Breast Feeding Information for mentors Gerry Lucas Sue Davis

Purpose of going BFI at UWE The midwifery team are enthusiastic to deliver a breast feeding syllabus that is recognised externally in providing students with high standards of breast feeding education. The purpose of this podcast is to ensure that all staff who have contact with students and breastfeeding women are prepared for mentoring students. The 18 learning outcomes of the BFI standard can be found in the programme handbook.

Reason The majority of health professionals in the UK appear to have had little formal education in breastfeeding and lactation management (Dykes 1995). This has resulted in many health professionals being ill- equipped to assist women to breastfeed, which in turn has resulted in many mothers being unable to breastfeed their babies successfully (Becker 1992). At UWE we hope to become accredited to show that we are educating our students appropriately. But, we cannot do this alone. The successful adoption of the Ten Steps or the Seven Point Plan and the 18 learning outcomes of the Baby friendly Initiative by students need to be supported by mentors in practice

Hours The Baby Friendly Initiative recommends that 18 hours of training, including 3 hours of supervised clinical practice, be given to all staff who support breastfeeding mothers. This is not an official requirement as they are more interested in the actual skills and knowledge of the staff, rather than how these are acquired. However, given the fundamental importance of training to the successful implementation of the standards, it is strongly advised that as much importance as possible is attached to this issue.

Your role as a mentor All mentors who have responsibility for caring for breastfeeding mothers should have received an education which places an emphasis on practical skills and an understanding of the breastfeeding process (Lang and Dykes 1996 ). The aim of the trust education would have been to equip you with a real understanding of how breastfeeding works so that you are able to understand why problems occur and how best to help women avoid them.

Good practice Staff should be able to explain the value of good practices such as baby-led feeding, skin- to-skin contact and the avoidance of teats and dummies. They should also be able to teach students and mothers how to manage breast feeding complications

We strongly recommend supervising clinical practices in positioning and attachment and hand expressing, as knowledge is only useful if accompanied by the clinical skills to pass it on to mothers. Clinical practice in positioning and attachment and hand expressing is the best way of ensuring that all students have the skills needed to properly support breastfeeding mothers. Making the clinical practices part of the programme helps ensure that all students have this opportunity

Content of programme When planning the education programme, we try to bear in mind what will actually assist staff to implement the breastfeeding policy successfully. This is particularly important when the time allowed for training is relatively short. Ensuring that all teaching is kept relevant to the Baby Friendly best practice standards is recommended. The students will have teaching sessions to familiarise themselves with the ten steps and the 18 learning outcomes. Attendance at these sessions is mandatory for student midwives.

Policy orientation All staff should have received orientation to the breast feeding policy within their trust. This will allow them to support students. Ideally students who are directly involved with breast feeding in the care of mothers and babies should receive a formal orientation to the policy within the first week of their placement. At the very least this should be in the form of a discussion with a mentor or senior member of staff about the implementation of the policy at the facility. It is recommended that the mentor and student are required to sign to confirm that full orientation has taken place. The resulting document can then be filed in the student’s portfolio

Assessment At assessment, all relevant students are expected to demonstrate the skills and underlying knowledge necessary to teach women on how to position and attach babies for breastfeeding and how to express breast milk by hand. They are also asked to demonstrate knowledge of how to help women to manage their breastfeeding successfully and an ability to give appropriate information concerning the introduction of foods other than breast milk.

Curricula Written curricula are available for mentors training students. They give enough guidance to allow mentors to teach breast feeding where required. This will include the details of the course content, aims,learning outcomes, subject areas covered. This can be obtained in the programme handbook and module handbooks. It is important that all the Baby Friendly best practice standards are clearly covered in the curriculum, especially practice

Skills required Post Qualification It is important that all student midwives leave their pre-registration training with the basic skills needed to help breastfeeding mothers and those health care providers should not have to pick up the bill for the extra training required to enable their staff to practise competently. Employers of health care staff are therefore encouraged to inform training institutions of their requirements and expectations for newly qualified staff.

References Becker G.(1992 )Breastfeeding knowledge of hospital staff in rural maternity units in Ireland. Journal of Human Lactation 1992; 8: Dykes F(1995.) Valuing breastfeeding in midwifery education. British Journal of Midwifery; 3: Lang S and Dykes F. (19960 WHO/UNICEF Baby Friendly Initiative - educating for success. British Journal of Midwifery; 5: Adapted from Baby Friendly Initiative UNICEF Training all staff 2010