Greenwich Breastfeeding Strategy An example of successful partnership working March 2010

About me Donah Francis Greenwich Breastfeeding Strategy Co-ordinator 0208 921 2537 Donah.francis@greenwich.gov.uk

Why breastfeeding?

Breastfeeding and health inequalities Breastfed babies born to mothers of lower socio-economic groups have better health outcomes than those babies born to mothers from higher socio-economic groups who are formula fed. Forster S (2004).

National recommendations and policy priorities Exclusive breastfeeding for six months – followed by continued breast milk, whilst introducing a more varied diet after this time Healthy Weight, Healthy Lives (Department of Health and Department for Children, Schools and Families, 2008) Health Inequalities – progress and next steps (Department of Health, 2008) Implementation Plan for Reducing Health Inequalities in Infant Mortality: a good practice guide (Department of Health, 2007)

Performance drivers and national targets PSA 12: Improve the health and wellbeing of children and young people - five key indicators including increasing breastfeeding prevalence at 6–8 weeks (PSA 12.1) and reducing childhood obesity (PSA 12.3) Vital Signs Monitoring System Indicator (VSB11) and National Indicator Set (NI) 53 – % infants breastfed at 6–8 weeks is included in the NHS Operating Framework (2008-11) and in the National Indicator Set for Local Area Agreements

Greenwich Breastfeeding Strategy Partnership Greenwich Council: Integrated Support, Children and Families NHS Greenwich: Public Health and Wellbeing Greenwich Community Health Services: Public Health Community Nursing Services for Children, Young People and Families South London Healthcare NHS Trust (Queen Elizabeth Hospital): the Maternity Dept. and Neonatal Unit Greenwich University: School of Health and Social Care

Vision To enable all pregnant women in Greenwich to make an informed choice about how they choose to feed their baby - and that if they choose to breastfeed, that they are adequately supported to do so.

Key programmes of work Quality of care Support in the community Raising the profile Public policy Data collection

UNICEF Baby Friendly Initiative A worldwide initiative which aims to improve quality of care for breastfeeding by implementing best practice standards Established in 1998 by WHO, Geneva Acknowledged by NICE and DH (2008)

Local achievements First in the country to undertake the UNICEF UK BFI co-ordinated approach (2005) The first borough in London to gain a Stage 1 award (2007) The first to be awarded Stage 2 for the community in London (2008)

Joint working Greenwich Council and Greenwich Community Health Services/ NHS Greenwich Breastfeeding drop-in groups held in local Children’s Centres Breastfeeding Advocates who work geographically and are aligned to set Children’s Centres Training for staff – Children’s Centres (25), Nurseries (44) and Registered Child Minders (447) Adoption of Volunteer Policy to support a local peer support programme

Joint working (cont.) Greenwich Council and Greenwich Community Health Services/ NHS Greenwich Local policy which supports breastfeeding in all public services buildings Greenwich Breastfeeding Strategy Group Meeting chaired on rotation The Breastfeeding Team currently housed in Greenwich Council with Integrated Support, Children and Families Direct input into local Children’s and Young Peoples Plan, LAA’s, Safeguarding Inspections etc.

Barriers to partnership working Working productively against the back-drop of organisational change and poor staffing levels Implementing change across services with competing agendas and priorities All-inclusiveness and good communication across all departments and services

Breastfeeding prevalence at 6-8 weeks in Greenwich

Breastfeeding prevalence at 6-8 weeks across neighbouring PCTs in South London

Priorities for 2010/11 Continue to improve clinical care and support Better postnatal support: between transfer home and new birth visit review of community drop-in groups Better insight and targeted support for those women least likely to breastfeed

And finally…