BREAST FEEDING POLICY - DCHS Home · BREAST FEEDING POLICY Document History Version Date: JULY 2012...

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: BREAST FEEDING POLICY Document History Version Date: JULY 2012 Version Number: 4 Status: Approved Next Revision Due: JULY 2014 Developed by: Lesley Wakefield, - UNICEF COMPLIANT Policy Sponsor: Head of Service EQIA completed: ( including reference number EIA/CLAIRESCOTHERN/08/05/2012 Approved by: Clinical Effectiveness Group Date approved: 26 th September 2012 Revision History Version Revision date Summary of Changes 2 April 2011 DCHS – adopted the UNICEF Community Breast Feeding Policy Baby friendly status for Trust applied for and UNICEF Policy more appropriate. 3 July 2011 Parent’s Guide name change to ‘Parents’ Guide to the community breastfeeding policy’. 4 April 2012 Transferred into new format. Appendix added The Ten Steps to Successful Breast Feeding. Reference list updated Policy Information Leaflet (delete if not applicable) Reference Number Title Available from 278957 Breastfeeding: Off to the Best Start DH Appendix 3 Parents’ Guide to the community breastfeeding policy.

Transcript of BREAST FEEDING POLICY - DCHS Home · BREAST FEEDING POLICY Document History Version Date: JULY 2012...

Page 1: BREAST FEEDING POLICY - DCHS Home · BREAST FEEDING POLICY Document History Version Date: JULY 2012 Version Number: 4 Status: Approved Next Revision Due: JULY 2014 Developed by: Lesley

:

BREAST FEEDING POLICY Document History

Version Date: JULY 2012

Version Number: 4

Status: Approved

Next Revision Due:

JULY 2014

Developed by: Lesley Wakefield, - UNICEF COMPLIANT

Policy Sponsor: Head of Service

EQIA completed: ( including reference number

EIA/CLAIRESCOTHERN/08/05/2012

Approved by: Clinical Effectiveness Group

Date approved: 26th September 2012

Revision History

Version Revision date

Summary of Changes

2 April 2011 DCHS – adopted the UNICEF Community Breast Feeding Policy Baby friendly status for Trust applied for and UNICEF Policy more appropriate.

3 July 2011 Parent’s Guide name change to ‘Parents’ Guide to the community breastfeeding policy’.

4 April 2012 Transferred into new format. Appendix added The Ten Steps to Successful Breast Feeding. Reference list updated

Policy Information Leaflet (delete if not applicable) Reference Number

Title Available from

278957 Breastfeeding: Off to the Best Start DH

Appendix 3 Parents’ Guide to the community breastfeeding policy.

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To help ensure that this policy is as accessible as possible, it has been left-aligned and is available in alternative formats and languages. To obtain a copy of the policy in large print, audio, Braille (or other format) or in a different language, please contact The Communications Team, by Tel: 01773 525099 or email [email protected]

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TABLE OF CONTENTS

1. Background ................................................................................................................. 3

2. Aim /Purpose .............................................................................................................. 3

3. Definitions and an Explanation of Terms Used........................................................ 3

4. Intended Users ............................................................................................................ 3

Table of Intended Users: .............................................................................................. 3 5. Flow chart

6. Full Details of the Policy ............................................................................................ 4

6.1 In support of this policy ................................................................................................. 4

6.2 The policy ........................................................................................................................ 5

6.3 Training health care staff ............................................................................................... 5

6.4 Informing pregnant women of the benefits and management of breast feeding ...... 5

6.5 Supporting the establishment and maintenance of lactation ..................................... 6

6.6 Supporting exclusive breast feeding ............................................................................ 7

6.7 A welcome for breast feeding families .......................................................................... 7

6.8 Encouraging community support for breast feeding ................................................... 8

7. Support and Additional Contacts .............................................................................. 8

8. References and Associated Documentsnts ............................................................. 8

9. Trust Accountability / Responsibilities ..................................................................... 9

10. Monitoring & Performace management of the Policy ....................................... 14

11. Equality Impact Statement ................................................................................... 15

12. Appendices ............................................................................................................ 16

Appendix 1 The seven point plan for sustaining breast feeding in the community ........ 16

Appendix 2 The seven point plan for sustaining breast feeding in Hospital .................... 17

Appendix 3 The WHO Code ................................................................................................... 18

Appendix 4 Parents' Guide to the community breastfeeding policy……………………19

13. Equality Impact Assessment....................................................................................

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Equality & Diversity Impact Assessment : Level I Screening .................................. 20

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Version number Page 3 of 24 Policy date

1. BACKGROUND i. This Trust believes breast feeding is the healthiest way for a woman to feed her baby and recognises the important health benefits now known to exist for both the mother and her child. ii. All mothers have the right to receive clear and impartial information to enable them to make a fully informed choice as to how they feed and care for their babies. iii. Community health care staff will not discriminate against any woman in her chosen method of infant feeding and will fully support her when she has made that choice.

2. AIM /PURPOSE i. To ensure that the health benefits of breast feeding and the potential health risks of formula feeding are discussed with all women so that they can make an informed choice about how they will feed their baby. ii. To enable community health care staff to create an environment where more women choose to breast feed their babies, confident in the knowledge that they will be given support and information to enable them to breast feeding exclusively for six months, and then as part of their infant’s diet to the end of the first year and beyond. iii. To encourage liaison with all health care professionals to ensure a seamless delivery of care, together with the development of a breast feeding culture throughout the local community.

3. DEFINITIONS AND AN EXPLANATION OF TERMS USED All relevant definitions are included within the body of the policy.

4. INTENDED USERS

Table of Intended Users:

Include the table and wording below

DCHS Chief Executive’s Department NO

Finance Performance and Information

NO

Quality NO Strategy NO

Service Delivery YES Human Resources NO Medical Directorate NO

Leicester Employees NO

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Within this policy where it states “all employees”, please note, that it relates to all the employees who are highlighted in the table above N.B If the policy also applies to people who are not directly employed by DCHS, they should also be listed here Derbyshire County Council Children’s Centre Workers In order to avoid conflicting advice, it is mandatory that all staff, including Children’s Centre workers, involved with the care of breast feeding women, adhere to this Policy. Any deviation from the Policy must be justified and recorded in the mother’s and/or baby’s health care records. This should be done in the context of professional judgement and Codes of Conduct (NMC 2008, NMC 2004).

5. FLOW CHART N/A

6. FULL DETAILS OF THE POLICY

6.1 In support of this policy i. In order to avoid conflicting advice it is mandatory that all staff involved with the care of breast feeding women adhere to this Policy. Any deviation from the Policy must be justified and recorded in the mother’s and/or baby’s health care records. ii. The Policy should be implemented in conjunction with the mothers’/parents’ guide to the Policy. It is the responsibility of all community health care professionals to liaise with the baby’s medical attendants (paediatrician, general practitioner) should concerns arise about the baby’s health. Iii No advertising of breast milk substitutes, feeding bottles, teats or dummies is permissible in any part of this Trust/health care facility. The display of manufacturers’ logos on items such as calendars and stationery is also prohibited. iv. No literature provided by infant formula manufacturers is permitted. Educational material for distribution to women or their families must be approved by the health improvement practitioners or lead for infant feeding. v. Parents who have made a fully informed choice to artificially feed their babies should be shown how to prepare formula feeds correctly, either individually or in small groups, in the post natal period. No routine group instruction on the preparation of artificial feeds will be given in the antenatal period as evidence suggests that information given at this time is less well retained and may serve to undermine confidence in breast feeding. vi. Health visitors are responsible for collecting the required infant feeding data, at birth, 10 days and 6-8 weeks to enable monitoring of breastfeeding rates.

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6.2 Communicating the Breast Feeding Policy:

i. This Policy is to be communicated to all health care staff who have any contact with pregnant women and mothers. All staff will receive a copy of this Policy.

ii. All new staff will be orientated to the Policy as soon as their employment begins.

iii. The Policy will be communicated effectively to all pregnant women and parents of your babies. Where a parents’ guide is displayed or distributed in place of the full Policy, the full version should be available on request. A statement to this effect will be included in the parents’ guide.

Information and communication that supports this Policy will be made as accessible to individuals as possible. This publication is available on request in other formats (for example, large print, easy read, Braille or audio version) and languages. For free translation and/or other format please call 01773 525099 extension 5587, or email us: [email protected]

6.3 Training health care staff i. Health Visitors have the primary responsibility for supporting breast feeding women and for helping them to overcome related problems. ii. All professional and support staff who have contact with pregnant women and mothers will receive training in breast feeding management at a level appropriate to their professional group. New staff will receive training within six months of taking up their posts. iii. Medical staff have a responsibility to promote breast feeding and provide appropriate support to breast feeding mothers. Information and/or training will be provided to enable them to do this. iv. All clerical and ancillary staff will be orientated to the Policy.

6.4 Informing pregnant women of the benefits and management of breast feeding

i. It is the responsibility of staff involved in the care of pregnant women to ensure that they are given information about the benefits of breast feeding and of the potential health risks of formula feeding. ii. All pregnant women should be given an opportunity to discuss infant feeding on a one-to-one basis with a midwife and/or health visitor or other member of the community health care team. Such discussion should not solely be attempted during a group parent craft class.

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iii. The physiological basis of breast feeding should be clearly and simply explained to all pregnant women, together with good management practices which have been proven to protect breast feeding and reduce common problems. The aim should be to give women confidence in their ability to breast feed. iv. Staff will inform mothers about/refer mothers to targeted interventions to promote breast feeding, as appropriate.

6.5 Supporting the establishment and maintenance of lactation i. An assessment of the mother and baby’s progress with breast feeding will be undertaken at the primary visit by community health care staff and an individualised plan of care developed as necessary. This will build on initial information and support provided by the maternity services, to ensure new skills and knowledge are secure. It will enable early identification of any potential complications and allow appropriate information to be given to prevent or remedy them. ii. As part of the initial breast feeding assessment, staff will ensure that breast feeding mothers know:

• The signs which indicate that their baby is receiving sufficient milk and what to do if they suspect this is not the case.

• How to recognise signs that breast feeding is not progressing normally (e.g. sore nipples, breast inflammation).

• Why effective feeding is important and are confident with positioning and attaching their babies for breast feeding.

They should be able to explain the relevant techniques to a mother and provide the support necessary for her to acquire the skills for herself. iii. Mothers will be encouraged to continue to keep their babies near them so that they can learn to interpret their babies’ needs. iv. Baby-led (or ‘demand’) feeding should be explained to mothers and encouraged for all healthy babies. Staff will ensure that mothers understand the nature of feeding cues and the importance of responding to them and that they have an awareness of normal feeding patterns, including cluster feeding and ‘growth spurts’. v. The importance of night feeding for milk production should be explained to all mothers. Ways to cope with the challenges of night-time feeding will be discussed, including issues related to bed sharing, to enable them to manage night-time feeds safely. vi. Staff will not recommend the use of artificial teats or dummies during the establishment of breast feeding. Parents wishing to use them should be advised of the possible detrimental effects such use may have on breast feeding to enable them to make a fully informed choice. The information given and the parents’ decision should be recorded in the baby’s health record.

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vii. The appropriate use of dummies for breast feeding babies later in the post natal period should be discussed with mothers, together with the possible detrimental effects they may have on breast feeding (in relation to demand feeding), to enable them to make fully informed choices about their use. viii. Staff should ensure that mothers are offered the support necessary to learn how to express their breast milk by hand. They should ensure that the mother is aware of the value of hand expression, for example, in the proactive treatment of a blocked duct to prevent the development of mastitis. A leaflet on hand expression should be provided for women to use for reference, where this has not already been provided by the maternity services. ix. All breast feeding mothers will be given information which will support them to continue breast feeding and maintain their lactation on returning to work.

6.6 Supporting exclusive breast feeding i. For the first six months no food or drink, other than breast milk, is to be recommended for a breast fed baby except by an appropriately trained health or medical professional. If supplementary feeds are recommended the reasons should be discussed in full with the parents. Any supplements which are prescribed or recommended should be documented in the baby’s health record along with the reason for supplementation. ii. Parents who elect to supplement their baby’s breast feeds should be made aware of the health implications and of the harmful impact supplementation may have on breast feeding to allow them to make a fully informed choice. iii. All mothers will be encouraged to breast feed exclusively for the first six months and to continue breast feeding for at least the first year of life. They should be informed that solid foods are not recommended for babies under six months. All weaning information should reflect this ideal. iv. Breast milk substitutes will not be sold by community health care staff or on health care premises.

6.7 A welcome for breast feeding families i. Breast feeding will be regarded as the normal way to feed babies and young children. ii. Mothers will be enabled and supported to breast feed their infants in all public areas where DCHS children’s community services staff come into contact with families. iii. Signs in all public areas where DCHS children’s community services staff come into contact with families’ facility will inform users of this Policy. iv. All breast feeding mothers will be supported to develop strategies for breast feeding outside the home and will be provided with information about places locally where breast feeding is known to be welcomed.

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v. Community health care staff will use their influence wherever possible to promote awareness of the needs of breast feeding mothers in the local community, including cafes, restaurants and public facilities.

6.8 Encouraging community support for breast feeding i. All breast feeding mothers will be provided with contact details for community health care staff that can provide support with breast feeding. ii. All breast feeding mothers will be informed about local and national initiatives to support breast feeding and provided with details and contact numbers for breast feeding counsellors/peer support programmes and support groups.

7. SUPPORT AND ADDITIONAL CONTACTS Ruth Oscroft, Health Improvement Practitioner for Breastfeeding. Breastfeeding Team Stubley Medical Centre,7 Stubley Drive,Dronfield Woodhouse,Derbyshire, S18 8QY Tel: Tel: 07833057237 [email protected] Jo Glossop, Health Improvement Practitioner for Breastfeeding. Breastfeeding Team. Stubley Medical Centre,7 Stubley Drive,Dronfield Woodhouse,Derbyshire, S18 8QY Tel 07876502967 Email: [email protected] Lesley Wakefield, Locality Manager/ Strategic Breastfeeding Lead. Tel: 01298 212870 Email: [email protected]

8. REFERENCES AND ASSOCIATED DOCUMENTS Blair P S, Heron J & Fleming P J (2010) Relationship Between Bed Sharing and Breastfeeding: Longitudinal, Population-Based Analysis. Pediatrics. published online 18 October 2010, 10.1542/peds.2. Department of Health (DH)(2004a) Choosing Health: making healthier choices easier, London: The Stationery Office.

Department of Health (2004) Every Child Matters, London.

Department of Health (2007) Maternity Matters, London.

Department of Health (2004) National Framework for Children and the Maternity Services (DH 2004) London.

Dfes (2007). The Children’s Plan: Building brighter futures. Public Service Agreement Improve the health and well being of children and young people.

FSID (2008) Breast feeding reduces the risk of cot death. Genna C W (2008) Selecting and using breastfeeding tools: improving care and outcomes Amarillo, TX: Hale Publishing.

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Hands A (2003). Safe storage of expressed breast milk in the home. MIDIRS Midwifery Digest. Vol.13. No.3 pp378-385.

Hill PD & Aldag J (2005) Milk volume on day 4 and income predictive of lactation adequacy at 6 weeks of non nursing preterm infants Journal of Perinatal and Neonatal Nursing 19 (3) 273 – 2832.

INFACT (2006) Risks of Formula Feeding - brief annotated bibliography Baby Milk Action, Lang S (2002) Breast feeding Special Care Babies 2nd edition, London: Bailliere Tindall. National Health Service Information Centre (2011) Infant Feeding Survey 2010 Early Results NHS IC. National Institute for Health and Clinical Excellence (NICE) (2006), Promotion of breast feeding initiation and duration. www.nice.org.uk

(NICE 2006) Routine Postnatal Care: Routine Postnatal Care of Women and their Babies.

NMC (2008) The Code: Standards of conduct, performance and ethics for nurses and midwives. NMC: London.

Quigley M.A., Kelly Y.J., Sacker A.S. (2007) Breastfeeding and Hospitalization for

Diarrheal and Respiratory Infection in the United Kingdom Millennium Cohort Study.

Pediatrics; 119; e837- e842

Standing Committee on nutrition of the British Paediatric Association (1994): Is breastfeeding beneficial in the UK? Arch Dis Child. 71:376-80.

UNICEF UK Baby Friendly Initiative (2001) Implementing Baby Friendly best practice standards. London: UNICEF.

World Health Organisation (1981) Code of marketing of breast milk substitutes. Geneva: World Health Organisation.

World Health Organisation (WHO) (1998). Evidence for the Ten Steps to Successful Breast feeding. WHO: Geneva.

9. TRUST ACCOUNTABILITY / RESPONSIBILITIES The Trust accountability / responsibilities section should identify the responsibilities of individuals, groups of employees or committees specific to the policy which is being developed. The wording, below can be copied and pasted into the policy being developed and additional information can be added – it is expected that 9.1 and 9.2 will be in every policy but that the others will be picked appropriately depending on the subject matter of

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the policy. This is not an exhaustive list and if there are other individuals or groups, for example, volunteers, that need to be in the policy, they should be added in as appropriate. 9.11 The DCHS Way Expectations: What we can all expect from DCHS:

• Share and support us in understanding our vision, values and priorities

• Be clear as to what is expected of us and what our part is to play in the organisation

• Support us to deliver our job in the best way

• Manage and support us to maximize our performance

• Communicate with us in a timely, open and honest way

• Listen to us and involve us in decision making

• Respect and value diversity What DCHS can expect from all of us:

• Put patients at the heart of what we are doing, promoting their health at every opportunity

• Go to the extra mile for patients, carers, colleagues and the good of the organisation

• Continuously improve our performance and our services

• Eliminate waste and ensure we work as efficiently and flexibly as possible

• Live the DCHS values and behaviours

• Fulfil the requirements of our professional standards

• Take responsibility for promoting the reputation and image of DCHS at every opportunity

9.2 Individuals: 9.2.1 Chief Executive The Chief Executive has responsibility from the DCHS Board for ensuring that there are safe and effective systems in place to deliver high quality services. 9.2.2 Director of Service Delivery The Director of Service Delivery is responsible for the high quality, efficient and effective community services provided by the four Service Delivery divisions within the Trust, ensuring that they meet and exceed performance standards. 9.2.3 Director of Quality / Chief Nurse The Director of Quality / Chief Nurse is responsible for the professional leadership of non medical clinicians across the Trust and for ensuring the highest possible quality of care for patients and service users. The Director of Quality is also responsible for the development and implementation of effective strategies and systems to improve patient safety and patient experience across the Trust. 9.2.4 Director of Strategy The Director of Strategy is responsible for developing and leading the Trust’s business development function, ensuring business opportunities and challenges are proactively identified and effectively managed to support delivery of the Trust’s strategy. 9.2.5 Director of Human Resources (HR) & Organisational Development (OD)

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The Director of HR & OD is responsible for providing visible, credible and effective leadership to the Trust in the development and delivery of a HR, workforce and organisational development strategy to support the delivery of both Trust strategies and objectives. 9.2.6 Director of Finance, Performance & Information The Director of Finance, Performance & Information is responsible for providing leadership and management to the finance, information and performance functions and takes responsibility for the financial stewardship, probity and governance of the Trust’s resources. 9.2.7 Medical Director The Medical Director is responsible for providing medical leadership and direction to the Trust Board to ensure that clinical issues are understood and appropriately drive the Trust’s strategic and operational plans. 9.2.8 Assistant Director depending on area The Assistant Director (Insert title of Assistant – TAKE OUT BRACKETS) is responsible for (Insert responsibilities – TAKE OUT BRACKETS) 9.2.9 Head of Service / Operational Managers The Heads of Service and Operational Managers have a responsibility to ensure that the policy is implemented within their area and that their teams are aware of the policy and have received the appropriate training. 9.2.10 Employees Professionally registered employees; all employees are accountable for their professional practice and hold individual responsibility to maintain their knowledge and skills. All employees have a responsibility to be aware of and read policies appropriate to their roles and others where necessary. They should be aware of, and comply with, their responsibilities within the individual policies of the Trust. 9.2.11 Policy Sponsor The policy sponsor is responsible for ensuring that:

• the policy is developed in line with this framework

• the policy is disseminated to its target audience;

• appropriate training is given in the use of the policy;

• the policy is properly implemented.

• its implementation is monitored and reviewed on a regular basis. The policy sponsor(s) for this policy is (Insert title – TAKE OUT BRACKETS) 9.3 Committees: 9.3.1 DCHS Board

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The DCHS Board has ultimate responsibility for DCHS. The Board’s prime duty is to ensure good governance throughout the Trust and act in the best interests of the public for the services DCHS provides. 9.3.2 The Quality Business Committee (QBC) QBC will be responsible for the Governance aspects of the Quality Business domain of the DCHS Way, on behalf of the Board and will shape, influence and provide overall assurance regardring the delivery of the Performance Framework, Financial strategy and investment, IM&T Strategy, Business Development Framework and Integrated Business Plan (IBP). 9.3.3 The Quality People Committee (QPC) QPC will be responsible for overseeing the development of the People and Organisational Development Strategy, providing assurance to the Board that DCHS has the right staff, in the right place, doing the right things. This will include ensuring that staff are recruited, trained and qualified to do the roles required, monitor DCHS’ Quality People performance targets, ensure that effective workforce plans and development are in place and ensure DCHS has effective staff involvement and engagement. The Quality People Committee will have joint responsibility with the Quality Service Committee for developing and assuring equality and diversity activity. 9.3.4 The Quality Service Committee (QSC) QSC will be responsible for shaping, influencing and providing overall assurance in relation to the quality of DCHS services. This will incorporate the three elements of quality governance i.e. – patient safety, the patient experience and the effectiveness of care in relation to patient outcomes. This will be achieved by working on the delivery of DCHS Quality Strategy and compliance against regulatory requirements and external scrutiny. 9.3.5 Safety Group The Safety Group is a formal sub group of the Quality Service Committee. The group will provide the QSC with the overall assurance on the safety management systems and processes in place, to meet statutory, mandatory, legislative and best practice requirements for patient safety, health, safety and environment and specialist prevention and protection.

9.3.6 Clinical Effectiveness Group The Clinical Effectiveness Group is a formal sub group of the Quality Services Committee. The group will provide the QSC with assurance on all relevant aspects of the clinical effectiveness of services and treatments provided to patients of DCHS as measured by both clinical outcomes and patient related outcomes 9.3.7 Patient Experience Group The Patient Experience Group is a formal sub-group of the Quality Services Committee. The Group will provide the QSC with assurance that DCHS puts patients at the “heart of everything we do” and that patient and public engagement and involvement are inherent parts of service design, delivery and improvement.

DCHS is responsible for providing safe, clinically effective services ensuring they are discharged to the highest standards. The Patient Experience Group will be responsible for providing the QSC with assurance that standards are achieved using patient experience as the guiding principle.

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9.3.8 Information Governance Group The Information Governance Group is a formal sub group of the Quality Service Committee. The aim is to ensure that DCHS is aware of and pursues best practice and statutory requirements in Information Governance and promotes Information Governance within DCHS. By implementing these requirements, the group will ensure that all patient and staff information is held securely, and that good quality, accurate information is available to clinicians and services at all times. 9.3.9 Workforce Planning & Development Group The Workforce Planning & Development Group is a formal sub group of the Quality People Committee. The DCHS Workforce Planning and Development Group will provide strategic direction to the organisation in order to give assurance to the Quality People Committee that the DCHS has a workforce plan asigned to the Integrated Business plan and service need and that the development needs of the organisation are being identified and met. The group is where the major decision making process will take place regarding the development of a safe, effective workforce in which quality of service delivery is maintained and driven up. 9.3.10 Organisational Effectiveness & Change Group The Organisational Effectiveness & Change Group is a formal sub group of the Quality People Committee. The Group will support the Quality People Committee in setting and ensuring that high standards of governance and behaviour are maintained in the conduct of the Trust’s business. 9.3.11 Equality Delivery System (EDS) Leadership Group The EDS Leadership Group is a formal sub group of the Quality People Committee. The EDS Leadership Group is responsible for critically monitoring, analysing and evaluating DCHS’ compliance with relevant equality legislation and key Department of Health requirements (including particularly the relevant CQC standards), ensuring that required actions are being progressed and good practice is disseminated in relation to promoting equality and delivering inclusion. 9.3.12 Staff Partnership Forum The Staff Partnership Forum is a formal sub group of the Quality People Committee. To create an environment of partnership working it requires effective two way communication and early engagement in both the strategic and operational priorities within DCHS. To support this, the monthly Staff Partnership Forum has been established for the Senior Leaders of DCHS and the Senior Staff Side Representatives to meet to discuss the organisations goals, objectives, local and national priorities and emerging issues. The Partnership Forum will also agree HR Policies and Procedure prior to formal ratification by the Quality People Committee, and negotiate local terms and conditions. 9.3.13 Information Management & Technology Strategy Group The Information Management and Technology (IM&T) Strategy Group is a formal group of the Quality Business Committee. The IM&T Strategy Group develops and oversees the delivery of DCHS’ IM&T Strategy. It is the main forum for the detailed discussion of strategic IM&T issues and provides assurance to the Quality Business committee.

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9.3.14 Charitable Funds Group The Charitable Funds Group is one of the key committees reporting into the Quality Business Committee. The group will oversee the day to day management of the Charitable Funds and any associated properties. The committee has delegated authority from the Board, as Corporate Trustees, to make decisions regarding the utilisation of the funds and the investment of surplus funds in line with the scheme of delegation. The Charitable Funds Group will support the Quality Business Committee in ensuring that high standards are maintained regarding the management of Charitable Funds and that the requirements of the Charity Commission are met. 9.3.15 Capital Planning Group The Capital Planning Group is one of DCHS’s key groups reporting to the Quality Business Committee. The group will formulate DCHS strategy in relation to capital investment. The group will be responsible for the delivery of a Board approved Capital programme and has delegated authority from the Board to make decisions and to vary the approved programme within agreed parameters. The Capital Planning Group will support the Quality Business Committee in ensuring high standards are set in the management and delivery of a capital investment programme.

10. MONITORING & PERFORMANCE MANAGEMENT OF THE POLICY The Policy should be implemented in conjunction parents’ guide to the Policy. The standard will be to collect data on the prevalence of both exclusive and partial breast feeding will be collected on initiation, -information from the midwifery handover - at 10.-14 days, 6/8 weeks. It is an essential requirement of the NHSLA Risk Management process that all policies relevant to the standards are monitored. As a minimum an audit should be carried out to ensure compliance against the content of the policy. The table below should be included in the monitoring section of each NHSLA policy to enable this to be carried out:

For all other policies, as a minimum requirement an audit should be carried out to ensure compliance against the content of the policy. The table below should be included in the monitoring section of each policy to enable this to be carried out:

Minimum Requirement Monitoring Who Frequency Review

Duties/Responsibilities

e.g. Review of policy

e.g. Policy Sponsor

2 Yearly – Policy review

Committee/Group relevant to Policy

NHSLA Criteria Monitoring Who Frequency Review

NHSLA Criteria to be added here

Audit Policy Sponsor

Annual Annual audit report presented to (relevant Committee/Group) to address any shortfalls and monitor any actions

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Process including any flow charts

Training Staff in Children’s Services attend UNICEF breast feeding course and have updates

One off attendance to UNICEF course. Yearly updates

Locality Managers at staff Appraisal

Monitoring PPI, UNICEF monitoring as part of baby friendly assessment

Breast feeding mothers

yearly Strategic Lead for Breast feeding

Appendices (If required) N/A

Equality Impact Assessment (EIA)

attached

11. EQUALITY IMPACT STATEMENT This section should contain the following two statements: ‘We welcome feedback on this policy and the way it operates. We are interested to know of any possible or actual adverse impact that this policy may have on any groups in respect of age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation. ‘The person responsible for equality impact assessment of this policy is Claire Scothern Clinical governance Coordinator Children’s Community Services. The Hub, Shiners Way, South Normanton, Derbyshire. DE55 2AA. Tel:01773814302 Email [email protected] ‘This policy has been screened to determine equality relevance for the following equality groups: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex and sexual orientation. The policy is considered to be equality relevant for the following groups: {list}. The equality relevance is considered to have low equality relevance. A full impact assessment has been conducted and the report is attached to this policy.

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APPENDICIES

Appendix 1

The Seven Point Plan For Sustaining Breast Feeding In The Community

1. Have a written Breast Feeding Policy that is routinely communicated to all health care staff.

2. Train all staff involved in the care of mothers and babies in the skills necessary to

implement the Policy. 3. Inform all pregnant women about the benefits and management of breast feeding. 4. Support mothers to initiate and maintain breast feeding. 5. Encourage exclusive and continued breast feeding with appropriately timed

introduction of complementary foods. 6. Provide a welcoming atmosphere for breast feeding families. 7. Promote co-operation between health care staff, breast feeding support groups, and

the local community.

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APPENDIX 2

The Ten Steps To Successful Breast Feeding (Hospital) 1. Have a written Breast Feeding Policy that is routinely communicated to all health

care staff. 2. Train all health care staff in the skills necessary to implement the Breast Feeding

Policy. 3. Inform all pregnant women about the benefits and management of breast feeding. 4. Help mothers initiate breast feeding soon after birth. 5. Show mothers how to breast feed and how to maintain lactation even if they are

separated from their babies. 6. Give newborn infants no food or drink other than breast milk, unless medically

indicated. 7. Practice rooming-in, allowing mothers and infants to remain together 24-hours a

day. 8. Encourage breast feeding on demand. 9. Give no artificial teats or dummies to breast feeding infants.

10. Identify sources of national and local support for breastfeeding and ensure that

mothers know how to access these prior to discharge from hospital.

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Appendix 3

The WHO Code

This was drawn up jointly by the World Health Organisation (WHO) and UNICEF. Its main aim was to protect both breast feeding and formula feeding mothers from undue commercial pressure. The code is summarised below. Further information can be found in the International Code of Marketing of Breast Milk Substitutes (1981) WHO, Geneva. WHO CODE:

• Prohibits advertising and other forms of promotion direct to the general public or through the Health Service.

• Lists nine specific requirements about what should and should not be included in material for mothers.

• Prohibits free samples to pregnant women, mothers or members of their families.

• Prohibits material inducements to health staff to promote infant formulae.

• Donated equipment may show only the company’s logo, not a product brand name.

• Manufacturers should disclose any fellowships, grants, study tours or conference attendances that they sponsor, and so should the recipient.

• Prohibits company staff from directly or indirectly contacting pregnant women and mothers.

• Prohibits words like “humanised” and “maternalised” on labels and prohibits pictures of infants.

• Code applies to all products used to replace breast milk, including bottle-fed weaning foods, bottles and teats.

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Appendix 4

Parents' Guide To The Community Breastfeeding Policy

Aims We support the right of all parents to make informed choices about infant feeding. All our staff will support you in your decisions. We believe that breastfeeding is the healthiest way to feed your baby and we recognise the important benefits which breastfeeding provides for both you and your child. We therefore encourage you to breastfeed your baby. Ways in Which We Will Help Mothers to Breastfeed Successfully All the staff have been specially trained to help you to breastfeed your baby. During your pregnancy, you will be able to discuss breastfeeding individually with a midwife or health visitor who will answer any questions you may have. A midwife will be available to explain how to put your baby to the breast and to help with feeds in the early days. A health visitor will provide support later on. We will show you how to express your breast milk and we will give you written information about this. We recommend that you hold your new baby against your skin as soon as possible after birth and keep him or her near you whenever you can so that you can get to know each other. We will give you information and advice about how to manage night feeds. We will encourage you to feed your baby whenever he or she seems to be hungry and we will explain to you how you can tell that he or she is getting enough milk. We recommend that you avoid using bottles, dummies and nipple shields while your baby is learning to breastfeed. This is because they can make it more difficult for your baby to learn to breastfeed successfully and for you to establish a good milk supply. Most babies do not need to be given anything other than breast milk until they are six months old. If for some reason your baby needs some other food or drink before this, the reason will be fully explained to you by the staff. We will help you to recognise when your baby is ready for other foods (normally at about six months) and explain how these can be introduced. We welcome breastfeeding on our premises. We will give you information to help you breastfeed when you are out and about. We will give you a list of people who you can contact for extra help and support with breastfeeding, or who can help if you have a problem. (This is your guide to the breastfeeding policy. Please ask a member of staff if you wish to see the full policy

Available on DCHS web site: http://www.breastfeedingderbys.co.uk

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12. EQUALITY IMPACT ASSESSMENT Breast Feeding Policy #4 Department Person Responsible Service Delivery Lesley Wakefield Created Last Review Tuesday 8th May, 2012 Friday 1st July, 2011 Status Next Review Mapped Wednesday 8th May, 2013 Screening Data 1. Please identify who is involved in completing this equality screening Claire Scothern Clinical Governance Coordinator Children's Community Services DCHS 2. Please register an EIA Reference Number EIA/CLAIRESCOTHERN/08/05/2012 3. Please give the title and a brief description of what is being assessed Breast feeding policy Supporting documentation can be found here : /store/98/documents/support/Breast-feeding-policy.doc 4. What are its aims and objectives? Why is it needed? How does it aim to deliver the organisations wider business objectives? To meet UNICEF level 3 requirements for breast feeding. To ensure all staff are aware of the health benefits of breast feeding ensuring liaison with other services to ensure a seamless delivery of care and the development of a breast feeding culture within DCHS. To ensure staff have clear guidance in the collection of data of breast feeding sustainment levels as part of the organisational performance management targets. 5. Who (which section, department and organisation/s) is responsible for implementing, monitoring and developing it? Health Wellbeing and Inclusion directorate Children's Community Services (DCHS) will implement and monitor this policy Children's Centre Workers employed by Derbyshire County Council are to follow the guidance in this policy when involved with the care of any breast feeding mothers 6. On a scale of high, medium or low, please make an assessment of its equality relevance (using the Guidance Notes below) 7. Is it relevant to, or does it support, one or more of the aims of the public sector equality duty? Please tick all that apply None 8. Which of the following equality groups (referred to as 'Protected Characteristics' in the Equality Act 2010) is it relevant to? None 9. What data, information or intelligence do you have that shows how it will affect (or does affect) each of the equality groups?

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Policy will not affect any of the equality groups as the aim of the policy is to ensure that a seamless supportive service is offered to all those mothers who choose to breast feed their baby. 10. Which equality groups are, or could be, particularly affected*? *This could include information about who it is intended to benefit and how All mothers who breast feed 11. Have you identified any gaps in data or information for one or more of the equality groups? no 12. Is a Full EIA recommended? no 13. If you have indicated that a Full EIA is recommended, please state when it will be completed by 14. If you have indicated that a Full EIA is not required, please explain why below The policy is not discriminatory against any particular group. The aim of this policy s to ensure that all staff within DCHS provide a consistent approach to meet the individual needs of those mothers that choose to breast feed their baby.

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