2. Breastfeeding in Northern Ireland The Way Forward Janet Calvert Regional Breastfeeding Coordinator

3. Regional developments 1997 Breastfeeding Strategy Group 1999 Breastfeeding Strategy for Northern Ireland 2000 Strategy Implementation Group 2002 appointment of Regional Breastfeeding Coordinator

4. Why breastfeeding is important Artificial feeding, increased risk of: gastro-enteritis (x5); urinary tract infections (x5); respiratory infections (x2); atophy where family history (x2); necrotising enterocolitis (x20).

5. Why breastfeeding is important Maternal health benefits, reduction in: pre-menopausal breast cancer; ovarian cancer; osteoporosis.

6. Initial incidence of breastfeeding (IFS: NISRA and Office of National Statistics ) 36 45 54 63 68 70 0 10 20 30 40 50 60 70 80 90 100 NORTHERN IRELAND ENGLAND & WALES 1990 1995 2000

7. Incidence of breastfeeding by social class (IFS: NISRA and Office of National Statistics ) 79 90 59 69 55 67 41 52 36 33 0 10 20 30 40 50 60 70 80 90 100 IIIIIIIVV 1995 2000

8. Effective Interventions - provision of information (informal sessions one-to-one or small groups) - evidence based best practice (Baby Friendly Initiative) - peer support programmes (targeting women on low incomes) (Kramer et al 2001, Heinig 2001, NHS Centre for Reviews and Dissemination, University of York 2000)

9. Areas for Action Provision of breastfeeding education for Health Professionals (Catteneo and Buzzetti 2001, DHSS 1999) multi-professional training; training updates; training for breastfeeding coordinators.

10. Coordinating Activities Support for best practice (Kramer et al 2001, Tappin et al 2001, WHO 1998) Identification of Key individuals within Boards and Trusts National Breastfeeding Committee and National Network of Breastfeeding Coordinators

11. Collecting Regional Information Improve on existing systems; Examine possibility of utilising neo-natal screening information; Participation in Infant Feeding Survey.

12. Achievements Increase in breastfeeding rates; 2 Baby Friendly Maternity Units; 1 Baby Friendly Community Trust; 2 Certificates of Commitment; breastmilk bank in Irvinestown; 5 Hospital Breastfeeding Coordinators; 3 Community Breastfeeding Coordinators.