Guest blog: Blackburn with Darwen: Celebrating the Breastfeeding Friendly Borough

Guest blog: Blackburn with Darwen: Celebrating the Breastfeeding Friendly Borough

In our latest guest blog, we hear from Donna Butler, Baby Friendly Lead at East Lancashire Hospital Trust, about the journey and success of Blackburn with Darwen becoming a Breastfeeding Friendly Borough.

Working in partnership with the Local Authority, the Baby Friendly Team in Blackburn with Darwen (BwD), led on the journey to becoming a Breastfeeding Friendly Borough as part of the 2017-2020 Eat well Move More Strategy. The strategy focused on the impact inequalities have on lifestyle choices, and the social, environmental and economic factors that impact overweight and obesity levels, with the vision ‘for everyone in BwD to move more, eat well and maintain a healthy weight’.

Evidence suggests breastfeeding has lifelong health benefits, including reduced risk of childhood obesity and obesity later in life. Breastfeeding also reduces the risk of infections, asthma, allergies and of type 2 diabetes [1]. For mother, evidence suggests breastfeeding can reduce the risk of breast and ovarian cancer and post-natal depression [2].

Compared to the England average, BwD has significantly lower rates of breastfeeding uptake and sustaining breastfeeding [3]. Breastfeeding rates fall by nearly half from around 76% at birth to 40% at 6 weeks. In response to the low breastfeeding rates, in 2018, BwD became a Breastfeeding Friendly Borough in a bid to improve uptake and continuation rates. In England, including BwD, many mothers stop breastfeeding due to lack of confidence about public feeding, and the influence of a formula feeding culture. The Equality Act (2010) supports BwD’s aim to ensure mothers feel confident to breastfeed anywhere, ensuring babies receive the best start in life, and to help mothers continue to breastfeed for longer.

By working collaboratively in BwD to become a Breastfeeding Friendly Borough, we have achieved the following:

  • Since 2017, a steady increase in 6–8-week continuation rates from 43% up to 49%
  • Promotional billboards installed in June 2018 led to an increase in breastfeeding initiation rates from average of 70% up to 82%, 84% and 80% in the following 3 quarters
  • Consistent continuation rates through the pandemic have remained at an average of 48% – this is due to consistent care plans including the 1st care plan to support a COVID+ woman to continue to breastfeed her baby
  • All core health and social care staff receive education on the benefits of breastfeeding for mother and baby along with the wider societal benefits, and how best to support a breastfeeding mother
  • Education and awareness raising within the community with ‘breastfeeding welcome stickers’, promoting breastfeeding in local leisure centres, restaurants, shopping centres, schools, nurseries, cafes, hairdressers, museums and libraries
  • Supporting local businesses to provide an encouraging environment for mothers to continue breastfeeding when they return to work by providing supporting resources for businesses to use, including a draft return to work policy
  • Engaging with local public transport agencies to ensure breastfeeding mothers feel welcomed to feed their babies on public transport
  • Supporting council buildings and health settings to be breastfeeding friendly, including engagement with Dentists, Pharmacies, GP practices and health centres
  • Challenging the ‘bottle feeding’ culture amongst targeted groups by utilising a mother centred / motivational conversation approach during pregnancy

In 2017, BwD’s maternity, health visitors and children’s centres became the first in the country to receive the UNICEF GOLD Baby Friendly Accreditation, which helped build a strong foundation for the sustained work around breastfeeding in the borough, and increased breastfeeding initiation rates from 27% in 1991 to 80% to date. Promotional work included a photoshoot with local mothers to display images of breastfeeding mothers in recognisable places across the borough, two permanent ‘Welcome to our breastfeeding friendly town’ signs and an official ‘unveiling’ followed during Breastfeeding Awareness Week including a social media programme themed around COVID recovery and the protective effects of breastfeeding in boosting immunity and reducing obesity. During Breastfeeding Awareness Week in June 2022, community celebration events took place to mark the Borough’s achievement in gaining a highly commended Local Government Chronicle Award (LGC) which recognises the collaborative and innovative work that has enabled more mums to breastfeed for longer in Blackburn with Darwen.

Public Health Outcomes Framework data shows that almost nearly 80% of babies born in BwD receive breastmilk as their first feed and continuation has increased by 55%. Despite a challenging few years for supporting breastfeeding mums with reduced face to face contact, BwD’s initiation rates and continuation rates have not been impacted during this time.

A whole system, partnership approach has been key to ensure the success of BwD’s Breastfeeding Friendly Borough plan. This work is a fantastic example of how our UNICEF UK Baby Friendly Initiative accredited services worked towards GOLD Status by showcasing interventions that are over and above the core Baby Friendly standards and working towards a sustainable culture around infant feeding. Without this commitment, the ambitions of the Obesity strategy may become compromised and an opportunity to address the determinants of unhealthy weight at a pivotal time in a child’s development may be missed.

Donna Mary Butler is a Baby Friendly Lead with experience of working in both acute and community settings in London and Northwest. Donna is a Registered Nurse (RN), Registered Midwife (RM), Health Visitor (HV), International Board-Certified Lactation Consultant (IBCLC) and Baby Friendly Initiative Qualified Leader BFIqL. Donna is currently working as a Baby Friendly Lead Midwife in Blackburn with Darwen community maintaining Baby Friendly in the Health Visiting, Family Hub/Children Centres and wider community settings and has supported her community to achieve UNICEF Baby Friendly Initiative GOLD accreditation award.

[1] Impact of Breastfeeding on Maternal and Child Health: Acta Paediatrica: Vol 104, No S467 (

[2] The benefits of breastfeeding – Start for Life – NHS (

[3] McAndrew F, Thompson J, Fellows L, Large A, Speed M, Renfrew MJ (2012) Infant Feeding Survey 2010, Health and Social Care Information Centre, pp. 111–112

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