Unmet Needs: Breastfeeding Pilot Project Kim Fraser Breastfeeding Project Leader.
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Transcript of Unmet Needs: Breastfeeding Pilot Project Kim Fraser Breastfeeding Project Leader.
![Page 1: Unmet Needs: Breastfeeding Pilot Project Kim Fraser Breastfeeding Project Leader.](https://reader035.fdocuments.net/reader035/viewer/2022070307/551ac7455503466b6a8b4fe8/html5/thumbnails/1.jpg)
Unmet Needs: Breastfeeding Pilot Project
Kim FraserBreastfeeding Project Leader
![Page 2: Unmet Needs: Breastfeeding Pilot Project Kim Fraser Breastfeeding Project Leader.](https://reader035.fdocuments.net/reader035/viewer/2022070307/551ac7455503466b6a8b4fe8/html5/thumbnails/2.jpg)
Unmet Needs• Pilot Project
• 3 NHS boards with highest deprivation
• Demonstrate a link with deprivation and health gain
• Evidence based
• Innovative, sustainable, partnership working
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Inequalities
• Disadvantaged areas-50% less likely B/F
• 1990- highest rates social class 1-3(Dundee Infant Feeding Study)
• 2000’s :• most affluent : 68.2% • Most disadvantaged: 29.4%
(Health Inequalities Strategy)
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0
20
40
60
80
100
120
DD11
DD12
DD13
DD14
DD15
DD23
DD24
DD30
DD36
DD37
DD39
DD40
DD46
DD48
DD49
%
Birth
Discharge
1st visit
6-8 weeks
Breastfeeding by Postcode
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Evidence
Systematic Review NICE 2005
Successful interventions • Include both antenatal and postnatal
periods• One to one interventions
Need further evidence especially deprived areas
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Evidence
Baby’s age when stopped
% who would have liked BF longer
<1 week 90
1-2 weeks 93
2-6 weeks 87
6 weeks-4 months 69
4-6 months 48
>6 months 37
Source: Hamlyn et al 2002
Mothers Who Would Have Liked to Breastfeed Longer
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Evidence : Variables
Health care factorsPartner and family supportLactation knowledge and understandingWorkplace environment
oYears of educationoParityoAgeoIncome
Source: Higginson 2001
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EvidenceUse of Healthcare Assistants
• DOH report on evaluation breastfeeding between 1999 and 2002
• 3 projects which explored the role of health care assistants providing extra support to breastfeeding mothers
• Qualitative evidence from these indicated that it was a successful way of working
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AIMS
• To provide women on low incomes in Dundee with additional information and support by breastfeeding support workers to improve breastfeeding initiation and duration rates
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Objectives
• Recruit and train BSW’s
• Identify mothers living in deprived areas from postcode areas
• Provide additional support , information and practical skills in the antenatal and postnatal periods
• Evaluate effectiveness
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Design
• Non- randomised experimental design
• Intervention group Depcat 5,6 and 7 areas of Dundee
• 2 control groups
• Inclusion Criteria- All pregnant women living in the designated postcode areas
• Exclusion Criteria- none
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Recruitment
• System that allows information to be obtained
• Information when collect hand held notes
• Contacted by BSW
• Rate 1 in 4 initially increased to 40%
• Not persuading
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Intervention
• Provided by Breastfeeding Support Workers
• Make contact in the antenatal period
• Continues postnatally in hospital and home
• Up to 6 weeks post discharge
• Additional support
• Not problem solving
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Results (July to March)
% Change in Breastfeeding Rates (July04-March 05 and July05-March06)
-15
-10
-5
0
5
10
15
Birth Discharge 1st visit 6-8 weeks
Time period
%
Intervention Control deprived Control Affluent
Source ISD September 2006
Intervention 9% increase (CI 4.7-13.3)Control increase 1.8%(CI -8.8- +12.4)
All points of examination statistically significant difference p<0.001
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Results first 6 months
0
10
20
30
40
50
60
70
80
90
100
Intention before birth
Birth Discharge 11 Days 6 weeks
Mixed feeding
ExclusiveBreastfeeding
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Results
Length of Visits
0
5
10
15
20
25
30
35
40
0-14mins
15-29mins
30-44mins
45-59mins
60-89mins
90-119mins
over 120mins
wastevisit
Time
%
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Qualitative Data
Maternal Satisfaction Questionnaires• 76% response rates• High levels of satisfaction
Emerging themes• Enabled establishment and continuation
of breastfeeding• Knowledge and Information• Supportive role• Increased confidence
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Qualitative dataFocus Groups• Breastfeeding Support Workers• Midwives• Health Visitors
In-depth Interviews• Mothers-12
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Continuation• In May NHS Tayside Executive
Team extended project until end March 2007 further data collection
• September- Executive Team agreed to non-recurring funding for 3wte breastfeeding Support Workers for further 2 years
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Conclusion
This is a project which has taken the limited evidence around breastfeeding and deprivation and through a research process has demonstrated an effective model of working that can improve breastfeeding rates for those living in deprived communities that can be used to inform future practice.