dr helen mcavoy
TRANSCRIPT
Breastfeeding on the island of
Ireland – shared challenges?
Dr Helen McAvoy MD MFPHUK
Director of Policy
Institute of Public Health in Ireland
www.publichealth.ie
1
Overview
1. Data – breastfeeding patterns
2. Data – breastfeeding experiences and contexts
3. Concluding observations
2
1. Data – breastfeeding patterns
3
Administrative data
• Recorded by service
providers
• Postnatal – linked to
engagement with
health services
Survey data
• Recorded by mothers
• Timing variable –
linked to response to
survey
Northern Ireland Ireland
At birth –
‘breastfeeding attempted’
NIMATS X pilot
underway!
On discharge from hospital CHS NPRS
First PHN visit
(within 72hrs)
X
HSE
Primary visit (10-14 days) CHS X
6 weeks CHS X
3 months CHS HSE
6 months CHS X
12 months X
1. Data – breastfeeding patterns
5
Northern Ireland Ireland
Infant Feeding Survey Last completed 2010 Once off – 2008
Longitudinal surveys of
childhood
UK Millennium Cohort Survey Growing Up in Ireland
1. Data – breastfeeding patterns
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1. Data – breastfeeding patterns
Source: Child Health System NI 2015/2016; NPRS RoI 2015
1. Data – breastfeeding patterns
Source: Child Health System NI; NPRS RoI (Data 2006 to 2015)
0
10
20
30
40
50
60
70
80
% o
f to
tal li
ve
bir
ths
Timepoints
Breastfeeding patterns UK and Ireland
Ireland
Northern Ireland
England
Scotland
Wales
1. Data – breastfeeding patterns
Source At birth Discharge/24hr 3 days 10-14 days 6-8 weeks
0.1 1 3 10 42
Ireland NPRS & HSE 58 54
Northern Ireland NIMATS & CHS 57 46 35 27
England Public Health England. Child Health-Early Years Data-Breastfeeding Indicators 74 44
Scotland ISD Scotland. Infant Feeding Statistics 63 50 41
Wales National Community Child Health Database 59 44 36
1. Data – breastfeeding patterns
0
10
20
30
40
50
60
Under 20 20-24 25-29 30-34 35-39 40+ Total
Perc
enta
ge o
f inf
ants
(%)
Age (years)
Discharge
Primary visit (10-14 days)
6 weeks
3 months
6 months
12 months
1. Data – breastfeeding patterns Prevalence of any breastfeeding across the first year of life by maternal age (Northern
Ireland, infants born in 2014/15)
Source: Child Health System NI
Why the gap?
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Hypotheses Comment
Cultural diversity of mothers Likely, some supportive evidence
Socio-economic profile of mothers Possibly, some supportive evidence
Other socio-cultural factors Possibly, but poorly understood
Demographic profile of mothers Unlikely
System differences (antenatal, postnatal) An unknown
Policy differences –breastfeeding, maternal and child
health
Unlikely, but there are some
Operational differences in delivery of policy approach Unlikely, but there are some
1. Data – breastfeeding patterns
2. Data – breastfeeding experiences
and contexts
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Community
Family
Mother
Baby
• Not just health services
• Not just ‘partner’
• Not just breasts!
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2. Data – breastfeeding experiences
and contexts
Source: Growing Up in Ireland; Infant Feeding Survey (2008)
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Source: UK Infant Feeding Survey (2010)
2. Data – breastfeeding experiences
and contexts
Culture eats…
• Strategy
• Infant formula
15
16
Republic of Ireland
• Healthy Ireland Survey
(2016)
• 79% ‘breastmilk meets a
baby’s nutritional needs for
the first 6 months’
• 81% ‘comfortable when
mothers breastfeed near
me in a public place’
• 52% disagree ‘infant
formula is as good as
breast milk’
Northern Ireland
• Healthy Survey Northern
Ireland 2014/2015
• 90% agree ‘breastfeeding
is good for baby’
• 92% agree ‘breastfeeding
is normal’
• 13% agree ‘breastfeeding
is embarrassing’
2. Data – breastfeeding experiences
and contexts
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44.1
27.3
11.9 9.1
4.1 3.6 0
5
10
15
20
25
30
35
40
45
50
Perc
enta
ge 1
1-16
yea
r old
s
Perception of healthiest way to feed 3 month baby
Breast and bottle feeding
Breastfeeding only
Bottle feeding only
Breast and bottle feeding andsome solids
Breastfeeding and some solids
Bottle feeding and some solids
2. Data – breastfeeding experiences
and contexts What is the healthiest way to feed a 3 month old baby? Views of 11-16yr olds in Northern
Ireland (YPBAS 2016)
Policy response to shared challenges
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3. Concluding observations
• Core issue = low initiation
• Core determinants of initiation = socio-
cultural
• Data interpretation
• What sort of data do we need to move
forward?
3. Concluding observations
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Acknowledgements
• Dr Joanna Purdy & Dr Noelle
Cotter (IPH)
• Siobhan Hourigan (HSE)
• Julie Neill & Janet Calvert (PHA)
• Rhian Osborne (Welsh Govt)
• Growing Up in Ireland Survey
• Infant Feeding Survey 2008
• Infant Feeding Survey UK 2010
Thank you Further details in our 2017 report ‘Breastfeeding on the
island of Ireland’ available at www.publichealth.ie
Any questions?
Email : [email protected]
www.twitter.com/publichealthie
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