Promoting and Protecting Promoting and Protecting BreastfeedingBreastfeeding

Hazel WoodcockHazel Woodcock

Infant Feeding CoordinatorInfant Feeding CoordinatorRFT Obstetrics & GynaecologyRFT Obstetrics & Gynaecology

Why doesn’t everyone Why doesn’t everyone breastfeed?breastfeed?

• Age, social class and educationAge, social class and education

• Cultural normsCultural norms

• Lack of confidence - Not enough milk?Lack of confidence - Not enough milk?

• Drug or medical C/I’s- rareDrug or medical C/I’s- rare

• Lack of informationLack of information

-- About breastfeedingAbout breastfeeding

-- About the risks of About the risks of notnot BF BF

-- About the support availableAbout the support available

ROTHERHAM BF INITIATION ROTHERHAM BF INITIATION 2010/112010/11

0

10

20

30

40

50

60

70

All 18 - 25 <18 6-8wks

South Yorkshire BF Initiation South Yorkshire BF Initiation Q1 April – June 2011Q1 April – June 2011

0102030405060708090

What are we doing to implement What are we doing to implement

changechange??The Unicef UK Baby Friendly The Unicef UK Baby Friendly

Initiative - BFIInitiative - BFI

Recommended by:Recommended by:

• Department of HealthDepartment of Health

• NICE Postnatal Care Guidance 2006NICE Postnatal Care Guidance 2006

• Nice Maternal & Child Nutrition Nice Maternal & Child Nutrition Guidance 2008Guidance 2008

Department of Health Department of Health DirectivesDirectives• Healthy Lives, Healthy People, Nov 2010Healthy Lives, Healthy People, Nov 2010

• Operating Framework, Dec 2010Operating Framework, Dec 2010

• NHS Outcomes Framework, Dec 2010 NHS Outcomes Framework, Dec 2010

• Maternity NSFMaternity NSF

• Children’s NSFChildren’s NSF

• National Obesity StrategyNational Obesity Strategy

• Healthy Child ProgrammeHealthy Child Programme

Baby Friendly – What is it?Baby Friendly – What is it?

It’s the It’s the expected minimum standard expected minimum standard of of care and health care organisations will be care and health care organisations will be judged by their progressjudged by their progress

Informed choice discussion in pregnancyInformed choice discussion in pregnancy

Best practice care postnatallyBest practice care postnatally

Ten Steps for Maternity UnitsTen Steps for Maternity Units

Seven Points for Community FacilitiesSeven Points for Community Facilities

So how can we protect So how can we protect breastfeeding?breastfeeding?

• Antenatally - don’t ask intentionAntenatally - don’t ask intention• Promote skin to skin contact at delivery -“The Promote skin to skin contact at delivery -“The

golden hour” - and golden hour” - and return baby to mum after return baby to mum after successful resuscitation, including in theatresuccessful resuscitation, including in theatre

• Offer assistance with the first feed to ALL mums Offer assistance with the first feed to ALL mums discuss benefits of colostrum, mothers who discuss benefits of colostrum, mothers who intend to AF can give a first BF, some continueintend to AF can give a first BF, some continue

• Kangaroo Mother Care on NNU and support for Kangaroo Mother Care on NNU and support for early and frequent milk expression – pump loanearly and frequent milk expression – pump loan

• Plenty of support networksPlenty of support networks• Supplementation only when clinically required –Supplementation only when clinically required –

preferably cups not bottlespreferably cups not bottles

WHO International Code of WHO International Code of Marketing for Breastmilk Marketing for Breastmilk

SubstitutesSubstitutes• No advertising of breastmilk substitutes No advertising of breastmilk substitutes

bottles and teats in the health care bottles and teats in the health care system and to the publicsystem and to the public

• No free samples to pregnant women, No free samples to pregnant women, mothers or health professionalsmothers or health professionals

• No contact between marketing personnel No contact between marketing personnel and mothers or pregnant womenand mothers or pregnant women

• Appropriate labelling and informationAppropriate labelling and information

Local PolicyLocal Policy

Strategic Plan 2010-2015: Strategic Plan 2010-2015: Better Health, Better Lives. Better Health, Better Lives.

Health & Wellbeing Strategy Health & Wellbeing Strategy 20112011

Maternity & Newborn Care Maternity & Newborn Care Strategy 2010-2012Strategy 2010-2012

Rotherham Child Health Rotherham Child Health Promotion ProgrammePromotion Programme

The Rotherham Breastfeeding The Rotherham Breastfeeding Policy 2010Policy 2010

Better Health, Better Lives Better Health, Better Lives 2010-20152010-2015

““Increasing breastfeeding Increasing breastfeeding duration rates to 35% in duration rates to 35% in Rotherham will reduce hospital Rotherham will reduce hospital admissions in children under one admissions in children under one year old by 5% (225 year old by 5% (225 admissions).” duration ie at 6 – admissions).” duration ie at 6 – 8 weeks8 weeks

• Discuss benefits, on admission, with parents of Discuss benefits, on admission, with parents of babies on SCBU, including donor milk (check local babies on SCBU, including donor milk (check local policy)policy)

• Consult appropriate sources if asked about safety Consult appropriate sources if asked about safety of medication for BF mothersof medication for BF mothers

www.ukmicentral.nhs.ukwww.ukmicentral.nhs.uk• Know how to refer to experienced BF support when Know how to refer to experienced BF support when

there are feeding problemsthere are feeding problems

• Reinforce DH and WHO weaning advice - no Reinforce DH and WHO weaning advice - no other fluids or food till around six months other fluids or food till around six months

What else canWhat else can medical staff do ? medical staff do ?

Thank youThank you