It is well recognised that breastfeeding (BF) is instrumental in providing key health benefits for both mother and baby, including prevention of infections and obesity. Global and national evidence is unequivocal that breastfeeding services are a cost effective intervention, and contribute to NHS savings by reducing GP attendances and hospital admissions. The Baby Friendly Initiative (BFI) is a worldwide programme providing an evidence-based staged approach to sustain breastfeeding in the community. It was launched in 1994 in the UK. This process involves policy development, robust data collection and staff training to ensure that pregnant and breastfeeding women are provided with appropriate and timely breastfeeding support and information.
In December 2013, Southern Health Foundation Trust achieved UNICEF Baby Friendly Accreditation (which recognises that the trust meets certain breastfeeding criteria). The challenges to sustained breastfeeding in Hampshire were similar to those we see all over the country. In Southern Health NHS Foundation Trust, up to 80% of mothers initiate breastfeeding at birth, but then the number falls to 58.1% at 10-14 days and to 45.1% at 6-8 weeks (August 2013 data). To address this high drop off rate, commissioners provided financial support for additional breastfeeding intervention to improve breastfeeding prevalence at 6-8 weeks and beyond while the trust were increasing the number of health visiting staff.
Three GP practices were selected across Winchester, Andover and Basingstoke to offer a phone assessment and support, signposting to local breastfeeding support groups and promote the trust’s breastfeeding pages and electronic resources on their website. A home visit was provided as appropriate.
The project commenced in mid-May 2013 and has achieved positive results so far. Of the women who received this early intervention 55% to 81% of their babies were still receiving breast milk compared to 37% to 54% before the study commenced. This is an increase in breastfeeding across the three GP practices of between 14% to 76%.
The trust collected feedback from parents and 75% said that the project had helped them with breastfeeding. They said,
“It was very helpful to have someone spend the time to watch a feed, check the latch and offer support and encouragement”.
“Just knowing there was someone on the end of the phone to call if having any problems helped, plus the support of the breastfeeding counsellors in the community. I had a few problems early on and the help I received definitely helped me to carry on Breastfeeding”.
“I am still breastfeeding now and I am going to continue for as long as I can/until I go back to work! After a difficult delivery I was very weak and we struggled at first and we have hit some bumps along the way, having someone to quickly call to help has been amazing I have used this a number of times. It also helped diagnose oral thrush in my daughter so we got her to the doctor's quickly”.
“I am exclusively breast feeding and don't think I would be without the support”.
The pilot programme has been extended because of the success we’ve seen so far, and areas with highest need have been prioritised for the expansion. The Trust have recruited two additional staff nurses to work alongside the original project worker, delivering the service to a further 10 practices in Gosport, Havant and Waterlooville, and Eastleigh. The service is ever-evolving and evaluation is continuing.
Helen Long is a Health Visitor at Southern Health NHS Foundation Trust