Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694819413247.pdf (Australia)
Submission no.

279 AUTHORISED: 1 7 / 4 / 0 7 /^ Brisbane Northside Population Health Unit - Health Promotion team supports an increased investment in breastfeeding to impact on amplification of uptake rates and duration of breastfeeding within Queensland.

Health promotion represents a comprehensive social and political process.
It not only embraces actions directed at strengthening the skills and capabilities of individuals, but also action directed towards changing social, environmental and economic conditions so as to alleviate their impact on public and individual health.

Health promotion is the process of enabling people to increase control over the determinants of health and thereby improve their health.
Consequently, the Brisbane North Health Promotion Team recognises the need to 'get in early' and invest in the early years specifically around optimal infant nutrition.

The team advocates the utilisation of the Ottawa Charter for Health Promotion Framework when developing projects and the need to consider supportive environments, healthy public policy, reorienting health services, strengthening community action and developing personal skills.
The Optimal Infant Nutrition: Evidence Based Guidelines 2003-2008 signify that there is escalating evidence demonstrating the correlations between optimal infant nutrition and a reduced risk of developing a range of illnesses and chronic diseases throughout infancy, childhood and adult life.

Breastfeeding has been strongly associated with a reduced prevalence of specifically obesity and mental health issues throughout childhood and continuing through the age spectrum to adolescence and adulthood.
Considering the prevalence of chronic disease within our community, state and nation, it is of vital importance that we begin to 'get in early' by focusing on the early years, in order to prevent this burden of disease increasing -.

impacting financially, physically and emotionally to individuals, families, communities, health, government and social systems.

The Queensland Strategy for Chronic Disease 2005-2015 lists breastfeeding promotion as an integral early life primary prevention strategy.
Section 24.3 of the strategy states "Support exclusive breastfeeding to six months and continued breastfeeding up to at least 12months in partnership with community breastfeeding organisations, general practice and Aboriginal and Torres Strait Islander communities".

This is further reinforced by The World Health Organisation whom defines breastfeeding as the optimal form of infant nutrition for human babies in its Global Strategy on infant and young child feeding (WHO, 2002).
Alarmingly, Queensland rates of exclusive breastfeeding to 6months are considerably low.

Rates upon discharge currently do not meet the target and drop significantly between 4weeks-12weeks.
With an increased awareness of the importance of breastfeeding within the community, changes in policy, supportive environments in which to feed infants and the capacity of the clinical sector to respond to feeding mothers, projects need to strive to have an impact on a mother's decision to either continue breastfeeding or to uptake breastfeeding upon birth.
With startling rates of childhood obesity in our state, projects need to strive to engage the community to address this major public health crisis by valuing children within the community.

Evidence strongly indicates the importance of a nurturing environment and stimulation on an infant's brain development.

Much current publicity has signified that the investment in the early years around infant attachment shows a marked difference in behaviour, physical and emotional development of a child.
Breastfeeding is a key strategy for promoting infant attachment, stimulation and good health and has been shown to markedly reduce the rates of obesity, mental health issues and has been correlated with higher IQ levels in children and generally a better health status.
The cost to the community regarding mental health and obesity is alarming, particularly to the clinical and acute health sector, thus the need to focus on the antenatal and postnatal period in order to prevent such morbidity rates from continuing to increase.

A 'whole-of-community' approach needs to be undertaken, reaching individuals, groups, businesses and sectors through various geographic, education, communication and capacity building strategies.
This 'whole-of-community' approach is recognised by Be Active Queensland as an approach that encourages integrated actions that address a broad range of socio-ecological determinants of physical activity and nutrition.

Breastfeeding is the physiological norm for feeding infants and significant scientific evidence supports the view that breastfeeding is superior to breast milk substitutes.
Breastfeeding is associated with improved general health, growth and development of infants and higher adult intelligence, protection against several acute and chronic diseases, including infectious disease, diabetes, obesity, allergic disease, autoimmune disease and dental caries.

Projects will need to increase the awareness of the importance of breastfeeding and the benefits not only to the infant but also to the mother and the community at large.
Many barriers to breastfeeding exist and include cultural perceptions, beliefs and practices, negative community attitudes, lack of supportive policies, legislation and environments, lack of supportive partner, family and/or peers, lack of adequate and consistent advice from health care professionals, low levels of education and/or literacy, low socioeconomic status, lack of ongoing breastfeeding support, or access to such support and lack of appropriate education and ongoing advice on techniques for successful breastfeeding establishment in the first 6weeks post-partum.
Projects need to break down many of these barriers in order to create a socially supportive environment for mothers choosing to breastfeed their babies.

As social systems change and communities grow, it is becoming critical for health service providers to work together, involving other sectors within the community to provide an integrated response to improving health and wellbeing.
Furthermore it is imperative that any emphasis on health not only focuses on the availability of health services for the population but also on prevention strategies that seek to prevent illness and promote wellness within the community.

It is recommended that organisations will work from such an integrated promotion prevention approach to address breastfeeding within Queensland.
In addition, it is significant that projects utilise a multi-strategic approach in order to reinforce (from a promotion, prevention perspective) optimal infant nutrition across the continuum (preconception, antenatal, postnatal, early years) addressing breastfeeding, linking to oral health, social supports, infant attachment and play.

Thank-your for the opportunity to comment and support breastfeeding within Queensland.
We look forward to continued and increased investment undertaking a multi-strategic promotion prevention approach to increase uptake, rates and duration of breastfeeding thus impacting on individuals, organisations, communities and society at large financially, socially, emotionally and physically.

Kind regards Giselle Pitot Senior Health Promotion Officer On behalf of Brisbane Northside Population Health Unit-Health Promotion Team