EAT FOR HEALTH Australian Dietary Guidelines

EAT FOR HEALTH – AusTRALiAn diETARy guidELinEs

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Guideline 4

lower socioeconomic status mothers

Women from the lowest socioeconomic quintile in Australia have lower breastfeeding rates than those from the

most affluent quintile.873,923-925

Mothers from culturally and linguistically diverse groups

limited available data suggest that, in general, the rates of breastfeeding among women from culturally and

linguistically diverse groups in Australia reflect trends in their countries of origin.926-930

Aboriginal and Torres Strait Islander mothers

Breastfeeding status varies by remoteness. In non-remote areas, non-Indigenous infants are likely to breastfeed

for longer than Aboriginal and Torres Strait Islander infants. However, in remote areas Aboriginal and Torres Strait

Islander infants breastfeed for longer than non-Indigenous infants.28,873 In the Perth Aboriginal Breastfeeding Study,

Aboriginal mothers had higher breastfeeding rates than non-Aboriginal mothers.^931

Mothers who use illicit drugs

WHO recommends that mothers who use illicit drugs while breastfeeding should be evaluated on an individual

basis. Breastfeeding may need to be discontinued,^932 but each case requires detailed medical assessment.^922

4.3.2 Supporting and promoting breastfeeding

Promoting breastfeeding in prospective parents

Overall, reviews of interventions to support breastfeeding have found that education before birth and continuing

support after birth for breastfeeding mothers were effective in breastfeeding continuation.

The uS Preventive Services Task Force found that primary care breastfeeding interventions significantly increased

rates of exclusive breastfeeding in the short and long term.^889

Effective education programs include information about the benefits of breastfeeding, principles of lactation, myths,

common problems and solutions, and skills training.^933 Peer support was particularly useful for socioeconomically

disadvantaged women, and peer counsellors were most effective if they were of similar cultural and social status

to the women they were counselling. The optimal mix of interventions to improve breastfeeding practices includes

education of mothers, peer support, hospital practices such as rooming-in and early skin-to-skin contact, staff training,

development and implementation of hospital policies, media campaigns, and paid maternity leave.^890

A more recent Cochrane review shows a protective effect of providing support on increasing duration of

breastfeeding.^888

Promoting breastfeeding in hospitals

The uNICEF and WHO Baby Friendly Hospital Initiative (BFHI) has been shown to increase breastfeeding rates in

accredited hospitals.^934 The steps in BFHI include the following:

1. Have a written breastfeeding policy that is routinely communicated to all health care staff.


2. Train all health care staff in skills necessary to implement this policy.


3. Inform all pregnant women about the benefits and management of breastfeeding.


4. Help mothers initiate breastfeeding within one hour of birth.


5. Show mothers how to breastfeed and how to maintain lactation even if they should be separated from
   their infants.


6. Give newborn infants no food or drink other than breast milk, unless medically indicated.


7. Practice rooming-in (allow mothers and infants to remain together) 24 hours a day.


8. Encourage breastfeeding on demand.


9. Give no artificial teats or pacifiers (also called dummies or soothers) to breastfeeding infants.


10. Foster the establishment of breastfeeding support and refer mothers to them on discharge from the
    hospital or clinic.