Why we should do this: what the evidence says

Educational institutions, government and employers collaborate to include education on breastfeeding in pre- and post-registration curricula for all health professionals who care for parents/caregivers and children. This education includes the social, cultural, political and economic influences on infant feeding decisions.

Educational curriculum or specialised training programmes for health professionals can improve breastfeeding knowledge and attitudes, and generate the confidence needed to support breastfeeding (Yang et al 2018).

Ministry of Health | Manatū Hauora works with relevant health professional colleges, associations and regulatory authorities to increase the maternal and child health workforces’ knowledge and understanding of their responsibilities under the Health Workers’ Code.

There are significant gaps in health workers’ knowledge and understanding of the Health Workers’ Code (Allen and Clarke 2018), particularly relating to:

  • responsibilities to provide guidance on the use of infant formula, including safe preparation, use and storage
  • the complaints process for the Infant Nutrition Council Code of Practice for the Marketing of Infant Formula in New Zealand.

Revise education requirements for primary health organisations and providers (such as practice nurses and GPs), and promote breastfeeding-friendly policies in primary health care practices.

Many health care professionals lack the necessary knowledge, attitudes and skills to effectively address parents’ breastfeeding concerns (Gavine et al 2016).

Support increased workforce capacity via updated funding models and referral pathways that improve integrated care and timely access to specialist breastfeeding support provided by professionals certified by the International Board of Lactation Consultants.

Collaborative approaches among health care professionals are essential for successful breastfeeding (Rosin and Zakarija-Grković 2016). Adequately resourced integrated care models optimise continuity, consistency and quality, while ensuring interdisciplinary cooperation and cost efficiency (OECD 2017).

Where are we now?

  • Breastfeeding education is included in the curricula of pre-registration midwifery qualifications but is not routinely included in pre-registration nursing or medical qualifications. A growing number of health professionals and others hold the additional International Board-Certified Lactation Consultant qualification (IBCLC), but there is a lack of Māori IBCLCs.
  • Compulsory continuing education on breastfeeding was withdrawn from the Midwifery Council Annual Practising Certificate (APC) cycle in 2017.

Next steps and considerations

  • Include breastfeeding in the curricula of pre-registration nursing and medical qualifications.
  • Reinstate compulsory continuing breastfeeding education for midwives as part of the APC cycle and ensure it is included in the Midwifery First Year of Practice programme.
  • Facilitate opportunities for continuing education in breastfeeding through health professional postgraduate programmes and other educational institutions.

Guiding documents and tools


Allen + Clarke. 2018. The Code of Practice for Health Workers: Analysis of Responses. Wellington: Allen + Clarke.

Gavine A, MacGillivray S, Renfrew M, et al. 2016. Education and training of healthcare staff in the knowledge, attitudes and skills needed to work effectively with breastfeeding women: A systematic review. International Breastfeeding Journal. 12(6).

OECD. 2017. Caring for quality in health: Lessons learnt from 15 reviews of health care quality. OECD Publishing.

Rosin S, Zakarija-Grković I. 2016. Towards integrated care in breastfeeding support: A cross-sectional survey of practitioners’ perspectives. International Breastfeeding Journal. 11(15).

Yang S, Salamonson Y, Burns E et al. 2018. Breastfeeding knowledge and attitudes of health professional students: A systematic review. International Breastfeeding Journal. 13(8).