Medical students 'should have clinical exposure to breastfeeding'

Despite improvements over the last 15 years, Ireland still has the lowest breastfeeding rates in Europe.

Medical students should have clinical exposure to breastfeeding and the HSE should increase the number of International Board-Certified Lactation Consultants (IBCLCs) and community breastfeeding groups to help encourage and support breastfeeding mothers.

That is according to a new paper from the Faculty of Paediatrics, Faculty of Public Health and the Institute of Obstetricians and Gynaecologists of the Royal College of Physicians of Ireland, which suggests a number of actions that can be taken to improve breastfeeding rates in Ireland.

Despite improvements over the last 15 years, Ireland still has the lowest breastfeeding rate in Europe.

At discharge from hospital, just 60% of mothers have initiated breastfeeding and at three months of age only 42% of babies are still receiving some breastmilk.

By six months of age less than 6% of infants in Ireland are exclusively breastfed compared to a global average of 40% and a European average of 25%.

“We know that breastfeeding provides optimal nutrition for infant’s growth and development, and that it has the potential to improve health on a nationwide scale,” Dr Anne Doolan, consultant neonatologist, International Board Certified Lactation Consultant (IBCLC) and lead author of the new paper, said.

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Breastfed babies have a lower risk of sudden infant death syndrome, allergy, and acute infections including gastroenteritis, otitis media and respiratory infections. In later childhood, infants who were breastfed are at lower risk of obesity and have improved cognitive performance.

“We have national policy which contributes to normalising breastfeeding," Dr Doolan said, "but barriers still exist.” 

Dr Doolan said it is difficult for many to access specialist support when needed as Ireland has "very limited numbers of publicly funded lactation consultants."

Dr Meredith Kinoshita, one of the paper's lead authors and Specialist Registrar in Paediatrics, also noted that mothers report receiving conflicting information about breastfeeding from health professionals which leads to uncertainty and undermines confidence. 

“Healthcare professionals should have the appropriate education and skillset to support breastfeeding, with consistent information and continuity between services in hospitals and the community,” she said, adding that clinical exposure is “key” in this regard.

The establishment of donor milk services for the Republic of Ireland would also be welcomed.

Some other suggestions within the paper included a social marketing campaign with positive outcomes of breastfeeding and continued breastfeeding after introduction of complementary foods and an extension of time and expressing/breastfeeding facilities in places of work for at least one year postpartum.

The paper's authors also noted that Ireland has "a substantial share in the global market for breast-milk substitutes" but said there should be no promotion of breastmilk substitutes to parents or healthcare staff within hospitals or community healthcare settings.

"The widespread marketing of ‘follow-on’ or ‘toddler’ milks in particular can be misleading for parents," they said.