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Introduction

The purpose of this release is to provide a statistical overview of breastfeeding in Wales including analyses of mothers’ characteristics. The data and analyses are used to inform Welsh Government’s maternity policy development and the All Wales breastfeeding 5 year action plan. This release also provides data to support the Wellbeing of Future Generations Act 2015 which states that every child in Wales should receive the best start in life.

Data in this release is sourced from Maternity Indicators dataset (MI ds) for mothers’ intention to breastfeed and from the National Community Child Health Database (NCCHD) for breastfeeding at all other ages.

Complimentary statistics on maternity and births will be published on 9 August 2023.

Main points

The longer-term trend of increasing breastfeeding rates at all points in time at which data is collected levelled off in 2022. There were slight decreases in the rates for mother’s intention to breastfeed, and for babies breastfed at birth and 6 months. However, there were marginal increases in the rate of babies breastfed at 10 days and 6 weeks, which were both the highest on record.

First-time mothers continued to report higher rates of intention to breastfeed than mothers who had previously given birth. But in 2022, the rate decreased for first-time mothers and increased for mothers with one previous birth, meaning the gap between both groups reduced to its smallest difference on record (3 percentage points). 

The breastfeeding rate at birth increased as the mothers age group increased. The rate at birth for children whose mothers were aged 35 or older was 31 percentage points higher than those whose mothers were aged 19 or younger.

While a higher percentage of mothers in older age groups breastfed at birth, the rate at which breastfeeding decreased as the child’s age increased was similar for all age groups. The rate for 6-month-old children whose mothers were 35 or older was 30 percentage points higher than those whose mothers were aged 19 or younger.

The breastfeeding rate for children who were born at home was 12 percentage points higher than children born in hospital.

Breastfeeding rates at birth were the same for Black and Asian babies, but 24 percentage points higher than the rate for White babies.

Breastfeeding rates for Black children were higher at 10 days, 6 weeks, and 6 months than in any other ethnic group. The breastfeeding rate did not decrease until the 6 month age group.

Breastfeeding rates for those from a White ethnic group were the lowest at all age points. The breastfeeding rate for Black children was around three times higher than it was for White children at both 6 weeks and 6 months.

Breastfeeding and age of child

The Maternity Indicators dataset records a mother’s intention to breastfeed prior to birth. Since this data refers to the mother, data presented refers to the 27,163 mothers who delivered in 2022, rather than children born in 2022.

Data for breastfeeding at birth and for babies turning 10 days, 6 weeks and 6 months are recorded in the National Community Child Health Database and refers to records where there was any breastfeeding. This includes babies fed with solely breastmilk and those who were combination fed.

For breastfeeding at birth, the data refers to the 28,388 live births in 2022. For breastfeeding at the other age points, data refers to the babies who became the reference age in 2022: 28,281 babies turned 10 days, 28,499 turned 6 weeks, and 29,009 turned 6 months. Only records with a known breastfeeding status are recorded in the rate calculations.

Figure 1: Intention to breastfeed and breastfeeding at birth, 10 days, 6 weeks, 6 months, 2014 to 2022 [Note 1] [Note 2]

Image

Description of Figure 1: Line chart showing that rates of breastfeeding at birth, 10 days, 6 weeks, 6 months, have all increased steadily over the past 7 or 8 years.

Source: Maternity Indicators dataset, National Community Child Health Database

Breastfeeding by age of baby and health board on StatsWales

[Note 1] Percentages are of the total records less records with no stated breastfeeding status: In 2022 there were no data for breastfeeding for 588 records at intention; 2,010 records at birth; 2,597 records at 10 days; 6,718 records at 6 weeks; and 8,527 records at 6 months.

[Note 2] Breastfeeding rates at birth are available from 2002 on StatsWales. Data for all other age points is available from 2014 or later only.

[Note 3] The denominator for percentage calculations at each point are: the number of women due to give birth for 'Intention to breastfeed'; all live births for 'birth'; and of babies turning the reference age for all other age points.

In 2022, nearly two thirds (63.7%) of all mothers intended to breastfeed prior to giving birth. This percentage has remained broadly stable over the longer term but decreased by 0.6 percentage points since the previous year.

Similarly, nearly two thirds (63.3%) of babies were breastfed at birth. The percentage has been on an upward trend over the longer term and is 1.6 percentage points higher than five years ago, but the trend has levelled off in recent years and decreased by 0.6 percentage points since the previous year.

A little over half (52.5%) of babies were breastfed at 10 days. The percentage has been on an upward trend over the longer term and is 4.3 percentage points higher than five years ago. The percentage increased marginally (less than 0.1 percentage points) since the previous year and is the highest on record.

A little fewer than 4 out of 10 (38.7%) babies were breastfed at 6 weeks. The percentage has been on an upward trend over the longer term and is also 4.3 percentage points higher than five years ago. The percentage increased marginally (0.1 percentage points) since the previous year and is the highest on record.

Just over a quarter (26.2%) of babies were breastfed at 6 months. The percentage had been on an upward trend over the longer term and is 4.1 percentage points higher than five years ago; however, the percentage decreased by 1.2 percentage points since the previous year.

Breastfeeding data at all points in time are subject to data quality issues as some mothers and babies have incomplete records. In 2022, the percentage of complete records at each stage of data collection ranged from 97.8% for intention to breastfeed, to 70.6% at six months. Breastfeeding data after birth is collected when children have health visitor and GP appointments through the Health Child Wales Programme. If a child does not receive a contact, their breastfeeding data may be missing at that contact point.

In addition to annual data, quarterly breastfeeding data with data completeness percentages are published on StatsWales, by local health board.

Breastfeeding and parity

The Maternity Indicators dataset records the number of times pregnant women have previously given birth (parity), which can be analysed with their intention to breastfeed.

Figure 2: Intention to breastfeed by number of times mothers had previously given birth (parity), 2017 to 2022 [Note 1]

Image

Description of Figure 2: Line chart showing that intention to breastfeed has been higher for first time mothers throughout the time series, but the percentage fell in the most recent year. The percentage has been lowest for mothers who have had multiple previous births, throughout the time series.

Source: Maternity Indicators dataset

Intention to breastfeed by number of times mothers had previously given birth (parity) on StatsWales

[Note 1] Percentages are of the total deliveries less births with no stated intention to breastfeed status. There were: 792 births with no data in 2017; 774 in 2018; 684 in 2019; 569 in 2020; 641 in 2021; 588 in 2022.

In 2022, 67.7% of first-time mothers (nulliparous) intended to breastfeed, compared to 64.5% of mothers who had given birth once previously (primiparous) intended to breastfeed, and 54.1% of mothers who had given birth more than once (multiparous) intended to breastfeed.

The intention to breastfeed rate for nulliparous mothers had been broadly stable since 2016, but decreased 1.9 percentage points in 2022 compared to the previous year. In contrast the rate for primiparous mothers has been on slight upward trend over the past four years and increased by 1.0 percentage points in the 2022. The rate for multiparous mothers has remained broadly stable over the past three years but decreased by 0.9 percentage points in 2022.

Breastfeeding and place of birth

Figure 3: Percentage of live births breastfed at birth by place of birth, 2013 to 2022 [Note 1]

Image

Description of Figure 3: Line chart showing that a higher percentage of babies born at home were breastfed at birth compared to those born in hospital, but the percentage for both has increased at a similar rate over the past ten years.

Source: National Community Child Health Database (NCCHD)

Breastfeeding at birth by place of birth and health board on StatsWales

[Note 1] Percentages are of the total live births minus births with no stated breastfeeding status at birth: 7% (1,885) had no stated breastfeeding status for hospital births; 12% (70) had no stated breastfeeding status at birth for home births in 2022.

In 2022, of the 600 babies born at home, 74.9% were breastfed at birth. This is a decrease of 2.8 percentage points from the previous year but is 10.0 percentage points higher than ten years ago.

Of the 27,657 babies born in hospital, 63.1% were breastfed at birth. This is a marginal decrease of 0.4 percentage points from the previous year but is 7.4 percentage points higher than ten years ago.

Note that in 2022, 51 babies’ place of birth was recorded as ‘born in transit’, while 80 had no stated place of birth.

Additional breastfeeding data for babies born in Neonatal Units (born at less than 33 weeks gestation) is published in the National Neonatal Audit Programme (NNAP) 2020 Annual Report, and shows that for 2020, 50% of babies born under 33 weeks in Welsh Neonatal Units were discharged from the units having received some breast milk. This was lower than in 2019 when the rate was 53%. 

Breastfeeding and age of mother

Figure 4: Breastfeeding at birth by mothers’ age group, 2016 to 2022 [Note 1] [Note 2]

Image

Description of Figure 4: Line chart showing breastfeeding rates at birth in older mother’s age groups has been consistently higher than in younger mother’s age groups. Rates in most mother’s age groups have remained broadly similar since 2016, with slight upward trends in mothers aged under 20 and mothers aged 25 to 29.

Source: National Community Child Health Database (NCCHD)

Breastfeeding by age of baby and age of mother on StatsWales

[Note 1] Percentages are of the total births less births with no stated breastfeeding status at birth: 3,028 births in 2016, 2,029 births in 2017, 1,425 births in 2018, 1,830 births in 2019, 2,100 births in 2020, 3,262 births in 2021, 2,010 births in 2022 had no stated breastfeeding status at birth.

[Note 2] There are a small number of births (less than 100) to mothers aged under 16 and 45 or over, therefore data for these categories is subject to large year-to-year volatility. 

In 2022, more than seven out of ten (72.6%) babies whose mother was aged 35 or older were breastfed. The rate decreased in each age category, where a little more than six out of ten (61.0%) babies were breastfed where the mother was aged 25 to 29, and a little more than four out of ten (41.3%) babies were breastfed where the mother was under 20.

Figure 5: Breastfeeding by mothers’ age group and age of baby, Wales, 2022 [Note 1]

Image

Description of Figure 5: Line chart showing that while breastfeeding rates were higher in the older age groups, the reduction in breastfeeding rates as the child gets older is similar across all age groups.

Source: Maternity Indicators dataset, National Community Child Health Database (NCCHD)

Breastfeeding by age of baby and age of mother on StatsWales

[Note 1] Percentages are of the total records less records with no stated breastfeeding status: In 2022 there were no data for breastfeeding for 588 records at intention; 2,010 records at birth; 2,597 records at 10 days; 6,718 records at 6 weeks; and 8,527 records at 6 months.

Between birth and 10 days, breastfeeding rates decreased by close to 10 percentage points for all age groups apart from mothers aged under 20 which fell decreased by 16 percentage points.

Between 10 days and 6 weeks, breastfeeding rates decreased by close to 14 percentage points for all age groups.

There was more variation in the decrease of breastfeeding rates between 6 weeks and 6 months, with the decrease ranging from 7 percentage points in mothers aged under 20, to 14 percentage points for mothers aged 30 to 34.

Breastfeeding and ethnic group

Figure 6 shows how breastfeeding rates differ between ethnic groups. Intention to breastfeed is based on the ethnic group of the mother, whereas breastfeeding rates at other points in time refer to the ethnic group of the baby.

Figure 6: Breastfeeding by ethnic group and age of baby, Wales, 2022 [Note 1]

Image

Description of Figure 6: Line chart showing that breastfeeding rates were higher for people of Black, Asian or Other ethnicities. The rates at which breastfeeding changed with the age of the child were different by ethnic group.

Source: Maternity Indicators dataset, National Community Child Health Database (NCCHD)

Breastfeeding by age of baby and ethnic group  on StatsWales

[Note 1] Percentages are of the total records less records with no stated breastfeeding status: In 2022 there were no data for breastfeeding for 588 records at intention; 2,010 records at birth; 2,597 records at 10 days; 6,718 records at 6 weeks; and 8,527 records at 6 months.

Breastfeeding rates for in the Black ethnic group were higher than any other ethnic group for all children’s age points from birth to 6 months. Close to 9 in 10 Black children were breastfed at age 10 days and 6 weeks, and more than 7 in 10 black children were breastfed at age 6 months.

The trend for Asian and Other ethnic groups was similar at all children’s age points. Asian mothers had the highest intention to breastfeed rates (83.2%), and at least 7 out of 10 Asian and other ethnic group children breastfed at 6 weeks. The rate decreased for children aged 6 months in both groups to 50.6% for children of Other ethnic groups and 44.6% for Asian children.

Just more than 7 out of 10 mothers of Mixed or multiple ethnicity intended to breastfeed and the same proportion of Mixed or multiple ethnicity children were breastfed at birth. The breastfeeding rate decreased at all age points after birth, and a little over a third (36.8%) of children from Mixed or multiple ethnicities breastfed at 6 months.

Breastfeeding rates for the White ethnic group were lower than any other ethnic group at all points at which data was collected. Close to 6 out of 10 mothers intended to breastfeed and a similar proportion of white children were breastfed at birth. The rate decreased to just less than half of White children breastfed at age 10 days (48.1%), a third (34.3%) breastfed at age 6 weeks, and just less than a quarter (23.3%) breastfed at age 6 months.

Breastfeeding and number of babies

Figure 7: Intention to breastfeed by number of babies, Wales, 2016-2022 [Note 1] [Note 2] 

Image

Description of Figure 7: Line chart showing a slightly higher percentage of mothers of singleton babies intended to breastfeed compared to mothers of multiple babies since 2016. The percentage has increased modestly over time for the multiple group but has been broadly stable for the singleton group.

Source: Maternity Indicators dataset

Intention to breastfeed by number of babies on StatsWales

[Note 1] Percentages are of the total records minus records with no stated breastfeeding status: 2% (558) had no stated breastfeeding status for singleton births; 8% (30) had no stated breastfeeding status at birth for multiple births in 2022.

[Note 2] Singleton refers to a single baby born; multiple refers to twins, triplets or more babies born through a single pregnancy.

63.8% of mothers who gave birth to one baby intended to breastfeed in 2022. This is 0.6 percentage points lower than the previous year and unchanged from the rate five years ago.

59.5% of mothers who gave birth to multiple children (twins or triplets) intended to breastfeed in 2022. This is 1.8 percentage points higher than the previous year and 3.3 percentage points higher than the rate five years ago.

Quality and methodology information

All data used in this release is published on StatsWales and more detailed information on the sources of data and analyses in this statistical release are provided in the quality report.

Quality of specific data items

Not all records on the Maternity Indicators data set and the National Community Child Health Database have complete records for breastfeeding status. The completeness rate decreases with the age of the baby and in 2022, was as follows: 97.8% for intention to breastfeed; 92.9% at birth; 90.8% at 10 days; 76.4% at six weeks; and 70.6% at 6 months.

A completeness table for all data items used in this release from both data sources is available in the quality report.

Well-being of Future Generations Act (WFG)

The Well-being of Future Generations Act 2015 is about improving the social, economic, environmental and cultural wellbeing of Wales. The Act puts in place seven wellbeing goals for Wales. These are for a more equal, prosperous, resilient, healthier and globally responsible Wales, with cohesive communities and a vibrant culture and thriving Welsh language. Under section (10)(1) of the Act, the Welsh Ministers must (a) publish indicators (“national indicators”) that must be applied for the purpose of measuring progress towards the achievement of the wellbeing goals, and (b) lay a copy of the national indicators before Senedd Cymru. Under section 10(8) of the Well-being of Future Generations Act, where the Welsh Ministers revise the national indicators, they must as soon as reasonably practicable (a) publish the indicators as revised and (b) lay a copy of them before the Senedd. These national indicators were laid before the Senedd in 2021. The indicators laid on 14 December 2021 replace the set laid on 16 March 2016.

Information on the indicators, along with narratives for each of the wellbeing goals and associated technical information is available in the Wellbeing of Wales report.

Further information on the Well-being of Future Generations (Wales) Act 2015.

The statistics included in this release could also provide supporting narrative to the national indicators and be used by public services boards in relation to their local wellbeing assessments and local wellbeing plans.

Contact details

Statistician: Craig Thomas
Email: stats.healthinfo@gov.wales

Media: 0300 025 8099

SFR 57/2023

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