Breastfeeding, Malta 2002

Abstract

Although the scientific and economic benefits in support of breastfeeding over formula feeds is overwhelming, Malta retains one of the lowest rates for breastfeeding in almost all developed and several under-developed countries. Recently, this rate had begun to improve: from just 45% of maltese mothers breastfeeding (exclusively or mixed feeding) at the time of discharge from St. Luke's Hospital in 1995, to 64% in 2000. Nevertheless, this improvement was not sustained and only 18% of maltese mothers were still exclusively or partbreastfeeding 9 months after delivery in 2000. Of greater concern is the apparent reversal of the improving trend with a decrease to 56% total/partial breastfeeding at discharge from hospital in the first half of 2002. This article reviews the reasons for these low rates and discusses the efforts being made to improve the situation. Organisation (WHO), amongst others. National health departments have, in the main but with varying commitment, taken on this responsibility with the establishment of national breastfeeding committees and programmes. Malta is no exception, although the changing trend toward breastfeeding has yet to gather momentum and the breastfeeding rate remains bottom of the European league table. Indeed, as shown in table 1, in 1995 just 45% of maltese mothers breastfed (including exclusive breast or mixed feeding) at the time of discharge from St. Luke's hospital 3, and that this rate dropped precipitously to 20% by the first month of life 4. The rates for gozitan mothers were approximately 5-10% less, whereas those for infants born in private institutions approximately 10-20% higher. These figures had improved in 2000, when up to 64% of mothers offered their newborns either exclusive breast milk or mixed feeds on discharge from the maternity unit at St. Luke's3 . Disappointingly, this improvement was not sustained and, of this cohort in 2000, 35% still exclusively or part-breastfed 2 months after delivery, and just 18% seven months later4. Furthermore, the breastfeeding rate at discharge has since dropped further to 56% in the first six months in 20023 . These dismal figures stem from several factors and can only improve with widespread changes in socio-cultural attitudes, national education and support facilities in the hospital, home and at work. This article discusses those issues that need to be addressed if the percentage of maltese infants receiving the benefits of breast milk is to increase.