Source document: https://docs-lawep.s3.us-east-2.amazonaws.com/1694573428799.pdf (Australia)
lu\c Submission no.
22 AUTHORISED: 2s 1 2 1 o 7 Submission for Parsiamentary [nquiry into the Health Benefits af Breastfeeding Prepared by Hunter New England Healith representatives: Carol k z o p a r d i Midwifery Manager John Hunter Hospital Pel: (02) 4921 3993 Deb Galboway Area Clinical Midwife Conswitant Parenting Education John Hunter Hospital Conjoint Lecturer School of Midwifery and Nurslng University of Newcastle TeE: (02) 4921 3593 Carolyn HzsEie Midwife Manager Gelmont Birthing Service TeE: 041 8428430 Megan Leuenberger Famil~es First and Parenting Ca-ordinator Hunter New England Wealth (HNE) (Southern) Conjo~nt lecturer School of tVi~dwifeqi anci Nursing University of Newcastle Tel: (02)49246352 Anne Saxton Servrce ManagerIDirector of Midwifery and Nursing Divis~on of Obstetrics and Gynaecology Conjoint Associate Professor School of Midwifery and Nursing University of Newcastle hel: (02) 4921 4390 Robin Skewes Clinical Midwife Consultant Maternity Services HNE (Northern) Te!
: (02) 6767731 8 , Y - ~ - T - - Y - & ~ - /f-~a----~--+~ &fi &L @@-Pi/‘ / & ~ ~ d - ~ ~ .&id ~~ ur*- /@4--/ /~&-...d5 6 .J .a?

,/ Return address Division of Obstetrics & Gynaecology John Hunter Hospital, Locked Bag No I, Hunter Region Mail Centre.
2310 2"d February 2007 Hunter New England Area Health Service Submission for Parlianientary Inquiry into Benefits of Breastfeeding February 2007 Introduction This submission describes and makes seven recommendations for the Commonwealth government to take a lead role in improving the health of the Australian population through suppori for breastfeeding.

I. impiementing "Core of Life Programs" in off high rchoolr 2.

Ongoing media campaign promoting breastfeeding, using ali forms of media 3.
Regulation of marketing of breastmilk substitutes 4.

Funded ia&ation consultant positions in regional and tertiary maternity units 5.

Establishment of drop-in community byeastfeeding support clinics 6.

Establish Home Help Seruice for mothers with newborn babies 7. fvlandatory education on breastfeeding for medical staff, Pradice I'.durses and ail tendergraduate health professionals 8.
Funding for horpitair to clppiy for the Baby Friendiy Health initiative (BFHI) and BFHI accreditation be included ai a standard of the A C M E Accreditation process fsr hospitahj Reasons far this submission a Breastfeeding is one of the most impoeant contributors to infant health and well-being, providing a range of benefits for an infants growth, immunity and development Breastfeeding problems require adequate time for a comprehensive assessment of feeding technique and infant behaviour.
Current midwifery staffing in maternity units and the existing Child and Family Health appointment system are unable to accommodate this requirement and needs to be changed to meet this need.

B The assistance support and advice given to breastfeeding mothers in the early post-parium period has longer breastfeeding outcomes.
Provision therefore needs to be made to provide a) additional midwife time to provide an appropriate level of support for all new mothers b) early intensive support required by some motherslparents c) an appropriate level of service for mothers of babies with special needs in NICU, Special Care nurseries and Paediatric units.
implications important for Submission for Parliamentary Inquiry into Benefits of Breastieeding February 2007 Breastfeeding probiems are more likely to arise in the first few weeks at home between discharge from the maternity service and before the first visit from the Chiid and Family Health Nurse.

This gap in service results in early weaning when timely advice and support is not readily available.
Exclusive breastfeeding to at least 6 months of age gives the best is recommended by the Australian nutritional start to infants and the World Health Government Department of Health and Ageing, Organisation (WHO), NHMRC and other health authorities Breastfeeding benefits maternal health and contributes to economic benefits to the family, healthcare system and workplace.
Breastfeeding is aimost universally silccessiul when there is appropriate management and support and no medical intervention or exposure to alternative feeding methods (Royal College of Paediatrics and Child Health, 2004) Barriers Bs successfu t breastfeeding include Community attitudes towards breastfeeding especially in public places Q Lack of timely access to support for mothers who require assistance prior to their first appointment with Child and Famiiy Health Nurses or their GP inconsistent advice from medical practitioners when consulted about breastfeeding probiems Glitzy advertising of breast milk substitutes Q Benefits of suceessfu!
breasf eeding for infants inciude: Protection against infection and some chronic diseases and improved cognitive development (NHSrlvlRC2003: pp.318-323) ~i Reduced incidence of infections erg, middle ear and the need for admission to hospital compared to infants fed breast milk substitutes Reduced incidence of eczema, food allergy and respiratory illness Economic benefits for famiiies as breast feeding is less expensive than is feeding infants with breast milk substitutes s Exclusive breastfeeding protects susceptible infants from Type?
irrsuiin Dependent Diabetes Helps prevent childhood obesity Reduces the risk of inflammatory bowel disease, childhood lymphoma Produces better cognitive and academic outcomes (an increase of 5%) Promotes optimal growth and development of the infant especially speech and jaw development * Reduced incidence and duration of diarrhoea1 illnesses Protection against respiratory infection and reduced prevalence of asthma Reduced occurrence of otitis media and recurrent otitis media o Possible protection against neonatal necrotizing enterocolitis, bacteraemia, meningitis, botulism, and urinary tract infection B Possible reduced risk of auto-immune disease such as Type 'l Diabetes and inflammatory bowel disease Possible reduced risk of developing cow's milk allergy Submission for Parliamentary Inquiry into Benefits of Breastfeeding February 2007 Possible reduced risk of adiposity later in childhood Improved v~sual acuity and psychomotor development (A Higher IQ scores, which may be the result of factors present in the breastmilk andlor of greater stiniuiation because of motheriinfant interaction (Adapted from the Dietary Guidelines for Children and Adolescents in Austraiia, NHMRC 2003:328) Health Advantages of B r e a s t f e d ing for Mothers: cl Mothers also benefit as breastfeeding assists the uterus to shrink to its pre pregnancy state and reduces blood loss post delivery Breastfeeding enhances maternaliinfant bonding, reduces risk of breast, ovarian cancers, multiple sclerosis and may reduce risk of osteoporosis Improved bone mineralization and thereby decreased risk of past- menopausal hip fracture Prolonged period of postpartum infertility, leading to increased spacing between pregnancies Associated accelerated weight loss and return to pre-pregnancy body weight Environmental benefits of successfu!
breastfeeding include: it is environmentaily sound, as uniike breastrniik substitutes there are no fossil fuels in its manufacture or preparation Reduction of pollutants created with by-products during the manufacture of plastics and breastmilk substitutes Reduces the burden on our landfills by lirniiing waste products Economic bewefits e Economic costs of poor breastfeeding practices to NSW health system are estimated as $20-40 million a year based on 5 illnesses alone; gastrointestinal illness, lower respirator).
infection, otitis media, eczema and necrotising enterocoiitis (NEC) (Hector, Webb & Lymer, 2004).

In the United States, it is estimated that a minimum of $5.6 billion would be saved if breastfeeding were increased from current US levels (64 per cent breastfed in hospital, 29 per centbreastfed at six months) to the targets recommended by the US Surgeon General (75 per cent and 50 per cent respectively).
(Weimer, 200'1 ) "Breastfeeding yields cost savings for families, the health care system, employers and government.

Those illnesses for which there is convincing and abundant evidence of a protective effect of breastfeeding are among the major health problems in Australia and contribute significantly to the health burden."
(Smith, 1997) 6 An alternative way of looking at the economics of breasffeeding is to assess breastmilk as part of the food supply, and in doing so estimate the net economic benefit of breastfeeding in Australia.
After adjustment for a Submission for Parliamentary Inquiry into Benefits of Breastfeeding February 2007 small increase in maternal food consumption this net benefit is estimated to be at least $2.2 billion a year, in 1997 Projected savings for reduction in Healthcare oiler a 10 year period using current CPI trends (grown out over 10 year as per Australian Bureau of Statistics (ABS)) a reductions in cost of Childhood Cancer - $7 3,688,633, Child hood Diarrhea - $1 36,886,322, Ear Infections - $684,431,662, - Tympanoslomies $3,559,044,645 and Hospitalisation for RSV (Respiratory Syncytial Virus) - $307,994,248.
(Projections based on ABS, 2007) Health advantages for mothers and babies are listed below, and clearly identify potential risks of poor health outcomes if breastfeeding rates are not improved Potentially could save the healthcare system $5.368 billion nationally Increasing breastfeeding in Australia could add $3.4 billion to the national food output.
(Smith, 1997) - $684,431,322, Juvenile Onset Diabetes Strategies We believe the following strategies require urgent Federal considerationlfunding in order to support a concerted natignwide effod to increase the rate and duration of breastfeeding.

implementing "Core of Life Programs" in aEb high schools - "Core of Life" is a unique life-education program which addresses adolescents' emerging attitudes to pregnancy, birth and early parenting.
One of the essential aims of Core of Life is to improve breastfeeding rates and hence chiid development.

Adolescents are forming attitudes and beliefs and this time is crucial for educating adolescents if we are to identify and rectify misconceptions about breastfeeding in the community.

(Core of Life, ww.Coreof1ife.orgj This strategy would ensure that all high school students would have a good understanding of the benefits of breastfeeding.
Information gained during adolescence is influential on decision-making as an adult and hence there should be a concomitant increase in the rate of breastfeeding in that generation.

2.

Ongoing media campaign promoting breastfeeding, using all forms of media to ensure that the general public are educated about the benefits of breastfeeding and that breastfeeding becomes the accepted method of feeding the majority of babies for at least 6 months.

3.
3.

Regulation of marketing of breastmilk substitutes - Advertising in the retail sector promotes bottle-feeding as the normal and desirable method of infant feeding.

When breastfeeding was promoted as the gold standard for infant nutrition, marketing strategies by formula companies usurped the 'gold standard' idea and reflected this in the way they coloured their labels on the formula products.
In contrast, breastfeeding is not promoted in the Submission for Parliamentary Inquiry into Benefits of Breastfeeding February 2007 community.

The strategy is to de\~elop and pro~note breastfeeding as the optimal and normal method of infant feeding by producing and displaying posters of women breastfeeding in alt community settings.

4..
4..

Creation of funded lactation consultant positirons in regional and tertiary maternity units to provide a service for new mothers who need more intensive support as well as for breastfeeding mothers in NICU, Special Care Nursery and Paediatric units.

5.

Establish drop-in community breastfeeding support clinics - staffed by qualified lactation consultants and located at existing Child and Family Health centres and shopping centres to enable easy access for advice and education.

8.
8.

Establish Home Help Service for mothers with newborn babies - mothers need to devote the majority of their time to their newborn babies in the first few weeks of life.

The added responsibility of having to do househoid tasks is often the reason why many women stop breastfeeding.

As one new mother said, "I can't get anything done in the house when I am breastfeeding."
A fully funded Home heip Service would assist new the mothers with demanding household breastfeeding relationship with their newborn infant.

The proposed strateghr is federally funded household assistance for a t least cane daylweek for a period 06 one month after birth.

interfere with tasks that 7.


Education for medical practitioners, practice n u r s e s and all undergraduate health prsfessionaEs - Contemporary breastfeeding educational toois need to be developed for medical practitioners, practice nurses and all undergraduate health professionals with an emphasis on providing current evidence-based information, problern-solving strategies and appropriate referral links to support their practice.

8.
8.

Consistency sf breastfeeding advice: through pr;o\fision sf funding for hospitals to apply $OF- the Baby Friendly Health Initiative (BFHi) - currently funding is sourced from existing health budgets.

All hospitals should be BFHI accredited and this should be a mandatory component of the ACHSE accreditation process.
Conformity with Begislation, policies and strategies P Successful breastfeeding practices are universally recommended by organisations such as: World Health Organisation Royal Australasian College of Physicians Royal Australian College of General Practitioners (P American Academy of Paediatrics Pharmaceutical Society of Australia a NHMRC Australia Submission for Parliamentary Inquiry into Benefits of Breastfeeding February 2007 INSlN Midwives Association B Australian College of IViidwives Incorporated 5 NSW Health has demonstrated commitment to breastfeeding with the development of Policy Directive; Promoting, Protecting and Supporting Breastfeeding in NSW.
(2006) PD2006-012 References Hector D., VVebb K., and Lymer S. (2004) Stale of Food and Nutrition in NSl/i/ Series: Repot?

on Breastfeeding in NSW2004.

NSW Centre for Public Health Nutrition/NS\/V Department of Health http://www.healtti.nsw.qov.aulpubs/2005/breastfeedinq rep.html NHFvlRC (2003) Infant Feeding Guidelines for Health Workers National Health and Medical Research Council, Canberra httis://wvtrini,nhmrc.aov.aui~ub~icationsls~nopses/dietsyn.
htm NSW Health (2006) Breastfeeding in NS\N: Promotion, Protection and Suppot?

PD2006_0'l2 Smith, J.

(I 997).

The economics of breastfeeding Australian Fiiriancial Review 7/2/97 Smith, J. cited in Zeretzke, K. (1 997).

Cost Benefits of Breastfeeding.

w ~ ~ ~ .

m e d e l a , c o ~ / N e ~ r \ l F i l e s / a p p x ~ ~ p p a ~ .

h t m l Weimer, J. P. (2001).

The Economic Benefits of Breasffeeding: A Review and Analysis.
Food atlo' Rural Economics Division, Economic research Service, US Department of Agriculture.

Food Assistance and Nutrition Research.

Report No.

13.

BiQBioglraphy Allen, J. and Hector, D. (2005).

Benefits of Breastfeeding The NSW Public Health Bulletin.

NSW Health.

Australian Breastfeeding Association.

VMMI.

breastfeedin~.asn.au Australian Bureau of Statistics.

www.abs.qo\/.au Baby Friendly Wealth Initiative Protecting, Promoting and Supporting Breasffeeding in Australia.
http://wv~w,bfhi.orq.aul Core of Life www.Coreoflife.org Submission for Parliamentary Inquiry into Benefits of Breastfeeding February 2007 International Lactation Consultant Association (ILCA) A Worldwide Network of Lactation Professionals, http://wl.ilca.orcti Royal College of Paediatrics, and Child Health i~ttp://v~tww.rc~ch.ac.ui;i Smith, J. and Ellwood, I\h.

(2006).

Where does a mother's day go?

Preliminary Estimates from the Australian Time Use Survey of New Mothers.
http:lInceph.anu.edu.au/R~searchiHealti SysternsAirne use survev nm.htmi The Baby Friendly initiative.

\mn~/.bab\~riei7dIy.org.uk Submission for Parliamentary Inquiry into Benefits of Breastfeeding February 2007