More than milk – the case for breastfeeding in Scotland

The saying that ‘breast is best’ is well known and has been demonstrated anecdotally by mothers who have successfully breastfed their little ones. It is good for both the infant and mother, promoting health and preventing disease in early and later life.

We put this anecdotal evidence to the test in a Glasgow Centre for Population Health Breastfeeding study, funded by the Scottish Collaboration for Public Health Research and Policy (SCPHRP). This study linked administrative records from different sources for a large (anonymised) cohort of infants born in Scotland between 1997 and 2009. This comprised information on:

• the child (year of birth, single/multiple birth, first/other child, hospital of birth, mode of infant feeding, admission to hospital, GP consultations);
• their parent(s) (age, marital status, social class, ethnic/religious background, education, country of birth);
• the area in which they resided (urban/rural, area deprivation).

More than half a million children were included in the study.

We found that socio-economic, healthcare-related, and cultural factors all influenced whether infants were breastfed at birth and up to 6-8 weeks after birth. In particular, infants who lived in more deprived areas, whose mother and/or father were of White British ethnicity, of a lower social class, or born in a non-accredited baby-friendly unit, were less likely to receive any breastmilk by 6-8 weeks after birth.

Infants who were not breastfed had a greater risk of visiting the GP or of having a hospital admission for a range of common childhood conditions (especially respiratory infections) – resulting in higher costs of care. The study also showed infants in the most deprived areas who were breastfed, had lower average healthcare costs compared to formula-fed infants living in any area, no matter the level of deprivation.

Scottish policy aims to give every child the best start in life, yet not all children get this nutritional advantage – through no fault of their own. Breastfeeding is cheaper and better than formula feeding for infants, their families, communities, healthcare services, and society at large. But it is not without cost, and requires significant time, knowledge, and support.

We need increased understanding, investment, and action at the family, community, local, regional and national level, to encourage and support more breastfeeding in Scotland. Creating the conditions for all children to have the best nutritional start in their early years should be a priority.

Breastfeeding should become a choice that all families can make, and implement (for longer), irrespective of their cultural or socio-economic background. It contributes to reducing inequalities in the early years; it is a vital part of our investment in early years.

Read the journal article here.

Download an infographic summarising the findings of the study