Hillingdon Community Health

Improving Breastfeeding

prevalence with partnership working

Jennifer TaubmanBreastfeeding Coordinator

The way we were…

• 2009/10 – Initiation 76.3%– Prevalence (6-8 weeks) 56.1%– 15% drop off rates between birth and 14 days

• Volunteer service – poor uptake, difficult to manage with Hospital Infant feeding lead

• Antenatal parent craft delivered by maternity services for 1st time parents

• Training for professionals optional (breastfeeding management)

What were the barriers in delivering breastfeeding support in Hillingdon?

• High birth rate (approx 4500 births annually)• Reduced workforce across maternity/ HV teams• Targeted antenatal parent education (first time

mums) • Targeted contact only from HV in the antenatal

period• Lack of consistent information and support for

women• Sporadic peer support across borough

What do parents want from antenatal parentcraft?

- To meet other local mother in the area - Breastfeeding information - Crying – a checklist! - The first few weeks - Financial advice, where to go for benefits/ assistance - Advice for mum after baby/ health/ sex - Weaning/ Baby food - Local groups/ for parents - Activities with babies - Weight control - Baby bath/ - How to handle the baby

What did the workforce say?• Poor parent preparation• High expectations of parenthood, leading to ‘failure’

in breastfeeding and contributes to PND• Lack of early breastfeeding support and

preventative information given antenatally• Do families know where to go for breastfeeding

support?• It is often too late (breastfeeding and other health/

social issues) when families are introduced to CC’s

What we did

• Photographs of HV workforce in children’s centres• Train all children’s centres to deliver antenatal classes• Train all children’s centre staff and community health

professionals in breastfeeding management• Provide breastfeeding support in groups not just for

breastfeeding mothers (no breastfeeding support groups!)• Create sustainable breastfeeding support by not relying upon

volunteers to run support groups alone

• Developed in-house volunteer training programme• Children’s centre based (and managed) volunteers (who are

local mothers)• Hospital based volunteers for maternity support

Where are we now?• Children centre antenatal classes across borough• Early access to breastfeeding support (from someone you

have met)• Consistent /evidenced messages• Support at any time in familiar surroundings• Happy volunteer workforce as part of teams• Volunteers represent local women• Sustainable breastfeeding support• Cost effective training

What have we achieved for families?• Consistency of information giving • Maximise early opportunity in antenatal period to

set realistic expectations of infant feeding, develop coping strategies, leading early breastfeeding support from same staff

• Meet the needs of local women by offering accessible / evidenced based support from someone women can identify with (age/ language/ ethnicity/ social background)

• ‘Normalise’ breastfeeding e.g breastfeeding support facilitated in all parent groups in children’s centres

What have we achieved professionally?• Great working relationships• Trust/ value• Joint training• Joint objectives / working together• Less overlap• More referrals to and from services• Greater recruitment of volunteers• Positive impression of breastfeeding across borough

Outcomes!Increased initiation, prevalence and duration of breastfeeding in Hillingdon• Initiation: 4.5% Increase (based on 2010/11 total data and running

average to date 2011/12)• 6-8 weeks: 5.2% Increase (based on 2010/11 total data and running

average to date 2011/12)

Reduced Inequalities:• Target intervention to those least likely to commence and continue to

breastfeed at key statistical intervals (antenatally, in the first days, following new birth visit)

• Increased trust in professional advice and likelihood of continued feeding

Thank Youmonica.sherry@nhs.net