Dr Amy Brown, of the College of Human and Health Sciences whose research examines the many social cultural and psychological barriers that new mothers face to breastfeed has signed the letter, which states: "The breastfeeding crisis in the UK is in fact a crisis of lack of support for those mothers who choose to breastfeed."

The letter follows the recent series in The Lancet on breastfeeding – the most comprehensive review of all the evidence on breastfeeding to date.

The letter calls on government, as a matter of urgency, to safeguard the public health budget. It is not a matter of persuading mothers to breastfeed – most mothers begin breastfeeding and initiation rates are around 80 percent. However, rates plummet in the first weeks and months after birth, and most mothers say they stopped breastfeeding before they wanted to.

Dr Brown said: “The signatories make it clear that the message of The Lancet series is that increasing breastfeeding rates is everyone's responsibility. Increasing the number of babies who are breastfed is important for the health of both mother and baby and ultimately saves money in reduced health care costs for the NHS. It therefore seems nonsensical to fail to invest in supporting new mothers to breastfeed. However, despite public health messages recommending that mothers should breastfeed, these messages are not backed up with support once the baby is born.

"Moreover, our society actively works against new mothers who try to breastfeed, criticising or shaming them. Together this results in low breastfeeding rates which translates into poorer health outcomes, higher health costs and damage to maternal wellbeing. If we want more babies to breastfed, we need breastfeeding to be supported, encouraged and protected and the government has a responsibility to do that."

The letter highlights the strategy that the government must adopt in order to increase breastfeeding rates in the UK. Research from other countries that have achieved this shows that a multifaceted approach is needed, with interventions delivered in combination. The authors call on the UK government and the national assemblies to:

• establish a multi-sectoral National Breastfeeding Committee to develop a National Breastfeeding Strategy
• all maternity and community settings must meet Baby Friendly standards, as per NICE guidelines
• all mothers in the UK must receive skilled, evidence-based breastfeeding support, as per NICE guidelines
• safeguarding the public health budget for universal health visiting services and breastfeeding support
• fully enact in UK law the International Code of Marketing of Breastmilk Substitutes, which would end the advertising of follow-on formula
• require employers to provide breaks to breastfeeding mothers to breastfeed or express milk at work

The Lancet report outlines the long-term health protection from breastfeeding, even in richer countries like the UK. Breastfeeding helps protect babies from diarrhoea, respiratory and ear infections, necrotising enterocolitis, sudden infant death syndrome, and reduces their chance of obesity and diabetes in later life. It also helps protect mothers from breast and ovarian cancer and diabetes.

It also said that low rates of breastfeeding for countries like the UK cost our economy billions of pounds. According to The Lancet, "Losses [from not breastfeeding] for high-income countries are $231·4 billion, or 0·53% of their GNI." The UK Gross National Income was $2.5183 trillion in 2014, according to World Bank statistics, 0.53% of which is $13.35 billion.

The letter adds: "If this were not enough, in the UK poorer mothers are far less likely to breastfeed than richer mothers, which increases health and social inequality."

 The full text of the open letter is here: http://ukbreastfeeding.org/open-letter/