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Background: Breastfeeding and the provision of human milk is the most accessible and cost-effective activity available to public health, which is known to prevent a range of infectious and non-communicable diseases (NCDs), specifically gastro-enteritis, childhood obesity, diabetes type 2 and maternal breast cancer[1],[2]. However, global efforts to further improve exclusive breastfeeding rates have had limited success, in part because effective scaling‐up frameworks and roadmaps have not been developed[3]. Breastfeeding rates in Scotland have improved in recent years, with an increase from 44% (2001/2002) to 51% (2017/2018) of babies reportedly receiving 'any breastfeeding' at first health visitor visit at 10-14 days, and the proportion of babies being breastfed at 6-8 weeks rising from 36% of babies (born in 2001/02) to 42% of babies (born in 2017/18)[4] However, the figures remain relatively low and drop off rates high when compared to other countries and recommended targets, with breastfeeding rates lower among women in areas of higher deprivation, exacerbating health inequalities.\ud \ud BBF: The Becoming Breastfeeding Friendly (BBF) toolkit was developed through highly structured technical and academic collaboration, led by Yale University and has been piloted in Mexico and Ghana. In the short term, it provides an evidence-based tool to guide countries in assessing their breastfeeding status and their readiness to scale up. In the long term, it supports countries to identify the concrete measures they can take to sustainably increase breastfeeding rates, based on data-driven recommendations. The BBF Gear Model is made up of eight simultaneous conditions which sustain breastfeeding: the gears. This conceptual model illustrates how each gear must be sufficiently mobilised to turn the next, whilst the central Coordination gear gathers and delivers timely feedback.\ud \ud Using the BBF framework, the BBF Scotland committee has prioritised a set of eight recommendation themes to take forward in order to scale up the protection, promotion and support of breastfeeding in Scotland.

In Wales, whilst over 60% of women intend to breastfeed, the figure falls to 26% reporting any breastfeeding at 6 weeks. There is considerable variation among Health Boards and breastfeeding rates are lower among some groups, exacerbating health inequalities. Sustained intervention is required to both improve the experience of breastfeeding for women, babies and families, and advance towards the WHO’s 2025 global target of increasing exclusive breastfeeding in the first six months to at least 50%. Supported by the University of Kent and facilitated by Public Health Wales, a Welsh Committee of experts worked from April 2018 to February 2019 to deliver the 5 step BBF process: a) to measure the current breastfeeding environment, and b) to develop a plan to implement recommendations to guide the scaling up of national breastfeeding protection, promotion and support efforts. This infographic presents the findings of the assessment of the Breastfeeding environment in Wales and the committee's six evidence-informed recommendation themes, based on the BBF Gear model.

The causes of obesity are complex; tackling the problem requires evidence-led action at every level, from the individual to society, and across all sectors. As part of their whole system strategy to halt and reverse the rising trend in childhood obesity, the London Bi-borough Public Health team are delivering Go Golborne, an innovative 3 year community-based pilot (2015-2018), in a highly diverse and deprived ward in the Royal Borough of Kensington and Chelsea (RBKC), with elevated levels of childhood obesity. CHSS is conducting a 4 year theory-led evaluation of the pilot to assess the effectiveness, feasibility and replicability of this ‘whole place’ multi-stakeholder approach.\ud \ud This presentation details the early findings of an online survey distributed to project partners and interview findings with project partners.

The UK has one of the lowest breastfeeding rates in the world; 80% of babies are breastfed at birth, only 1% are exclusively breastfed by 6 months. Breastfeeding rates are lower among women in areas of higher deprivation, exacerbating health inequalities. The Becoming Breastfeeding Friendly toolkit was developed through highly structured technical and academic collaboration, led by Yale University. It has been piloted in Mexico and Ghana. In the short term, it provides an evidence-based tool to guide countries in assessing their breastfeeding status, and their readiness to scale up; and in the long term, it supports countries to identify the concrete measures they can take to sustainably increase breastfeeding rates, based on data-driven recommendations. \ud Launching BBF GB, breastfeeding experts from Scotland, Wales and England attended the first GB Engagement Committee in December 2017, agreeing to deliver BBF separately in each country to reflect structural and cultural variation. The CHSS team is now supporting three locally developed Country Committees of experts in Scotland, Wales and England to carry out the 5 step meeting process.