2. Enhanced Breastfeeding Support Project Presented by Sarah Mckie Breastfeeding Specialist MW/IBCLC Sarah.mckie@stockport.nhs.uk

3. Background LAA Target DOH Target Increase breastfeeding initiation, Primary visit and 4-6 weeks. Increase support women receive whilst breastfeeding. Develop peer support network

4. 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%

5. 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

6. 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.

7. 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

8. Enhanced Breastfeeding Support Breastfeeding Specialist Midwife Lactation Consultant Jane Graves Peer Supporter www.breastfeeding stockport.org.uk Sue Adamson Midwife Lactation Consultant Breastfeeding support Clinic Wednesdays Breastfeeding Helpline 0161 419 5502 1:1 telephone support Peer supporter BFN training

9. Telephone Support/Breastfeeding Helpline 5567 116 Week 0161 419 4430 23 Day

10. Enhanced Breastfeeding Support

11. 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.

12. 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.

13. 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?

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

15. 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.

16. SHH, ANC, Wednesdays 1-3pm Mondays Bridgehall Childrens Centre Baby Massage, Tuesdays 3-4pm Shaw Heath Clinic X Bramhall Health Centre X Hazel Grove CC Mondays 10-12 Bredbury/Woodley CC Tuesdays 1-3pm Brinnington Childrens Centre Wednesdays 1130-130 Heaton Norris Health Centre Fridays 1-3pm Reddish Vale CC Tuesdays 1030-1130 Offerton Clinic Tuesdays 10-1130 Guywood Centre Guywood Lane Romiley Wednesdays 12-1pm Cheadle Heath Clinic Fridays 10-12 Adswood CC Monday 1-2pm Cheadle and Gatley CC

17. Breastfeeding Support Group Attendance April 08 – To Date

18. Hospital Breastfeeding Support Group/Clinic

19. 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)

20. 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%

21. 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%)

22. What now? Did not achieve full LAA reward target. Lactation Consultant – funding ends September 2009 Paid Peer Supporter – funding ends March 2010 2 nd 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) 1 st phase BFN Breastfeeding Helpers – support groups, existing and new, and voluntary in hospital Frenulotomy Service 2010 Childrens Centre Staff to be appropriately trained. Developed a breastfeeding problem checklist/treatment to be given to all GPs, HV and MW teams

23. 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)

24. THANK YOU FOR YOUR HELP AND CONTINUED SUPPORT