Analysis of the Australian Maternity Service Breastfeeding Policy

This report provides a detailed analysis of the Australian Maternity Service's Breastfeeding Policy, examining its implementation, objectives, and impact on infant and maternal health. The report explores the benefits of breastfeeding, including its nutritional advantages, emotional bonding, and protective effects against childhood illnesses. It delves into the policy's goals, strategies, and the role of organizations like the Australian Breastfeeding Association (ABA). The analysis covers the economic, environmental, and social frameworks influencing the policy's success, including the Baby Friendly Hospital Initiative (BFHI) and challenges like inadequate support and funding. The report also examines the policy's implementation in New South Wales (NSW), highlighting initiatives like the NSW Aboriginal Maternal and Infant Health Strategy (AMIHS), and provides a comprehensive assessment of the policy's achievements and areas for improvement, with a focus on increasing breastfeeding rates and promoting community acceptance.

Running head: REPORT ON AUSTRALIAN MATERNITY SERVICE; THE
BREASTFEEDING POLICY 1
Report on Australian Maternity Service; the Breastfeeding Policy
Name
Institution
Date

REPORT ON AUSTRALIAN MATERNITY SERVICE; THE BREASTFEEDING POLICY 2
Report on Australian Maternity Service; the Breastfeeding Policy
Breastfeeding is an unequalled nutrition a mother provides for her baby which contains
the baby with the needed nourishment it needs for growth (WHO, 2018). It also enables both
mother and baby to have an emotional and physical attachment. A person's breastmilk cannot be
exchanged for an animal's milk, and it is irreplaceable. Breast milk contains colostrum which the
breasts produce after childbirth. Colostrum is also known as the first immunization for the baby
which transfers minerals and vitamins, antibodies and growth factors to the babies which helps to
guard it against some childhood illnesses such as diarrhea, rashes, asthma, skin infections,
respiratory diseases among others. It also enhances intellectual development of the baby
Breastfeeding and is profitable to the mothers by supporting quick recovery from childbirth,
minimizing the possibility of breast and ovarian cancers in future, and lower the risk of maternal
depression (Department of health, 2017). The promotion of breastfeeding is an international
public health priority and the recommendation to exclusively breastfeed until around six months
of age has been adopted by many countries around the world including Australia (Daly, Pollard,
Phillips, & Binns, 2014). The government of Australia and some private healthcare sectors are
responsible for the formulation and implementation of public health policies. Healthcare policies
are a set of decisions, plans and actions taken to arrive at healthcare goals within a society
("WHO | Health policy," 2018). Such programs can be viewed as deliberations of the
government's intent outlining the vision, priorities and their establishment (Althaus, Bridgeman
& Davis, 2013). The success of a government in providing excellent healthcare services to its
population depends on the kind of the healthcare policy and its implementation. A useful plan
factors in social, political, economic and environmental factors. Australia is a country that posts
an advanced healthcare system and so is its maternity services. Among the public health policies

REPORT ON AUSTRALIAN MATERNITY SERVICE; THE BREASTFEEDING POLICY 3
that have received much attention both nationally and internationally is the maternity services in
the form of the exclusive breastfeeding (EBF) plan. EBF is a widely accepted component of
public health as the best option for infant feeding (Eidelman et al., 2012). The World Health
Organization (WHO) recommends six-month continuous breastfeeding of newborns followed by
a gradual introduction of complementary food as breastfeeding continues up to two years or
beyond (World Health Organization & UNICEF, 2003). Many countries including Australia
have incorporated the EBF into their health policies (Binns, Lee, & Low, 2016). This paper will
analyses the critical points for the implementation process of the national breastfeeding policy in
Australia and evaluate its achievements and failures thus far.
In 2001 the WHO provided guidelines for comprehensive breastfeeding as well as its
benefits (World Health Organization & UNICEF, 2003). For example, EBF is both a long-term
and short-term beneficial factor to a good relationship between the mother and the infant
(Victoria et al., 2016). Also, breast milk is crucial to the initial activation of immunological and
epigenetic roles in the infant as well as controlling microbial changes of the gut (Fujita, Lo &
Brindle, 2017). Furthermore, well-breastfed children are less likely to have diarrhea (Ogbo et al.,
2016), obesity, otitis media and reduced chances of mortality (Lamberti et al., 2011).
Breastfeeding mothers lower their chances of developing breast and ovarian cancer as well as
type II diabetes when they breastfeed their infants to the recommendation duration (Victoria et
al., 2016). An adequately breastfed child has a higher likelihood of developing a better
intellectual functioning (Horta, Loret de Mola & Victoria, 2015). The benefits mentioned above
and other documented benefits of breastfeeding compelled the WHO member states in 2002 to
adopt a global strategy for infant and young child feeding. The comprehensive approach
enhances the implementation of national policies aimed at promoting, protecting and supporting

REPORT ON AUSTRALIAN MATERNITY SERVICE; THE BREASTFEEDING POLICY 4
appropriate infant and young children feeding practices. The intention of the global strategy
advocated for infant breastfeeding from birth through four to six months which extends to two
years with appropriate weaning foods at six months. A Baby Friendly Hospital Initiative (BFHI)
campaign was launched to support the goal. The BFHI offered guidelines and recommendation
to foster maternity services that encouraged and incorporated breastfeeding support systems.
Many hospitals advanced their maternity services to acquire a BHI accreditation as the strategy
expanded to other healthcare providing facilities as well as into the community (Cai, Wardlaw &
Brown, 2012; Daly et al., 2014).
Furthermore, besides the benefits of breastfeeding and it is being accepted as the ideal way to
feed babies, there have been some barriers which deter women from practicing breastfeeding.
Among these are inadequate family support, inadequate knowledge of the importance of
breastfeeding, short paid maternal leave, insufficient breastmilk, the age of the mother, maternal
beliefs and perceptions (Ogbuanu, Glover, Probst, Liu, & Hussey, 2011). Evidence shows that
commencing and sustaining EBF among postpartum women through education and support, will
have an enormous impact in tackling some of the barriers to EBF (Bevan & Brown, 2014). In
Australia by 2006, there were still few facilities (19%) that were Baby-Friendly Hospital
Accredited (BFHA) (Bartington, Griffiths, Tate & Dezateux, 2006). The government then
initiated breastfeeding research to facilitate implementation of the plan. The study came up with
recommendations of mandating the federal department of Health and Aging to provide finances
for the Australian College of Midwives to control BFHI efforts and be responsible for
accrediting maternity facilities (Lum, Todd & Porter, 2016). Later, a strategy requiring every
state and Territory governments to adhere to the policy was launched after the Australian Health
Ministers endorsed the "Breastfeeding strategy 2010-2015".

REPORT ON AUSTRALIAN MATERNITY SERVICE; THE BREASTFEEDING POLICY 5
AIMS AND OBJECTIVES OF BREASTFEEDING
The goals of the system are; to create awareness for breastfeeding as a natural and
socially ethical act for the infant feeding, to fully inform those involved in raising children of
breastfeeding value and increase the number of babies that undergo complete breastfeeding.
Another aim of breastfeeding according to the Australian Health Ministers conference (2015) is
to enhance the wellbeing, nourishment and welfare of babies and young children and the health
as well as the well-being of the mothers by promoting and overseeing breastfeeding. The
objective of breastfeeding is to raise the ratio of infants who are breastfed from birth to six
months of age, with continued breastfeeding and complementary foods to twelve months and
beyond (Australian Health Ministers conference, 2015).
STRATEGIES
Some strategies to achieve the aims and objectives of breastfeeding is to advocate for
breastfeeding friendly organizations and environments, provide relevant and sufficient
information to mothers and carers of babies regarding breastfeeding. Further promote paid
parental leave, education to raise community acceptance of breastfeeding as a public norm and
practice (Australian Health Ministers conference, 2015).
In 2001, an organization of 1,100 women was formed comprising of volunteers in
counselling and educating other women about benefits of breastfeeding. The organization was
called Australian Breastfeeding Association (ABA), and it instructed the community on the
importance of full breastfeeding practices to both the mother and the infant.
POLICY ANALYSIS

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The implementation of the breastfeeding policy in New South Wales (NSW) commenced
in 2002 due to an NSW Childhood Obesity Summit that recognized breastfeeding as a remedy
for the obesity pandemic. Due to the policy, many midwives and Nurses undertook training
which supported breastfeeding women and its practices. Further, the plan saw the establishment
of BFHI in many health facilities due to public health funding for the maternity facilities
(Sheehan & Schmied, 2011). Another version of the NSW Breastfeeding policy was in 2011 by
the Department of Health which outlined the integral part the midwives, children and family
health practitioners could play to meeting the policy's objectives (wales, 2006). In the NSW
state, the plan has been propagated by the Breastfeeding Working Group as well as the BFHI
NSW committee. One of the challenges to the success of the policy is limited funding to the
policy's initiatives since there are still very few, about eight, hospitals that have BFHI
accreditation in NSW. Also, the NSW Aboriginal Maternal and Infant Health Strategy (AMIHS)
is another initiative aimed at advancing the health of the Australian indigenous mothers during
pregnancy to reduce perinatal mortality and morbidity (Murphy & Best, 2012). Moreover, the
implementation of strategies that enhance policies depends on financial empowerment as well as
other factors, such as, social, environmental and political factors for the breastfeeding system.
Below is a detailed framework assessment that will enhance the effectiveness of the
breastfeeding policy.
ECONOMIC FRAMEWORK
Breastfeeding has cost benefits to the individual, community and nation at large.
Breastfeeding exclusively for six months and above goes a long way to provide immunologic
protection against different types of childhood illnesses. This decreases hospitalization rate for

REPORT ON AUSTRALIAN MATERNITY SERVICE; THE BREASTFEEDING POLICY 7
both mothers and babies. Mothers have good mental health from breastfeeding. Also, there will
be reduced or no cost of buying formula for the first six to twelve months of the infant's life.
Indirect cost such as wage and time spent looking after the baby while sick with diarrhea,
respiratory illness, gastrointestinal disorders etc. could be saved by actively breastfeeding
(Breastfeeding Coalition Tasmania', 2015). The government has utilized the training of midwives
as a way of reaching to the aboriginal mothers who have a less tendency of seeking professional
maternal services due to low socio-economic status (Lording, 2009). Research has shown that
the number of indigenous infants that are exclusively breastfed after leaving the hospital is small
as compared to non-indigenous (Australian Institute of Health, & Welfare, 2012). When about
90% of mothers are encouraged to breastfeed exclusively, 13 billion health care dollars would be
saved (Bartick & Reinhold, 2010).
ENVIRONMENTAL FRAMEWORK
Breastfeeding is also beneficial to the environment in a way that it is a sustainable
essential resource that is the most environmental-friendly sources of food. Breastmilk does not
cause pollution in its preparation, storage, shipping or refrigeration; it generates no waste and is a
renewable resource (Save the Children, 2012). Women who breastfeed exclusively have high
tendency to experience natural contraception associated with lactation, and this helps to control
unplanned pregnancies that will pose stress on the family, environment and nation at large
(Brown & Sear, 2017). According to the United States Breastfeeding Committee (USBC), 2013,
employers who support breastfeeding are likely to reduce absenteeism by mothers calling in sick
to look after their babies. Bosses are at a higher risk to lose money due to training new staffs to
take over maternity leave positions.

REPORT ON AUSTRALIAN MATERNITY SERVICE; THE BREASTFEEDING POLICY 8
SOCIAL FRAMEWORK
The social environment for breastfeeding mothers such as her partner, family, and allies
play a role in forming a positive attitude towards initiating and sustaining the policy (York &
Hoban, 2013). The experiences other women relatives have undergone through while
breastfeeding their infants are significant in influencing breastfeeding behaviors of other mothers
especially the new mothers (Rollins et al., 2016). Grandmothers in specific have been found to
be vital in shaping young mothers to perform exclusive breastfeeding (Negin, Coffman, Vizintin
& Raynes-Greenow, 2016). The social network is essential to the breastfeeding mothers as it
means availing oneself to a reality that transforms biological aspects associated in the
breastfeeding process, which is not narrowed to the regular counselling about the convenience of
breastfeeding, but that is infused by essence and intentions (Souza et al., 2016). Indigenous
people benefit more from social support due to their lower socioeconomic status. About Seventy
per cent of Indigenous children from age 0- 3 years residing in homes with lower socioeconomic
ratio were breastfed 90% more than those in a higher socioeconomic proportion (Australian
Health Ministers conference, 2015).
OBJECTIVES AND GOALS IN IMPLEMENTING THE POLICY
According to the Australian Health Ministers conference, (2015), the objectives and goals
of breastfeeding are to increase the breastfeeding rate of infants from birth to six months of age,
while gradually introducing supplementary foods up to twelve months and beyond. Also,
develop universal acceptability and advocacy of breastfeeding. According to the NSW
Breastfeeding policy, the objectives are to maintain the current percentage of infants who are

REPORT ON AUSTRALIAN MATERNITY SERVICE; THE BREASTFEEDING POLICY 9
ever breastfed, to raise the rate of babies exclusively breastfed to six months and lastly to
increase the period of breastfeeding.
Furthermore, the goal is to give pertinent information and training of staffs to enable
them to promote, protect and reinforce breastfeeding. According to the Australian National
Breastfeeding Strategy (2015), the goals identified were to raise the community compliance of
breastfeeding as a cultural rule. Also, to encourage policymakers in the community to see the
relevance in breastfeeding and to serve as mentors to motivate mothers and families and to
empower breastfeeding mothers to make use of reserved public places, to enable them to
continue with their breastfeeding when out and about. What needs to be achieved is that
according to the international code of marketing of Breastmilk substitutes, it recommended that
Breastfeeding must be severely guarded and advocated in all countries and the government
taking measures to ensure that everyone has information on the merits of breastfeeding and is
supported in the use of this information. This can be achieved by law enforcement, training and
education of mothers, nurses etc., advocacy and appropriate support to those involved.
PRIORITIES
The priority group noticed for the breastfeeding policy is the indigenous women and
babies between six months to one year and beyond. Right from the initial stages of pregnancy,
the women qualify as a priority to this policy. Prior information about the infant breastfeeding
will enhance the successful implementation of the system for the benefits associated with the
adoption of the plan will persuade the women into adhering to it.
Resources

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The source of funding the implementation of the policy is the national government
through public funding by allocating some budget to the department of health. Besides the
finances, the other resources will be the midwives, children and family healthcare practitioners
who will disseminate the policy informant as well as facilitate its implementation. Creating
awareness among the Australian women and funding activities that promote the policy should
utilise these funds. Also, in the maternity facilities, the programs that enhance the
implementation of the procedure such as BFHI is to be supported by the government as well.
Timeframes
The women and children that enroll in the program require a minimum of two years to
enhance the comprehensiveness for infant breastfeeding as the policy postulates. The maternity
services are to incorporate the breastfeeding strategies to ensure that the mother and the infant
experience many steps during their stay in the hospital to enhance exclusive breastfeeding.
SEARCH FOR ALTERNATIVES
There is numerous evidence-based practice that amplifies the benefits of the
breastfeeding policy. The policy initiates a quality life for the infants and benefits the mother,
family and the society. Quality hospital maternity has been found to be critical in the successful
implementation of the breastfeeding policy (Wen et al., 2009). The information and services
provided at the initial stages of the postpartum period have a positive impact on breastfeeding in
the long term. Also, the WHO and UNICEF have devised ten guidelines for successful feeding
based on best evidence-based hospital practices which have been adopted by most maternity
facilities. Research has shown that the more the steps the mother is taken through, the higher the
possibility of leaving the facility after having exclusively breastfed. Furthermore, the experience

REPORT ON AUSTRALIAN MATERNITY SERVICE; THE BREASTFEEDING POLICY 11
increases the duration and intensity of breastfeeding after discharge (DiGirolamo, Grummer-
Strawn & Fein, 2008).
However, the success of this policy in the contemporary world depends on the quality of
information available on the internet. A professor of Pediatrics at the University of Colorado,
Maya Bunik, reiterates that many women that especially the new parents that go online to
sources for information are often misled. The misinformation affects the initiation and successful
continuation of breastfeeding (Bunik, 2017). Further, Bunik noted that there are 20.7 million
articles on breastfeeding whereby about 50% discredit the importance of the policy. She
highlighted the ten step private maternity practice as an evidence-based practice that should
extensively make available on this platform. Therefore, the internet is an excellent platform to
enhance the implementation of the policy only if agencies and organizations overseeing the
strategy regulate the information available.
Conclusion
The benefits of the breastfeeding policy cannot be overestimated. As highlighted above
its economic, social and environmental importance are tremendous. Channeling more efforts by
increasing resources and advancing the implementation frameworks will be pivotal to the success
of this policy. More importantly exclusive breastfeeding that is endorsed and propagated by the
NSW breastfeeding policy. The plan requires the participation of all the stakeholders since it is
for the overall well-being of the society. The BFHI enhances the implementation of this policy
through the maternity services offered in the healthcare facilities. Furthermore, the ten steps
formulated by the WHO and the UNICEF have proved to be one of the best evidence-based
practices that increase changes of exclusive feeding among women. Among the challenges faced

REPORT ON AUSTRALIAN MATERNITY SERVICE; THE BREASTFEEDING POLICY 12
in the establishment of the policy are the inadequacy of quality information and its effective
dissemination. In this technologically advanced world where information is easy to access, the
type of information obtained is crucial in determining the steps the mother is to take regarding
this policy. More research on the benefits of breastfeeding will be appropriate to complement the
already available benefits. Also, this information should be used to create awareness among the
public and not only the women. More groups in the society should be educated about the policy
to increase chances of the correct information being accessed. To speed the implementation of
the procedure the informal sector and their contributions should be acknowledged. For this
reason, their efforts can be complimented and be viewed as one of the critical agencies of the
policy. The breastfeeding system in the NSW has achieved great success so far through
incorporating various agents in both the informal and formal sector. However, there is still more
to be executed.

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