding in New South Wales is legislative and regulatory environment in relation to protection of breastfeeding. The protection in breastfeeding is about allowing women to breastfeed their children and infants without any fear of harassment with confidence in legislative and regulatory environment, employment entitlements like restriction on the scale and marketing of infant formula, parental leave (Australian National Breastfeeding Strategy 2010 – 2015, 2009).

 This also plays significant role in reducing the discrimination against breast feeding mothers. It is legalized in each and every state of Australia to breastfeed in public (Wen, Baur, & Rissel, 2009). There are other jurisdictions having special law thereby making it difficult to discriminate portal in case of family dispute, when parents get separated they must make arrangements which facilitate breastfeeding to children. As per the Family Law Act 175, it states that in case where parenting order is related to children, then in those case court must act in the in the best of children (Protection, promotion, and support of breastfeeding in facilities providing maternity and newborn services: the revised Baby friendly Hospital Initiative, 2107). In determining decision related to child interest, the court must also consider the scenarios and circumstances which facilitates breastfeeding. According to a study, some legal professionals suggest breastfeed as a strategy to limit family access to children without considering the significance of breastfeed in relation to child health. Hence, the legal framework covered all the aspects protecting women in freely breastfeeding their children without any fear.

The Breastfeeding in NSW: Promotion, Protection and Support policy delivers framework for actions and priorities for Australia government at every level to address promotion, protection, support and monitoring breastfeeding in community. The main objective of this policy is to contribute in improving the nutrition, health and well- being of the youth and infants and that of mother by promoting, protecting, monitoring and supporting breastfeeding (Somlyay, 2007).

In order to achieve goals and objectives the following points needs to be considered:

1. The community acceptance of breast feeding to be increased as a cultural and social norm.
2. Need to provide roper support too the mothers so that they feel comfortable in their breastfeeding relationship.
3. There should be breastfeeding friendly communities, child care environments, public spaces, work-place to encourage mothers to continue their relationship.
4. The community leaders, public figures, role model should encourage and promote breastfeeding.
5. Protecting breastfeeding from commercial pressures and misleading information.
6. Providing chances for pregnant women along with their relatives to learn more about the significance of breastfeeding.
7. There should be accessibility and access to antenatal education with information on the value of breastfeeding.
8. The pregnant women should be encouraged and allowed to take decisions about breastfeeding.
9. The pregnant women should establish breastfeeding support network so that the are linked to support groups. The healthcare providers should have proper training so that they can provide appropriate advice and support regarding breastfeeding. Improvement in breastfeeding initiation rates. Providing evidences-based advice consistently in order to support initiation and facilitating successful breastfeeding.
10. All the healthcare centers have breastfeeding policy written which is actively promoted among all the staffs and also includes breastfeeding friendly strategies.
11. Providing continuous care between health services breastfeeding support services and networks and community services. The staff should ensure that the mother and their family members know about the breastfeeding services are available and how to use them.

As per WHO, breastfeeding is a way of providing food for development and health growth for infants. It also considers breastfeeding as a significant part of reproductive process having significant implication for the health of mothers (WHO priorities, 2018). WHO and UNICEF recommendations regarding breastfeeding, mothers and infant health are as follows:

1. The start or initiation of breastfeeding from the 1^st hour of life.
2. The WHO recommends exclusive breastfeeding meaning there should not be any other materials except mother’s milk. It even recommends not to use water during breastfeeding for 6 months.
3. The breastfeeding should be available all the time.
4. There should not be use of bottles, pacifiers, or teats.

There are some parameters in decision making which comes into account during policy development and its implementation. These are required resources, timeframe and priorities. The resources while making decision consists several factors like human resources, monetary resources, political and legal settings. In any policy development process, the human resources play an important role. The health care practitioners, doctors, nurses etc. comes under human resource under health care system (Somlyay, 2007). Apart from the human resources, there should be favorable political environment for the development and implementation of policy. In addition to this, there is always involvement of key government officials in any decision-making process. Similarly, the legal back up and financial resources are equally important for any decision-making process.

Once the policy objectives are clear, the panel member or analyst can judge how much time and attention the particular issue deserve (Ogbo & Eastwood, 2017). If the existing issue does not attract attention then the policy makers may approach towards an increment solution which is making minor modifications in the existing programs or extension of a well-known procedures to a new domain. This helps in minimizing search and evaluating appropriate time.

The policy maker may encounter other issues for which there may not be any incremental solutions (Urban, 2012). Therefore, further analysis may be required for creating new laws, programs or institutions. There must be greater investment in research and evaluation before the development of any policy. In some cases, even the available investment, appropriate policy options are not available. This means lack of credibile or reliable information about the issue which can further lead to:

1. Not able to analyze or divide the issue into manageable or separate units.
2. Inability to estimate various courses of actions.
3. Lack of belief in the modes demanding policy options.
4. If analysis fails during the process then the different parameters affecting a decision becomes unclear. This further means the policy makers are encountering a difficult scenario indicating more research and time is required.

This phase of analysis demands research. The main aim of this stag is to collect as much reliable, credible information in order to identify possible responses (Allison & Shannon, 2016). As it is known that, a problem can have different scenarios, the team approach towards that problem can be vital.

The various sources of idea may consist of:

1. The existing policies available at local level or in other jurisdictions.
2. The research on the basis of global findings on best practice over the required area.
3. Current review, feedback, reports on the problem.
4. Research or study of academic journals. Continuous discussion with subject matter expert both within and outside of government.
5. Consultation with the clients.
6. Sessions involving consultation with operational staff and service delivery.

Thus, the search phase considers all the viable options. It also compresses the potential universe of responses, narrow down the possibilities into choices which can meet the objective of decision makers.

Conclusion:

The above paper explained a wide range of policy context required for improving the health outcome, nutrition and wellbeing of young children and infants. In order to achieve the desired outcome there should be proper implementation of roles and responsibilities for government.

Breastfeeding is an important measure which is responsible for protecting the infants and mothers from various short term and long-term health problems. The social and legal framework ensures safety and freedom for both mother and infant by promoting breast feeding. There should be enough support and encouragement for the pregnant woman and she should be allowed to take her own decision on breastfeeding. There should be proper availability of specialist and skilled health provider who can guide mother correctly during prenatal and postnatal period.

The children should only be breastfed for first six month as the mother milk protects children from several diseases. The legal framework ensures women are not discriminated or harassed at any place during breastfeeding. It gives rights to women to breastfeed her child openly without any embarrassment or fear. According to WHO and UNICEF breastfeeding is a way of giving food for the development and heathy growth of infants. The WHO and UNICEF recommends exclusive breastfeeding, which means the infants should only be given breastmilk without any addition of food or water.

This paper also discussed about the parameters such a resource. Timeframe and policies which are essential for any decision-making process.

The society and communities should be open towards breastfeeding so that it provides favorable environment to empower women in continuing their relationships. There should be trained healthcare workers who should organize awareness programs on breastfeeding to make most of the people to understand the importance of breastfeeding.

References

Allison, M., & Shannon, P. (2016). The Impact in the United States of the Baby-Friendly Hospital Initiative on Early Infant Health and Breastfeeding Outcomes. Breastfeeding Medicine, 11(5), 38-49. https://doi.org/10.1089/bfm.2015.0135.

Australian National Breastfeeding Strategy 2010 – 2015. (2009, November 13). Retrieved from Australian Health Ministers’ Conference: https://www.health.gov.au/internet/main/publishing.nsf/Content/6FD59347DD67ED8FCA257BF0001CFD1E/$File/Breastfeeding_strat1015.pdf

Breastfeeding – Protection, Promotion and Support. (2012, April 19). Retrieved from ROYAL HOSPITAL FOR WOMEN: https://www.seslhd.health.nsw.gov.au/rhw/Manuals/documents/Lactation/Breastfeeding%20-%20protection%20promotion%20and%20support.pdf

Breastfeeding. (2017). Retrieved from World Health Organization: https://www.who.int/nutrition/topics/exclusive_breastfeeding/en/

Breastfeeding protection, promotion and support. (2010). Retrieved from Child and Adolescent Community Health: https://ww2.health.wa.gov.au/~/media/Files/Corporate/general%20documents/CACH/CHM/CACH.CH.BreastfeedingProtectionPromotionAndSupport.pdf

Esterik, P. v., Blystad, A., & Leshabari, S. C. (2010). Ways ahead: protecting, promoting and supporting breastfeeding in the context of HIV. International Breastfeeding Journal, 5: 19. Retrieved from International Breastfeeding Journal.

Greiner, T. (2008). Programs to Protect, Support and Promote Breastfeeding. Retrieved from International Child Health: https://www.child-encyclopedia.com/breastfeeding/according-experts/programs-protect-support-and-promote-breastfeeding

Innocenti declaration: On the protection, promotion and support of breastfeeding. (2010). Ecology of Food and Nutrition , 26(4), 271-273 .

Lutter, C. K., & Morrow, A. L. (2013). Protection, Promotion, and Support and Global Trends in Breastfeeding. Advances in Nutrition, 4(2), 213–219. Retrieved from Advances in Nutrition.

Mangasaryan, N., & Martin, L. (2012). Breastfeeding Promotion, Support and Protection: Review of Six Country Programmes . Retrieved from Nutrients: https://www.mdpi.com/journal/nutrients

Ogbo, F. A., & Eastwood, J. (2017). Prevalence and determinants of cessation of exclusive breastfeeding in the early postnatal period in Sydney, Australia. International Breastfeeding Journal, 12, 16.

Pérez-Escamilla, & DJ, C. (2012). Breastfeeding protection, promotion, and support in the United States: a time to nudge, a time to measure. PubMed, 28(2), 118-21.

Protection, promotion, and support of breastfeeding in facilities providing maternity and newborn services: the revised Baby friendly Hospital Initiative. (2107). Retrieved from Draft for public consultation: https://www.who.int/nutrition/events/consultation-protection-promotion-support-breastfeeding-draftdocument.pdf

Smith, J., McIntyre, E., Craig, L., Javanparast, S., & Strazdins, L. (2013, December). Workplace support, breastfeeding and health. Retrieved from Australian Institute of Family Studies: https://aifs.gov.au/publications/family-matters/issue-93/workplace-support-breastfeeding-and-health

Somlyay, A. (2007, February). Parliamentary inquiry into Breastfeeding. Retrieved from Standing Committee on Health and Ageing: www.aphref.aph.gov.au_house_committee_haa_breastfeeding_subs_sub280.pdf

Urban, A. (2012). Societal Barriers to Breastfeeding. Retrieved from The International Chiropractic Pediatric Association: https://pathwaystofamilywellness.org/Breastfeeding/societal-barriers-to-breastfeeding.html

Wen, L. M., Baur, L. A., & Rissel, C. (2009). Intention to breastfeed and awareness of health recommendations: findings from first-time mothers in southwest Sydney, Australia. International Journal of Breastfeeding, 4, 9. https://doi.org/10.1186/1746-4358-4-9.

WHO priorities. (2018). Retrieved from World Health Organization: https://www.who.int/dg/priorities/en/