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Breast ironing, also known as breast flattening, is a harmful cultural practice primarily found in parts of Africa, especially Cameroon. The process involves pressing or massaging the breasts of adolescent girls using hot objects (such as stones, wooden pestles, or heated spatulas) to delay the development of their breasts. The intent is to protect young girls from early marriage, sexual harassment, or rape by making them less sexually attractive.

Prevalence in the UK

Breast ironing is not widespread in the UK but has become a growing concern due to migration from countries where this practice is more common. The Home Office recognises it as a form of child abuse. However, as with female genital mutilation (FGM), it is often hidden and unreported, making it difficult to accurately assess how many girls are affected.

Impact on Victims

Breast ironing can cause both physical and psychological harm:

• Physical injuries: burns, scarring, infections, deformities, and potentially the development of cysts or cancer.

• Psychological impact: long-term trauma, anxiety, depression, and low self-esteem due to body image issues.

What Early Years Practitioners Need to Look Out For

Practitioners in health care, education, and social work need to be vigilant. Signs a girl may be subjected to breast ironing include:

1. Physical Indicators:

   • Burns, scars, or injuries on the chest area.

   • Complaints of chest pain or discomfort.

   • Disproportionate breast development (one breast larger or smaller than the other).

   • Wearing loose, baggy clothing to hide the chest area.

2. Behavioural Signs (especially in older children):

   • Reluctance to change clothing in front of others (e.g., avoiding PE classes or swimming).

   • Absenteeism from school, especially around puberty.

   • A sudden decline in school performance or participation in activities.

   • Withdrawal from social interactions or signs of depression and anxiety.

3. Cultural Indicators:

   • Families from communities where breast ironing is practiced, particularly Central and West African countries.

   • A family history of traditional practices aimed at controlling or delaying sexual development.

How Early Years Practitioners Can Help

If a practitioner suspects a child is being subjected to breast ironing, immediate intervention is crucial. Here’s what practitioners should do:

1. Document Evidence:

   • Maintain a detailed record of any physical signs or symptoms noticed.

   • Record any concerning behaviours or statements made by the child.

2. Speak to the Child:

   • Approach the subject sensitively, allowing the child to speak freely in a safe and private environment.

   • Avoid confronting the child in front of their parents or guardians, as this may put the child at further risk.

3. Involve Safeguarding Teams:

   • Follow safeguarding policies by immediately referring the case to the safeguarding lead or designated child protection officer.

   • Ensure the LADO is informed.

4. Medical Attention:

   • If the child shows signs of injury, medical advice should be sought according to your setting’s policy.

   • Physical and psychological therapy should be recommended to support healing and mental well-being.

5. Education and Awareness:

   • Schools, social workers, and healthcare providers should receive training on breast ironing to increase awareness.

   • Multi-agency cooperation is essential, involving healthcare providers, teachers, social workers, and police.

Legal Framework in the UK

Breast ironing is recognized as a form of child abuse and falls under the category of physical abuse within UK law. It is illegal under the Children Act 1989 and 1993, as well as the Serious Crime Act 2015. Practitioners are legally obligated to report suspected cases of abuse, and failure to do so can result in penalties. The police may also be involved to ensure the child's safety and investigate the case under the Forced Marriage (Civil Protection) Act 2007 or the Female Genital Mutilation Act 2003, depending on the severity of the case.

Cultural Sensitivity and Preventive Measures

While safeguarding the child is paramount, cultural sensitivity is also essential. Practitioners should:

• Avoid judgmental language when engaging with the family or community.

• Educate families on the health risks of breast ironing, offering alternative ways to ensure their daughters' safety and well-being.

• Collaborate with community leaders and cultural mediators to spread awareness and work toward preventing the practice.

Breast ironing in the UK remains a hidden but serious issue affecting a small number of girls from specific communities. Practitioners need to stay vigilant, recognise the signs, and follow legal and safeguarding protocols to protect vulnerable children from this harmful practice.