1. Hillingdon Community Health Improving Breastfeeding prevalence with partnership working Jennifer Taubman Breastfeeding Coordinator

2. The way we were… 2009/10 – Initiation 76.3% – Prevalence (6-8 weeks) 56.1% – 15% drop off rates between birth and 14 days Volunteer service – poor uptake, difficult to manage with Hospital Infant feeding lead Antenatal parent craft delivered by maternity services for 1 st time parents Training for professionals optional (breastfeeding management)

3. What were the barriers in delivering breastfeeding support in Hillingdon? High birth rate (approx 4500 births annually) Reduced workforce across maternity/ HV teams Targeted antenatal parent education (first time mums) Targeted contact only from HV in the antenatal period Lack of consistent information and support for women Sporadic peer support across borough

4. What do parents want from antenatal parentcraft? - To meet other local mother in the area - Breastfeeding information - Crying – a checklist! - The first few weeks - Financial advice, where to go for benefits/ assistance - Advice for mum after baby/ health/ sex - Weaning/ Baby food - Local groups/ for parents - Activities with babies - Weight control - Baby bath/ - How to handle the baby

5. What did the workforce say? Poor parent preparation High expectations of parenthood, leading to ‘failure’ in breastfeeding and contributes to PND Lack of early breastfeeding support and preventative information given antenatally Do families know where to go for breastfeeding support? It is often too late (breastfeeding and other health/ social issues) when families are introduced to CC’s

6. What we did Photographs of HV workforce in children’s centres Train all children’s centres to deliver antenatal classes Train all children’s centre staff and community health professionals in breastfeeding management Provide breastfeeding support in groups not just for breastfeeding mothers (no breastfeeding support groups!) Create sustainable breastfeeding support by not relying upon volunteers to run support groups alone

7. Developed in-house volunteer training programme Children’s centre based (and managed) volunteers (who are local mothers) Hospital based volunteers for maternity support

8. Where are we now? Children centre antenatal classes across borough Early access to breastfeeding support (from someone you have met) Consistent /evidenced messages Support at any time in familiar surroundings Happy volunteer workforce as part of teams Volunteers represent local women Sustainable breastfeeding support Cost effective training

11. What have we achieved for families? Consistency of information giving Maximise early opportunity in antenatal period to set realistic expectations of infant feeding, develop coping strategies, leading early breastfeeding support from same staff Meet the needs of local women by offering accessible / evidenced based support from someone women can identify with (age/ language/ ethnicity/ social background) ‘Normalise’ breastfeeding e.g breastfeeding support facilitated in all parent groups in children’s centres

12. What have we achieved professionally? Great working relationships Trust/ value Joint training Joint objectives / working together Less overlap More referrals to and from services Greater recruitment of volunteers Positive impression of breastfeeding across borough

13. Outcomes! Increased initiation, prevalence and duration of breastfeeding in Hillingdon Initiation: 4.5% Increase (based on 2010/11 total data and running average to date 2011/12) 6-8 weeks: 5.2% Increase (based on 2010/11 total data and running average to date 2011/12) Reduced Inequalities: Target intervention to those least likely to commence and continue to breastfeed at key statistical intervals (antenatally, in the first days, following new birth visit) Increased trust in professional advice and likelihood of continued feeding

14. Thank You monica.sherry@nhs.net