breastfeeding in fife belinda morgan gina graham breastfeeding support co-ordinator
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Breastfeeding in Fife
Belinda Morgan Gina Graham
Breastfeeding Support Co-ordinator
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2008• Healthy Eating, Active Living – (HEAL )• Equally Well
– Tackling health inequalities a priority– Improving maternal nutrition during
pregnancy effective action to address future health inequalities
– Improve breastfeeding rates in deprived areas and among disadvantaged groups
– HEAT Targets H7
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CEL 36 (Sept 08)– Nutrition of women of childbearing age, pregnant women and children under 5 in disadvantaged areas
– Increase uptake of Healthy Start– Support delivery of HEAT target
on breastfeeding– Invest in specialist nutritional
services– Enable training for those involved
in interventions with the target group
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Breastfeeding at 6-8 weeks Scotland
Breastfeeding at the 6-8 Week Review by NHS Board of Residence - Year of Birth 2008p
0
10
20
30
40
50
60
70
Total (allparticipatingNHS Boards)
NHSAyrshire &
Arran
NHS Borders NHSDumfries &Gallow ay
NHS Fife NHS ForthValley
NHS GreaterGlasgow &
Clyde
NHSHighland
NHSLanarkshire
NHS Lothian NHSShetland
NHS Tayside NHSWestern
Isles
NHS Board of Residence
% B
reas
tfed
% Mixed breast and formula fed
% Exclusively breastfed
p - Data for 2008 are provisionalSource: CHSP-PS, ISD ScotlandFebruary 2009
National Target (32.7% exclusively breastfed at 6-8 weeks by 2010/11)
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Breastfeeding at 6-8 week review
NHS Fife 2001-08ISD 11 May 09
0
10
20
30
40
50
60
70
2001 2002 2003 2004 2005 2006 2007 2008
Year of Birth
% B
reas
tfed
% Breastfed (includes mixed breast and formula fed)
% Exclusively breastfed
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Breastfeeding by CHP 2001-08
Exclusive Breastfeeding at 6 weeks by CHP and Year of Birth
0
5
10
15
20
25
30
35
40
45
50
2001 2002 2003 2004 2005 2006 2007 2008p
%
Scotland
NHS Fife
D&WF CHP
G&NEF CHP
K&L CHP
HEAT Target
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NICE RecommendationsFor Health Boards• Adopt a multifaceted approach
across different settings. This should include training for health professionals, peer support programmes and education for pregnant women, followed by proactive support during the postnatal period.
• Implement a structured programme, using BFI as a minimum standard… Subject it to external evaluation
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Where are we?
• BFI accredited hospital• Breastfeeding Management Training
since 2002• 11 Breastfeeding Groups• Projects where improving breastfeeding
initiation / duration is key aim– Breastfeeding Buddies– Family Health Project– VIP Project
• Raising Awareness of Breastfeeding in schools and via parenthood on schools
• Increased social marketing • BF Award scheme
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Family Health Project
• 6 month data • 92 mothers supported via 1:1
structured midwifery led support • 45% aged 15-19 years • All Depcat 4 and 5 • 29% Breastfeeding & 20% of 15-19yrs• 33% smoking & 13% of 15-19yrs
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Challenges
• Resources• Short-term, limited funding• Service organisation / change • Geographic variations / health
inequalities
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What next?
• Breastfeeding Support Team in Forth Park– Ongoing work to maintain BFI
Standards– Initiation of breastfeeding
•Biological Nurturing•Clip-on cots
– Breastfeeding Problems Clinics– Bumps to Baby talks
•Bumps to breastfeeding DVD • Is natural right for you? CD Rom•Hospital & Community
"
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Breastfeeding Buddies
• 70% said seeing a buddy antenatally helped them decide how to feed their baby
• 80% said buddy helped them feed longer than they would have otherwise
• 70% named buddy in ‘Most helpful people question’
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Breastfeeding Buddies
• ‘It helped knowing my buddy was at the end of a phone when I needed support’
• ‘I was nervous leaving hospital as I hadn’t really mastered feeding. I came straight home and lifted phone to my buddy’
• ‘Although I didn’t breastfeed for long, my buddy was there to support me to try again, give me advice and be there with me’
• ‘They weren’t forceful like the hospital midwives who make you feel breastfeeding is the only way, they were also patient’
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Breastfeeding Buddies
• Challenges– Part-time nature of project– Short term funding – Limited to certain areas– Referrals / engaging other
Health Professionals– Reliance on volunteers– ‘Nosey neighbour’
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What next?
• Community Breastfeeding Co-ordinator post extended– New Breastfeeding Support
Workers – Breastfeeding Buddies– Training– BFI in community
• Breastfeeding in schools
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NICE RecommendationsFor Health Professionals• Ensure mothers who breastfeed can
demonstrate how to position and attach the baby to the breast and can identify signs that the baby is feeding well
• Breastfeeding peer support workers should contact mothers directly within 48 hours of transfer home.– Part of multi-disciplinary team– Receive training– Offer ongoing support according to
mother’s needs– Can consult a health professional
for support