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Report on National Survey into Factors Influencing Breastfeeding

CDRF released the Report on National Survey into Factors Influencing Breastfeeding on February 25. The Report was based on the “National Survey of Factors Influencing Breastfeeding” conducted by the CDRF in 2017, and its subjects encompassed mothers of 10,223 children under one year old in 12 urban and rural areas. This survey was also the first nationwide comprehensive survey on the factors influencing breastfeeding in China.



  According to the survey results of the Report, the rate of exclusive breastfeeding for the first 6 months of life was only 29.2%, which still fell short of the goal of 50% by 2020 set forth in the Outline for the Development of Chinese Children (2011-2020) and the National Nutrition Plan (2017-2030), and was far below the world average of 43% and the average level of 37% in low- and middle-income countries.


The survey observed that manufacturers and sellers of breast-milk substitutes promoted such substitutes to mothers and families of infants through a wide range of channels, thereby substantially increasing the chance that mothers of infants would feed their infants 0-6 months old with formula by 30.8 percentage points while decreasing that of exclusive breastfeeding by 11.2 percentage points.


To solve this problem, Fang Jin, Deputy Secretary General of the CDRF, called for dedicated legislation to strictly curb the sales of breast-milk substitutes, with a view to closing the legal loopholes caused by the abolition of the Measures for Administration of Breast-milk Substitutes, comprehensively and effectively regulating the sales market of breast-milk substitutes, and eliminating the negative impact of marketing breast-milk substitutes on breastfeeding. In the meantime, efforts should be stepped up in the enforcement of the Advertising Law, and prohibition should be imposed on any advertisement on mass media or public places for dairy products, beverages and other foods for infant that are claimed to be able fully or partially replace breast milk.


The survey identified that apart from promotion of breast-milk substitutes, breastfeeding in China was also restricted by several factors.


First, public awareness of breastfeeding is insufficient. Nearly half of the mothers of infants do not know that babies under 6 months of age should be breastfed, and more than half of them are not aware of the potential health risks of infant formula and the benefits of breastfeeding to both mothers and children.


Second, there is an urgent need for medical and health institutions to strengthen breastfeeding education and support. The rate of receiving breastfeeding education provided by health-care institutions for pregnant women is 68.1%. The proportion of infants with early skin-to-skin contact (SSC) and early initiation of breastfeeding is only 11.3%, which is far lower than the world average of 45%. In case of difficulties in breastfeeding, less than half of mothers would seek professional medical staff for help.


Third, the relatively short maternity leave inhibits mothers of infants from continuing breastfeeding after they return to work. 86% of mothers of infants entitled paid maternity leave can take less than 6 months of maternity leave. Mothers who have returned to work within 6 months are significantly more likely to wean their children or use infant formula or other complementary foods as breast-milk substitutes than mothers who have not yet returned to work.


Fourth, breastfeeding facilities in workplaces and public places are insufficient. 32.8% of formally employed mothers are not entitled to one-hour breastfeeding break a day. Only 19% of workplaces set up lactation rooms, which dismally fails to meet the need of mothers of infants for continuing breastfeeding after they return to work.


Fifth, there are significant regional differences in the status of breastfeeding. There are dramatic regional differences in exclusive breastfeeding rates in large cities, small and medium cities, and rural areas, which are 35.6%, 23.3%, and 28.3%, respectively. As the market for infant formula has been shrinking in recent years, small and medium cities, and rural areas have increasingly become the primary growth engines for sales of infant formula, which has also produced considerable impact on breastfeeding in these areas.


To resolve the above problems, Fang Jin recommended adopting an array of measures to enhance the status of breastfeeding in China. For a start, it is of great necessity to increase the public awareness of breastfeeding knowledge by strengthening the publicity of breastfeeding knowledge and skills. Second, medical and health institutions should play a pivotal role in providing mothers of infants with all-round breastfeeding education and professional technical support for mothers of infants before, during and after childbirth. Additionally, national laws should stipulate that maternity leave be extended to 6 months, so as to provide better institutional guarantee for mothers of infants to practice exclusive breastfeeding in the first 6 months of life. Meanwhile, employers should be encouraged to provide support for breastfeeding, such as setting up lactation rooms and allowing lactating female employees to work with a flexible schedule, so as to ensure that lactating mothers can continue breastfeeding after returning to work.


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