Becoming Breastfeeding Friendly (BBF) Wales Recommendations Briefing Report

Background: Breastfeeding and the provision of human milk is the most accessible and cost-effective activity available to public health which is known to prevent a range of infectious and non-communicable diseases (NCDs), specifically gastro-enteritis, childhood obesity, diabetes type 2 and maternal breast cancer. However, global efforts to further improve exclusive breastfeeding rates have had limited success, in part because effective scaling‐up frameworks and roadmaps have not been developed. The UK has one of the lowest breastfeeding rates in the world; 80% of babies are breastfed at birth and only 1% are exclusively breastfed by 6 months. In Wales, whilst over 60% of women intend to breastfeed, the figure falls to 26% reporting any breastfeeding at 6 weeks, with considerable variation among Health Boards and breastfeeding rates lower among women in areas of higher deprivation, exacerbating health inequalities. Sustained intervention is required to improve the experience of breastfeeding for women, babies and families and work towards the WHO’s 2025 global target of increasing exclusive breastfeeding in the first six months to at least 50%.

BBF: The Becoming Breastfeeding Friendly (BBF) toolkit was developed through highly structured technical and academic collaboration, led by Yale University and has been piloted in Mexico and Ghana. In the short term, it provides an evidence-based tool to guide countries in assessing their breastfeeding status, and their readiness to scale up. In the long term, it supports countries to identify the concrete measures they can take to sustainably increase breastfeeding rates, based on data-driven recommendations. The BBF Gear Model is made up of eight simultaneous conditions which sustain breastfeeding: the gears. This conceptual model illustrates how each gear must be sufficiently mobilised to turn the next, whilst the central Coordination gear gathers and delivers timely feedback. This report contains a set of briefings detailing the six themes and their accompanying recommendations and actions.