Implementing the Becoming Breastfeeding Friendly Initiative in Scotland

Alison McFadden (Lead / Corresponding author), Sally Kendall, Tamsyn Eida

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)
67 Downloads (Pure)


Despite strong policy support in Scotland, United Kingdom, key challenges to scaling up promotion, protection and support for breastfeeding remain. These include low breastfeeding rates and socioeconomic and regional inequalities. The Becoming Breastfeeding-Friendly (BBF) process was implemented to highlight actions that could address these challenges. The Scottish BBF committee employed an iterative process of documentary analysis and evidence reviews supplemented by 18 interviews with key informants. The data were mapped to BBF benchmarks and each gear was scored accordingly. Nineteen draft recommendations addressing policy and practice gaps were prioritised. Ten recommendations were grouped into eight themes, which cross-cut the BBF gears. The process took place from May 2018 to May 2019. The overall BBF Index score for Scotland was 2.4 indicating a strong scaling-up environment for breastfeeding. Five gears were assessed as strong gear strength, and the remaining three were judged as moderate gear strength. Three recommendation themes illuminate strengths and areas for development. The theme ‘reinforcing political will’ showed effective leadership, strong policies and significant investment in supporting breastfeeding and highlights actions to sustain this. The theme ‘strengthening and coordinating breastfeeding messages’ revealed a need for coordination between government, health services and the third sector. The theme ‘promoting a supportive return to work environment’ highlighted that, while employment legislation is not devolved to the Scottish government, action could be taken by employers to optimise an enabling environment for breastfeeding. The BBF process identified strengths and triggered actions to enhance breastfeeding promotion, protection and support in Scotland.

Original languageEnglish
Article numbere13304
Number of pages9
JournalMaternal and Child Nutrition
Issue numberS1
Early online date11 Jan 2022
Publication statusPublished - Jan 2023


  • Breastfeeding
  • Policy
  • Public Health
  • Monitoring and evaluation
  • Multidisciplinary approach
  • government
  • scaling-up
  • UK
  • health services
  • Scotland
  • breastfeeding
  • policy

ASJC Scopus subject areas

  • Medicine(all)
  • Health Professions(all)
  • Public Health, Environmental and Occupational Health
  • Obstetrics and Gynaecology
  • Nutrition and Dietetics
  • Pediatrics, Perinatology, and Child Health


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