Australian National Breastfeeding Strategy 2010-2015

4.1 Jurisdictional stocktake

Page last updated: 15 July 2010

The Australian and state and territory governments have a range of breastfeeding activities in place. Breastfeeding policy and programs are spread across a number of areas within the health system such as nutrition, health promotion, infant/child and maternal health, health surveys and statistics, and community health and hospital settings. Responsibilities are shared between various levels of government, non-government organisations and the private health sector. The Australian National Breastfeeding Strategy seeks to achieve greater coordination and integration of breastfeeding efforts across Australia.

An important component of the developmental work for the Australian National Breastfeeding Strategy was identifying areas of excellence, and gaps and opportunities for improvement by completing a stocktake and mapping exercise of breastfeeding related activities. This included the exploration and analysis of information about existing policies, programs, and initiatives, and evaluation findings from past and present programs.

Key findings from the jurisdictional stocktake include:

  • Some jurisdictions, such as New South Wales, South Australia and Queensland, have a more comprehensive approach and are guided by an overarching policy or framework. Others include breastfeeding as a focus within broader public health policy such as Tasmania’s Food and Nutrition Policy. Some jurisdictions have a less formal or coordinated approach, and still others, such as Victoria are exploring the possibility of developing an action plan pursuant to the Australian National Breastfeeding Strategy.

  • Several states and territories such as Tasmania, Western Australia and New South Wales have appointed bodies that coordinate breastfeeding policies and programs and facilitate collaboration between government and non-government organisations.

  • All states and territories offer educational and promotional material that captures antenatal and post birth information, with the majority directed towards pregnant women.

  • South Australia and Queensland have current experience with mass media breastfeeding social marketing campaigns.

  • Support programs appear to account for a large proportion of state and territory assistance to breastfeeding mothers at the postnatal stage. Support is offered in different ways across the country. Support to mothers in the community appears to be a focus.

  • There are three Aboriginal and Torres Strait Islander specific programs funded by the Australian Government Department of Health and Ageing with a focus on improving maternal and child health:

    • Healthy for Life Program provides the necessary funding for primary health care services to increase capacity by employing additional staff, developing better infrastructure and improving data collection in the areas of child and maternal health services, men’s health and chronic disease care. The program also has a focus on increasing participation in the Indigenous health workforce.

    • New Directions Mothers and Babies Services provides Aboriginal and Torres Strait Islander children and their mothers with increased access to antenatal care, standard information about baby care, practical advice and assistance with parenting, nutrition and breastfeeding; monitoring of developmental milestones, immunisation status and infections, and health checks and treatment for Indigenous children before starting school.

    • Australian Nurse Family Partnership Program (ANFPP) provides regular nurse home-visiting services to mothers pregnant with an Aboriginal or Torres Strait Islander child. The services include step-by-step life course guidance and education, rather than clinical services. This program is highly dependent on referring patients to existing programs in the community (e.g., smoking cessation programs, antenatal programs and clinics, substance abuse treatment programs, early learning centres, and playgroups). The program directly integrates and is complementary to the services provided under the Healthy for Life and New Directions Mothers and Babies programs.

  • A 2004 evaluation of the New South Wales Aboriginal Maternal Infant Health Strategy (AMIHS) found that the service provision model was associated with improved breastfeeding rates, particularly in locations where there was high intensity contact with women in the antenatal and postnatal period with home visits and support.

  • The stocktake did not provide significant information on activities specifically targeting other priority groups. This may have been because some of these activities are very small, and are funded or delivered by non-government organisations, with or without government funding. Alternatively, this may be because few exist.

  • The Australian, state and territory governments work closely with non-government organisations, in particular the Australian Breastfeeding Association. The Australian Breastfeeding Association provides a range of programs across the country. A key feature of this activity is the National Breastfeeding Helpline (1800 MUM 2 MUM), which provides toll-free 24 hour breastfeeding information and peer support. The Breastfeeding Helpline, funded by the Australian Government, received in excess of 58,000 calls between October 2008 and July 2009. More than 200 trained peer support volunteer breastfeeding counsellors staffed the helpline in that time. Survey results indicate that most callers (96.1 per cent) are mothers, almost half are between the ages of 30-34 years, and most have only one child. Seventy seven percent of respondents identified themselves as being born in Australia and almost 80 per cent of callers were from metropolitan areas. Work is underway to expand the promotion and marketing of the helpline.

  • The Get Up & Grow: Healthy Eating and Physical Activity for Early Childhood (2009) guidelines promote breastfeeding after returning to work and provide guidance on supporting breastfeeding in childcare settings.

  • Different members of the workforce are trained in different ways to varying extents and there is no consistency across states and territories. The Australian Government is funding the Australian Breastfeeding Association to enhance training and education opportunities for breastfeeding counsellors and health professionals across Australia. A number of jurisdictions provide electronic learning modules or subsidised training opportunities for health service staff. There are also some relevant university courses and offerings from private commercial providers.

  • Very few breastfeeding programs appear to be evaluated.

  • Monitoring of breastfeeding rates is conducted by all jurisdictions to varying extents. However, it is not well coordinated across the country.