There are internationally recommended terms defining breastfeeding practices which are used to guide breastfeeding data collection and reporting (WHO 2008). These can be summarised as:
- Exclusive breastfeeding requires that the infant receive only breast milk (including expressed milk) and medicines (including oral rehydration solutions, vitamins and minerals) but no infant formula or non-human milk.
- Predominant or ‘full’ breastfeeding has a slightly less stringent definition as in addition to breast milk and medicines the infant may receive water, or water-based drinks, tea or fruit juice (which are not recommended for babies) but no non-human milk or formula.
- Complementary feeding or partial breastfeeding requires that the infant receive solid or semi-solid food in addition to breast milk, including expressed milk. This may include any food or liquid, including non-human milk and formula.
- Breastfeeding or ‘any’ breastfeeding includes all of the above definitions.
- Ever breastfed means that the infant has been breastfed or received expressed breast milk or colostrum, at least once.
ProtectionBreastfeeding protection is about enabling mothers to breastfeed their babies and young children anywhere a mother and child have a right to be, with confidence and without harassment. Breastfeeding protection includes legislative and regulatory environments, leave and employment entitlements, and the creation of baby and breastfeeding friendly environments in the health system and broader community. There is some overlap between the concepts of breastfeeding protection and promotion.
PromotionBreastfeeding promotion includes but is not limited to education and social marketing. Overlap can occur with breastfeeding protection and support. The Australian National Breastfeeding Strategy recognises the many facets of health promotion and defines breastfeeding promotion in this context:
A combination of educational, organisational, economic and political actions designed with consumer participation, to enable individuals, groups and whole communities to increase control over, and to improve their health through attitudinal, behavioural, social and environmental changes (Howat et al. 2003).
In keeping with the spirit of the Ottawa Charter for Health Promotion (WHO 1986) the Australian National Breastfeeding Strategy is designed to create an enabling culture for change by strengthening community action, reorienting health services, building healthy public policy, creating supportive environments, and developing personal skills.
SupportSupport is defined within the Australian National Breastfeeding Strategy as support provided to mothers at the antenatal and postnatal stages, for both breastfeeding initiation and maintenance. This support may take the form of verbal advice, physical assistance (e.g., to help the mother and baby establish good positioning and attachment) or infrastructure, such as publicly available breastfeeding rooms or workplace facilities.
Breastfeeding support encompasses training provided to breastfeeding support staff, including doctors, midwives, pharmacists, nurses and International Board Certified Lactation Consultants, as well as voluntary counsellors, Aboriginal Health Workers and support workers. Support activities target a range of groups such as first-time mothers, mothers with other children, workplaces, health facilities, partners, grandparents, extended family, and peers. It should target Aboriginal and Torres Strait Islander, young, culturally and linguistically diverse, and low socio economic status women, their partners or families.
Support can be provided from a range of different sources, including health professionals, trained peer counsellors, family members, friends, Aboriginal matriarchs and community leaders and Elders. The Australian National Breastfeeding Strategy differentiates between peer and lay support:
- peer support is provided by people who usually have had some experience in breastfeeding, and have received a level of specific training to assist in their support role (Shealy et al. 2005). A good example of peer support is the counselling and assistance provided through the Australian Breastfeeding Association national 24 hour toll-free Breastfeeding Helpline available on 1800 MUM 2 MUM (1800 686 2 686).
- lay support is provided by other mothers, family members or friends who may have some experience in breastfeeding but have not received any formal training.