Breastfeeding in Fife

Belinda Morgan Gina Graham

Breastfeeding Support Co-ordinator

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

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

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)

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

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

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

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

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

Challenges

• Resources• Short-term, limited funding• Service organisation / change • Geographic variations / health

inequalities

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

"

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’

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’

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’

What next?

• Community Breastfeeding Co-ordinator post extended– New Breastfeeding Support

Workers – Breastfeeding Buddies– Training– BFI in community

• Breastfeeding in schools

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