Enhanced Breastfeeding

Support ProjectPresented by Sarah Mckie

Breastfeeding Specialist MW/IBCLCSarah.mckie@stockport.nhs.uk

Background

• LAA Target• DOH Target• Increase breastfeeding initiation, Primary

visit and 4-6 weeks.• Increase support women receive whilst

breastfeeding.• Develop peer support network

Where were we?

• 2005/06 – 66.2% initiation• Goal - 74% initiation of breastfeeding• 2005/06 – Primary Visit 47.3%• Goal - Primary Visit 59%• 2005/06 – 4-6 Week Visit 39.1%• Goal - 4-6 Week Visit 48%

STOCKPORT BREASTFEEDING SUPPORT 2007-08

• Training – mandatory for all staff in FT & PCT• All women who deliver in Stockport are given

the ‘blue card’ on discharge by MW or HV.• www.breastfeedingstockport.org.uk• Personal invite by MW or HV – preferably A/N.• Goodie bag scheme• Posters• Auditing attendance for each group• Self Health section in all libraries in Stockport

–books• Breast pump hire and sales scheme

Training – to date• Training conducted by

breastfeeding specialist midwife.

• Training: workshop 7.5 hours, workbook 5 hours, reflective practice 5 hours (UNICEF state staff need up to 18 hours training per year).

• Workbook developed and printed

• 2007: 164 Attended training• 2008: 238 Attended training• 2009: to date 139 attended

training• Obstetric and Paediatric

Doctors SHO/REG attend update, every 6 months.

• GP training x 1 surgery has received 1 hour update.

MANDATORY BREASTFEEDING TRAINING

0

50

100

150

200

250

300

350

1 2 3

2007-2009

ATTE

NDAN

CE

OTHER

PRIMARY CARE TRUST

FOUNDATION TRUST

Enhanced Breastfeeding Support• Big drop off from when the Midwives transfer

the care to the Health Visiting Team.• To address this we secured funding from

SMBC to:• Telephone • Breastfeeding helpline• Paid Peer Supporter 15 hours PW • Lactation Consultant 7.5 hours PW• Antenatal Breastfeeding Workshop• Postnatal Support Group (hospital based)• Peer Supporter Training

Enhanced Breastfeeding Support

BreastfeedingSpecialist Midwife

Lactation Consultant

Jane GravesPeer Supporter

Sue AdamsonMidwife

Lactation Consultant

Breastfeeding Helpline

0161 419 5502

1:1 telephonesupport

Peer supporterBFN

training

Breastfeeding supportClinic

Wednesday’s

www.breastfeedingstockport.org.uk

Telephone Support/Breastfeeding

Helpline

5567

116 Week

0161 419 4430

23 Day

Enhanced Breastfeeding Support

enhanced bf support

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50

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150

200

1 5 9 13 17 21 25 29 33 37 41 45

week

cont

acts

telephone contacts

ward/clinic/1:1

home visits

Peer Support – Groups/Training

• Unify the existing groups.• Peer support networking day – support,

recruit and retain current peer supporters.• Develop, support and co-ordinate existing

groups• Co-ordinate the development of new groups• Funding for the BFN breastfeeding helper

training• BFN breastfeeding helpers – support them

to work in the local community and volunteer work in the hospital.

What is Peer Support?

It is not a new concept!

The goal of peer support is to encourage and support pregnant women and those who are breastfeeding.

The peer supporter is a true peer of the breastfeeding mother and not a healthcare professional.

• Improve local breastfeeding rates• Raises the awareness of the benefits of

breastfeeding in the local community• Aims to improve the social acceptability of

breastfeeding within the local community• Provides an informal network of support for

local mothers both before and after the baby is born

• Improves access to easy to understand and evidence based breastfeeding information

• Embraces a partnership approach between the lay breastfeeding supporters, local primary healthcare professionals, and other local organisations that promote breastfeeding.

How do Peer Supporters Help?

Training Programmes

• La Leche League• The National Childbirth Trust• The Association of Breastfeeding Mothers• The Breastfeeding Network• The Thurrock Peer Supporter Programme.

BFN Breastfeeding Helper Training

• 15 week course ran by BFN facilitator (plus monthly supervision sessions for 6 months).

• Course content typically includes; principles of breastfeeding and ways of supporting mothers, debriefing on personal experiences, self awareness, listening skills, role boundaries and responsibilities, record keeping, child protection issues, confidentiality, working safely in others’ homes and support mechanisms.

• Within all the programmes there is a general recognition that peer supporters are there to listen to women, to validate their experiences, to facilitate and empower.

• Supporters tend to experience personal growth and a feeling of empowerment as a result of the training programme.

SHH, ANC, Wednesday’s

1-3pm

Monday’sBridgehall

Children’s CentreBaby Massage,

Monday’s10-12

Bredbury/WoodleyCC

Tuesday’s1030-1130

Offerton Clinic

Tuesday’s 10-1130Guywood CentreGuywood Lane

Romiley

Tuesday’s 1-3pmBrinnington Children’s

Centre

Wednesday’s 1130-130

Heaton Norris Health Centre

Tuesday’s 3-4pmShaw Heath Clinic

XBramhall Health

Centre

Wednesday’s 12-1pm

Cheadle Heath Clinic

XHazel Grove

CC

Friday’s 1-3pmReddish Vale

CC

Friday’s10-12

Adswood CC

Monday1-2pm

Cheadle and Gatley CC

Breastfeeding Support Group Attendance April 08 – To Date

Attendance to Breastfeeding Support Groups April 08-to date

020406080

100120140

1 3 5 7 9 11 13 15 17

month

cont

acts

brinnington

reddish

romiley

offerton

heaton norris

adswood

bridgehall

shaw heath

Hospital

cheadle heath

bredbury/woodley

bramhall

hazel grove

Series14

Hospital Breastfeeding Support Group/Clinic

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15

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30

1 4 7 10 13 16 19 22 25 28 31 34 37

week

num

ber

of c

onta

cts

women attended

first visit

needed 1:1

Has it made a difference?

• Primary Visit has increased from 47.3% to 55.6% (8.3% increase)

• At 4 weeks 39.1% to 47.1% (8% increase)

Breastfeeding Initiation and Maintenance 2005-2008

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InitiationSHH

InitiationPCT

PrimaryVisit

4 -6weeks

When recorded

Brea

stfee

ding%

2005

2006

2007

2008

Since the Enhanced Support Project…• End of May 2008 Primary Visit 51.9% • End of Feb 2009 58.5%

• End of May 2008 4 weeks 44.4% • End of Feb 2009 50.3%

• End of Aug 2008 37.4% at 6 weeks, • End of Feb 2009 56% at 6 weeks (DOH).• Breastfeeding at 6 weeks has increased

by 18.6%

Inequalities Gap - Breastfeeding• In the more deprived areas the gap has

reduced from a gap of 24.1% to 15.4% at primary visit.

• That is from 34.4% 2005/06 to 46.6% 2008/09.

• In the more deprived areas the gap has reduced from a gap of 23.2% to 16.3% at 4 weeks.

• (26.7% bf 2005/06, year 2008/09 37.5%)

What now?• Did not achieve full LAA reward target.• Lactation Consultant – funding ends September 2009• Paid Peer Supporter – funding ends March 2010• 2nd phase of BFN Breastfeeding Helper has started• Monitoring the amount of contact with women out of

midwifery care (over 28 days old), Paediatric and GP contacts

• Developing more PS groups (Cheadle Hulme July 09)• 1st phase BFN Breastfeeding Helpers – support

groups, existing and new, and voluntary in hospital• Frenulotomy Service 2010• Children’s Centre Staff to be appropriately trained.• Developed a breastfeeding problem

checklist/treatment to be given to all GP’s, HV and MW teams

Evaluation of Project• Questionnaire• 8 month baby check - please signpost all

mothers who have breastfed (regardless of duration or exclusivity) to complete questionnaire

• And put in labelled envelope ( to go in the internal mail)

THANK YOU FOR YOUR HELP

AND CONTINUED SUPPORT