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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’s 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 was published on 14 July 2022.

Main points

  • Breastfeeding rates were at a record high, at all stages where data is collected.
  • More than 6 out of 10 mothers intended to breastfeed (64%) and actually breastfed at birth (63%).
  • Just over half of mothers breastfed at 10 days (52%) and just over a third at 6 weeks (37%).
  • 28% of babies were breastfed at 6 months and the rate improved by more than in any other age group compared to the previous year. Data collection at this age is affected by relatively low data coverage (30% of records with missing data).
  • Older mothers (aged 30 and above) had higher breastfeeding rates than younger mothers.
  • Mothers who gave birth at home had higher breastfeeding rates than those with hospital births.
  • First-time mothers were more likely to intend to breastfeed than mothers who had previously given birth.
  • Breastfeeding rates were highest for babies of black ethnic origin, at all stages at which data is collected.
  • Breastfeeding rates were lowest for babies of white ethnic origin, at all stages at which data is collected.

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 27,657 mothers who delivered in 2021, rather than children born in 2021.

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 28,879 live births in 2021. For breastfeeding at the other age points, data refers to the babies who became the reference age in 2021: 28,621 babies turned 10 days, 28,295 turned 6 weeks, and 27,945 turned 6 months. Only records with a known breastfeeding status are recorded in the rate calculations.

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Rates of breastfeeding at birth, 10 days, 6 weeks, 6 months, have all increased between the years 2014 and 2021.

Annual breastfeeding status at birth, live births to Welsh residents on StatsWales

Breastfeeding rates at all points of data collection show an upward trend over the short and longer term, and annual breastfeeding rates are the highest on record in 2021.

64.3% of all mothers intended to breastfeed prior to birth. This is 0.3 percentage points higher than the previous year and 1.7 percentage points higher than in 2017 (five-year change).

63.9% of babies were breastfed at birth. This is 0.4 percentage points higher than the previous year and 3.4 percentage points higher than in 2017.

52.4% of babies were breastfed at 10 days. This is 0.7 percentage points higher than the previous year and 5.4 percentage points higher than in 2017.

38.6% of babies were breastfed at 6 weeks. This is 1.2 percentage points higher than the previous year and 3.9 percentage points higher than in 2017.

27.5% of babies were breastfed at 6 months. This is 2.2 percentage points higher than the previous year and 4.7 percentage points higher than in 2017. 

Breastfeeding data at all points in time is subject to data quality issues as not all records are complete. In 2021, the percentage of complete records at each stage of data collection ranged from 97.7% for intention to breastfeed, to 70.2% 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 how many times mothers have previously given birth (parity), which can be analysed with their intention to breastfeed.

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Intention to breastfeed was higher in first time mothers than in mothers who had given birth before.

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

A higher percentage of first-time mothers intended to breastfeed their babies than mothers who have given birth before.

In 2021, 70% of first-time mothers (nulliparous) intended to breastfeed, compared to 63% of mothers who had given birth once previously (primiparous) intended to breastfeed, and 55% of mothers who had given birth more than once (multiparous) intended to breastfeed.

There is a marginal upward trend in the intention to breastfeed rate prior to birth for multiparous mothers, but little change over the last five years for the other categories.

Breastfeeding and age of mother

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In most age groups the percentage of mothers who breastfed at birth has increased between 2017 and 2021.

The breastfeeding rate at birth increased as the age of the mother increased.

In 2021, when only considering age groups where more than 100 births occurred, the highest rate of breastfeeding at birth was in the 35-39 age group where 73% of babies with a known breastfeeding status were breastfed. The lowest rate was the 16-19 age group where 35% of babies with a known breastfeeding status were breastfed.

The majority of age groups have a slight upward trend over the last five years, but the rate has decreased for mothers aged 16-19 in recent years.

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Breastfeeding rates decrease over time in mothers of all ages.

Breastfeeding by age of baby and age of mother on StatsWales

Chart 4 shows how breastfeeding rates change by the age of baby and age of the mother. The breastfeeding rates for all mothers’ age groups decrease with the age of the baby in a broadly uniform pattern.

Breastfeeding and place of birth

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At the wales level babies born at home were more likely to be breastfed at birth compared to those born in hospital, but the percentage for both has increased over the ten years.

Of those with a place of birth recorded, babies born at home have been more likely to be breastfed than those born in hospitals.

In 2021, 935 babies were born at home, and 78% were breastfed at birth. This compares to 27,827 babies born in hospital and 63% were breastfed at birth.

Note that in 2021, 53 babies’ place of birth was recorded as ‘born in transit’ while 64 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 ethnic group

Chart 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.

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Breastfeeding rates were higher for mothers of black, asian or mixed ethnicities, and these groups of mothers breastfed for longer.

Breastfeeding by age of baby and ethnic group on StatsWales

A higher percentage of black mothers intended to breastfeed, and a higher percentage of black babies were breastfed than any other ethnic group, at all stages at which data is collected.

The breastfeeding rate at 10 days was higher than at birth for black, Asian and other ethnic groups. Whereas the rates fell slightly for babies of mixed or multiple ethnicities and fell more sharply for babies of white ethnicity.

After 10 days the decrease in breastfeeding rates at 6 weeks and 6 months was similar for all ethnic groups other than the black ethnic group. This suggests a higher proportion of babies of black ethnic origin continued to be breastfed at older ages than babies of all other ethnic groups.

White mothers had the lowest intention to breastfeed rates and a lower percentage of white babies were breastfed than any other ethnic group at all stages at which data is collected.

Breastfeeding and number of babies

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Mothers of singleton babies were more likely to intend to breastfeed compared to mothers of multiple babies, but the percentage for both has increased since 2017.

A greater proportion of mothers who gave birth to one baby (64%) intended to breastfeed compared to mothers who had twins or triplets (58%).

The gap between the two groups has remained broadly consistent over the past five years, with some small year-to-year fluctuations.

Quality and methodology information

All data used in this release is published on StatsWales or as an Excel table. All Excel tables are in the process of being moved onto StatsWales.

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 2021, was as follows: 97.7% for intention to breastfeed; 88.7% at birth; 87.8% at 10 days; 74.0% at six weeks; and 70.2% 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 166/2022

National statistics