Obviously a single document will not cause problems that have existed for generations, to vanish overnight.  As I understand it, every primary care trust (PCT) in the UK now *must* do something to improve BF rates, including as a bare minimum going Baby-Friendly, and enabling peer support by having schemes to *pay* peer supporters in every district.  

I believe this last point will serve as a corrective that will do much to strengthen the remand on health visitors (and midwives and GPs) to improve their own practice, as will the very comprehensive training health visitors are receiving in connection with implementation of the UK-WHO growth charts.  Training of the peer supporters is being conducted by highly qualified people from the voluntary sector.  This means that the Dept of Health recognizes that health visitors are not in possession of the necessary skills and knowledge to do this, and that voluntary organizations are.  

To my knowledge this is unprecedented in the world.  For once, a country with dismal BF rates has made a decision at the highest level of policy-making, to do something meaningful to improve the situation and they seem to have tried to anticipate the usual pitfalls and made plans to avoid them.

PCTs have their performances rated annually, and the results for all PCTs are published.  One of the outcomes on which performance is based, is BF rates at 6-8 weeks.  It will be incumbent on each and every PCT to do what needs to be done to increase that number, and there are incentives in place with that in mind.  (In comparison, Norway has stopped collecting national data on breastfeeding rates after discharge from hospital; any district may do so if it likes but there is nothing to compel them to, something those of us working with breastfeeding find astonishing.)

Of course change will take time, since this is an area where one-to-one contact between health services staff and mothers is the main arena for action.   I choose to rejoice at a plan that seems to me well thought out and clear in its goals and in its implementation scheme, in accordance with the magnitude of the problem it aims to solve.  

Rachel Myr
still digesting the events of the weekend, spent hosting the yearly national meeting of Ammehjelpen here in Kristiansand, appreciating my local chapter of Ammehjelpen, and picking the brain of Magda Sachs who is standing in my study as I write this post

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