Press release

Latest technology supports new mums to breastfeed

Public Health England’s Start4Life and Amazon Alexa helping mothers to breastfeed for longer.

Breastfeeding mother

Almost three-quarters of women start breastfeeding when their child is born, however by 6 to 8 weeks this drops to just 44%. This makes breastfeeding rates in England among the lowest in the world.

A new survey of 1,000 mothers of young children commissioned by Public Health England (PHE) revealed that in hindsight, mothers wished they had been better prepared for breastfeeding. Before the birth of their first child, mums’ biggest priorities were:

  • buying baby equipment (66%)
  • preparing for labour (49%)
  • buying baby clothes (40%)

However, post birth, nearly a quarter (24%) wished they had read about and were more prepared for breastfeeding and 1 in 4 (26%) of those who had given breast milk to their first child wished they had known that asking for help can make a real difference.

Evidence shows the right support helps mothers to breastfeed for longer. PHE’s programme Start4Life has created the Breastfeeding Friend to encourage parents to adopt healthy behaviours. It is available for free on a range of platforms, including Facebook Messenger, and now for the first time it will also be available as a skill for Amazon Alexa’s voice service.

Mothers can ask Alexa a variety of questions about breastfeeding and the answers will be provided tailored to the age of the baby. This means that they can get helpful advice even when their hands are full.

The survey also highlighted that almost a third (31%) of mothers also felt embarrassed about asking for help with breastfeeding from healthcare professionals. Many mothers can find breastfeeding challenging and often this may cause them to give up.

It also found that almost two thirds (64%) felt that access to 24 hours a day, 7 days a week breastfeeding support, such as a phoneline, website or chatbot, would make new mothers:

  • more likely to have a positive experience of breastfeeding
  • more likely to decide to try breastfeeding (59%)
  • breastfeed for longer (58%)

PHE recommends exclusive breastfeeding for around the first 6 months. Breastfeeding boosts a baby’s ability to fight illness and infection, and babies who are not breastfed are more likely to get diarrhoea and chest infections. Breastfeeding also lowers a mother’s risk of breast cancer and may reduce the risk of ovarian cancer.

Viv Bennett, Chief Nurse at Public Health England said:

Breastfeeding, whilst natural, is something that mothers and babies learn together, and whilst learning, women may have questions and setbacks. PHE is working with health professionals to make sure women are not embarrassed and receive timely help. Health professionals do an excellent job of caring for new mothers, but they cannot be available 24 hours a day, 7 days a week, which is where our Breastfeeding Friend from Start4Life is designed to help. This tool, together with the range of support materials from Start4Life, can provide breastfeeding advice at any time of night or day and support mothers and their partners and families through challenges they may face.

These digital offerings will help guide new parents through their first weeks of breastfeeding and beyond, providing help at any time of the day or night, and aim to complement support and advice from health care professionals and breastfeeding specialists. The information provided by all the Start4Life services is NHS approved and both services are independent of Amazon and Facebook.

Dr Cheryll Adams CBE, Executive Director Institute of Health Visiting, says:

This innovative new service will enhance those already provided by health professionals. Whether a mother manages to establish breastfeeding is largely determinant on the support she receives in the first few days after birth. However, with such short hospital stays, professional support is not as widely available as it once was. To have this back up, which can be accessed from anywhere, will be hugely helpful and we expect health visitors to want to promote the service.

Justine Roberts, CEO and Founder of Mumsnet, says:

Breastfeeding is a hard-won skill for many women, and most mothers will experience a setback along the way, particularly in the first few weeks. We see from conversations on Mumsnet that mothers are looking for breastfeeding support 24 hours a day, 7 days a week, and in fact middle of the night crises when face-to-face help isn’t available can be the most profoundly lonely and difficult. These new round-the-clock digital services could provide help when mothers need it most.

More information, advice and tips on breastfeeding is available on the Start4Life website.


1 - Once Breastfeeding Friend from Start4Life is enabled from the Alexa app, users can activate the skill on their Alexa by using the wake word ‘Alexa’ and asking for the ‘Breastfeeding Friend’. A ‘card’ will be sent to the user’s Alexa app showing some of the most common questions the Breastfeeding Friend can answer. Users can access quick tips or advice, and ask Alexa a variety of questions about breastfeeding. The answers will be provided tailored to the age of the baby. The 24 hours a day, 7 days a week Breastfeeding Friend from Start4Life aims to make it simple and easy for breastfeeding mums to ask for help if they are facing any breastfeeding difficulties.

2 - In addition to the Breastfeeding Friend from Start4Life there are many other ways that mothers can get breastfeeding support. The Start4Life website has a range of advice and resources which can help mothers continue breastfeeding. Mothers can also call a national helpline (0300 100 0212) provided by the Breastfeeding Network 365 days a year. Mothers can also get help through:

  • friends and family
  • their Midwifery team
  • their health visitor
  • local breastfeeding drop-in services

3 - The survey was conducted by Kantar Public from 26 January to 7 February 2018 with a nationally representative sample of 1005 mothers in England with children under the age of 4, on behalf of PHE. The data were weighted to population statistics based on age of mum, region and socio-economic group. Findings show:

  • of those who ever gave breastmilk to their first child, younger mums were more likely than older mums to use online sources (42% of 18 to 34 years compared to 30% of 35 to 50 years) when researching or starting to breastfeed
  • of mums who breastfed their first child, a quarter wished they’d known it can take a long time, but it’s quality time to spend with their baby (25%) and there is lots of help and support available from breastfeeding groups, other parents and online (24%)
  • 1 in 4 (26%) mums felt using more online/digital tools and information would have helped them to be more prepared for becoming a mum
  • in hindsight, mums wished their main priorities before the birth of their first child had been preparing for labour (33%), spending time with friends and family (26%), reading about and preparing for breastfeeding (24%) and preparing for night feeds (22%)

4 - Sometimes breastfeeding isn’t possible for a range of reasons. If this is the case, in terms of liquids babies should only be given infant formula milk for the first 12 months and no other types of milk.

5 - Start4Life’s Information Service for Parents and Start4Life website offers NHS information and advice for parents-to-be and parents of 0 to 5 year olds providing them with the advice they need to help get their child off to the best start in life.

6 - The Department of Health is also supporting Unicef UK to develop a neonatal infant feeding network to support sick and preterm babies.

7 - PHE exists to protect and improve the nation’s health and wellbeing, and reduce health inequalities. It does this through world-class science, knowledge and intelligence, advocacy, partnerships and the delivery of specialist public health services.


Published 1 March 2018