Why should do this: what the evidence says

Provide breastfeeding parents who have social, health or medical risk factors with targeted support to continue breastfeeding.


Breastfeeding parents experiencing multiple social or other medical risk factors that contribute to stopping breastfeeding may be assisted by additional or more intensive support (Johnson et al 2015).

Support the provision of full-time dedicated breastfeeding and lactation support in NICUs and special care nurseries, paediatric wards and mental health units.

Research demonstrates that providing dedicated NICU breastfeeding and lactation support can be cost effective and is associated with improved breastfeeding outcome measures for high-risk preterm infants (Gharib et al 2018; Renfrew et al 2009).

Review evidence to ensure breastfeeding recommendations for parents with HIV are in line with current best practice evidence.

WHO guidelines (World Health Organization and UNICEF 2016) recommend that infants should be exclusively breastfed for the first six months, regardless of the HIV status of the breastfeeding parent.

Ensure skilled breastfeeding and lactation support is available to breastfeeding parents who are incarcerated and those with children and infants in child protection services.

Supporting breastfeeding parents who are incarcerated is a cost-effective and promising approach to protect the health and welfare of parents and their children (Baxter, Cooklin and Smith 2009; McIntyre 2017). Evidence suggests that recidivism can be reduced by utilising a prison nursery/mother-baby unit model (Carlson 2018).

Work with the Ministry of Justice and Department of Corrections to review the practicality and implementation of M.03.03 Feeding and bonding facilities and M.03.02 Female and pregnant prisoners Assist with appropriate updates to support national and international best practice, especially in the area of Mothers with Babies Units.

Supporting prisoners to have regular contact visits, or be co-located with their children in feeding and bonding facilities, minimises the impact of their imprisonment on their children and actively contributes to a reduced likelihood of intergenerational criminality (Department of Corrections 2018; Elliott-Hohepa and Hungerford 2013).

Work with Oranga Tamariki, Ministry of Justice and Ministry of Social Development to review the practicality and implementation of the Oranga Tamariki Maintaining family/whānau relationships polices (Maintaining breastfeeding).


When an infant is removed from a birth parent, it is generally deprived of its right to the nutritional and immunological benefits of breast milk, which research shows has a long-term impact on healthy development (The Paediatric Society and Children’s Hospitals Australasia 2018; Ministry of Children and Family Development and Representative for Children and Youth 2018).

In addition, breastfeeding may be a protective factor against maternal neglect (Report of the Health Committee 2013; Strathearn et al 2009).


Baxter J, Cooklin A, Smith J. 2009. Which mothers wean their babies prematurely from full breastfeeding? An Australian cohort study. Acta Paediatrica. 98(8 ): 1274–7.

Carlson J. 2018. Prison nurseries: A way to reduce recidivism. The Prison Journal. 98(6): 760–75.

Department of Corrections. 2018. Prison Operations Manual – M.03.03 Feeding and bonding facilities. Wellington: Department of Corrections.

Elliott-Hohepa A, Hungerford R. 2013. Report on phase three of the formative evaluation of the Mothers with Babies Units. Wellington: Department of Corrections.

Gharib S, Fletcher M, Tucker R, et al. 2018. Effect of dedicated lactation support services on breastfeeding outcomes in extremely-low-birth-weight neonates. Journal of Human Lactation. 34(4): 728–36.

Johnson A, Kirk R, Rosenblum K, et al. 2015. Enhancing breastfeeding rates among African American women: A systematic review of current psychosocial interventions. Academy of Breastfeeding Medicine. 10(1): 45-62.

Ministry of Children and Family Development, Representative for Children and Youth. 2018. Promoting access to breastfeeding in child welfare matters: A joint special report. BC, Canada: Ministry of Children and Family Development.

McIntyre J. 2017. Mother-and-infant facilities at Adelaide Women’s Prison: A cost effective measure in the best interests of the child. Report to the Minister for Correctional Services. Adelaide: University of Adelaide.

Renfrew M, Craig D, Dyson L, et al. 2009. Breastfeeding promotion for infants in neonatal units: A systematic review and economic analysis. Health Technology Assessment. 13(40): 1–146.

Report of the Health Committee. 2013. Inquiry into improving child health outcomes and preventing child abuse. Wellington: New Zealand House of Representatives.

Strathearn L, Mamum A, Najman J, et al. 2009. Does breastfeeding protect against substantiated child abuse and neglect? A 15-year cohort study. Pediatrics. 123(2): 483–93.

The Paediatric Society, Children's Hospitals Australasia. 2018. Charter of Tamariki/Children’s and Rangatahi/Young People’s Rights in Healthcare Services in Aotearoa New Zealand: A consensus statement by Children’s Hospitals Australasia (CHA) and the Paediatric Society of New Zealand. Wellington: The Paediatric Society and Children’s Hospitals Australasia.

World Health Organization, UNICEF. 2016. Guideline: Updates on HIV and infant feeding. Geneva: World Health Organization.