A network of trained peer support is an essential part of high quality integrated breastfeeding services.
Unicef UK Baby Friendly Initiative (BFI) outlines three components that good local breastfeeding services must include, in order to be awarded Baby Friendly accredited status.
Basic, or Routine Care
All health workers who work with new families (health visitors and any allied healthcare assistants in the community services) have been trained to BFI standard (approximately 18 hours of initial in service training, with yearly updates of an hour or more).
Here BFI outlines how every health visiting and community service must be embedded in and well supported by a network of trained peer supporters, or other social and trained breastfeeding support. NICE recommends that peer support programmes be externally accredited. Good practice includes not only training, but also regular supervision and updates of skills and knowledge. Typical peer support programmes require peer supporters to be experienced breastfeeding mothers, and often expects them to come from similar communities as the population they are supporting. Training generally is part time, over 16-36 hours. Peer supporters work in a supervised setting, acting as an “informed friend,” and referring complex cases on to health professionals or an advanced breastfeeding practitioner such as an IBCLC or breastfeeding counsellor, using a referral pathway.
Breastfeeding counsellors in the UK are also experienced breastfeeding mothers, so they also provide a type of peer support, or “mother-to-mother” support. Their training typically take around two years, and they are autonomous practitioners, who can be responsible for leading their own local breastfeeding support groups, usually through one of the main UK breastfeeding voluntary organisations.
Mothers who are experiencing breastfeeding challenges often need more than one visit – and they need the time that it requires for skilled listening as well as exploration of possible breastfeeding strategies to resolve the issue. Although many health visitors have additional breastfeeding training and skills, the health visitor workforce is vastly overstretched, and it simply isn’t possible to provide the time and the number of visits that many breastfeeding mothers need.
But peer support programmes can provide this – they offer groups where lonely mothers can meet others and gain confidence in their own mothering, alongside skilled listening and well- informed support. Many mothers will find their own “village” in their local breastfeeding support group, and will return again and again. Some will go on to train as peer supporters or breastfeeding counsellors themselves.
Peer support groups are the beating heart of breastfeeding support
Helen Gray, WBTi Joint Coordinator
Every area should have a referral pathway to specialist care at the IBCLC (International Board Certified Lactation Consultant) or similar level, for those complex cases where breastfeeding issues cannot be resolved at the level of basic/ routine care or by additional peer support.
The different roles of breastfeeding support in the UK have been outlined in the chart below:
WBTi’s research: Case studies of best practice The WBTi 2016 Report featured several case studies of areas who showed best practice in providing well joined up, integrated breastfeeding services: Brighton and Harrow.
More recently, our WBTi team has presented posters featuring these and additional case studies of best practices in providing integrated breastfeeding services: Medway, Harrow and Swindon.
These examples of best practice in integrated breastfeeding services gave concrete results.
– a 2% rise in breastfeeding rates in a socially deprived area in 2018 (Medway),
– a 15% rise in initiation and a 12% rise in continuation of breastfeeding over a six year period (Harrow)
– and a 6% reduction in drop off rates from birth to 6-8 weeks over six years (Swindon).
Our WBTi team are always on the lookout for further examples of best practice in integrated breastfeeding services, and we submit them to Public Health England. Please do contact us if you would like to submit your local services!
Guidance is needed on infant and young child feeding for families in the UK affected by disasters and emergencies.
Heather Trickey and Helen Gray.
Disaster and emergency situations – floods, fires, terrorist attacks and widespread power failures – can affect any country, including the UK. In any disaster or emergency, babies are vulnerable and continued access to adequate and safe nutrition is essential. Families need support to ensure that children continue to be cared for and fed in line with their needs.
Babies who are fully or partially formula fed are at risk if their caregivers lose access to clean water, are unable to sterilise feeding equipment or suffer disruption or contamination of their formula milk supplies. A suitable environment for preparation and storage of feeds, sterilising equipment, boiling water and safe storage such as a refrigerator, are all needed to prevent bacterial contamination
Risks for breastfed babies
Breastfeeding protects against infection and can be comforting to infants and mothers during difficult times. Mothers’ supply of breastmilk is resilient, however, chaos, displacement and emotional strain, coupled with commonly held misconceptions about how breastfeeding works, can undermine a mother’s confidence and result in less frequent feeding. Breastfeeding mothers need access to the option of feeding in a private space and reassurance that continuing to breastfeed is the best option for their baby.
Skilled support can help mothers resolve breastfeeding problems and maintain the protective effect of full or partial breastfeeding. If breastfeeding helpers are not pre-authorised as part of planned disaster response the immediate help that families need can be delayed.
Risks associated with donated formula milk
The world is a better place than we sometimes think. When a disaster strikes, ordinary people often respond with an outpouring of generosity. We give clothes, equipment and food spontaneously and in response to public calls.
In the absence of guidance, agencies responsible for co-ordinating emergency response and volunteers working on the front line are often not aware that donations of formula milk can put babies at risk. Risks from donated formula milk include inadvertently distributing products that are unsuitable for babies under six months or for babies with special nutritional needs, as well as distributing milk that is contaminated or out-of-date. There is also a risk that donations will be inappropriately provided to parents of breastfed babies, which can undermine the protective effect of breastfeeding and cause parents to become dependent on a continued supply of formula milk.
International guidelines for emergency feeding caution against accepting donations of formula milk. It is recommended that emergency planners and first responders, with expert advice, take responsibility for purchase and distribution of appropriate formula milks in line with the needs of each family.
UK-based emergencies have tended to be highly localised and short-term. However, UK guidance will need to ensure preparedness for longer-term support needs, for UK charities and for displaced families and unaccompanied children who have sought refuge from outside of the UK.
How to help ensure babies’ nutritional needs are protected
In the absence of national guidance, relief co-ordinators and agencies and members of the public will be concerned to do the right thing in response to a disaster. There is an urgent need to improve planning and raise awareness about the best ways to support infant and child feeding. These key points from have been adapted from UK and international guidance: 1) Members of the public
DO donate money to key agencies. This is the best way to support parents who need to buy formula milk. Money will allow parents, caregivers or coordinating aid organisations to buy the most appropriate milk to meet the individual needs of each baby. Donated formula milk can inadvertently put babies at risk.
DO offer your time to help agencies co-ordinating relief. Support and encourage mothers who are breastfeeding. Breastfeeding is protective against infection, and provides the baby with the safest possible nutrition.
2) Relief workers and aid agencies
DO have a local plan to support infant and young child feeding in emergencies in place for local authorities, first responders and aid agencies. All families should be screened to ensure they receive appropriate support or supplies.
DO ensure that mothers who are fully or partially breastfeeding have the support they need to continue. Mothers can seek support from their midwife or health visitor. Local emergency planning should have identified appropriate infant feeding support from local health and voluntary services. There are telephone helplines which support caregivers with all aspects of infant feeding:
NCT helpline (0300 330 0700)
The National Breastfeeding Helpline (0300 100 0212).
DO encourage donations of money to recognised agencies so that parents, caregivers and agencies can buy any formula or supplies needed, rather than donations of formula products.
Appropriate support or supplies including cash cards specifically for the purchase of infant formula and complementary foods for young children could be considered.
DO ensure that formula milk is purchased and distributed only for babies who need formula milk, following basic screening of families (simple triage tools have been recently been developed for use in emergency situations in Greece and Canada).
DO NOT distribute formula milk in an untargeted way.
There is an urgent need for UK governments to ensure infant and child nutrition is protected as part of the planned new strategy for resilience in major disasters. Local authorities and relief agencies require national guidance to develop local strategies so that we can all be better prepared.
Heather Trickey is a Research Associate based in DECIPHer, Cardiff University. Her research focuses on public health policy and parents, particularly Infant Feeding Policy.
Helen Gray is Joint Coordinator of the World Breastfeeding Trends (WBTi) UK Working Group.
Support is the theme for National Breastfeeding Celebration Week in England this year. Mothers are sharing their photos and stories of key support from their own “breastfeeding best friend” on social media with the hashtag #bffriend17
Who was YOUR “breastfeeding best friend”? #BFfriend17?
Ruth’s experience is typical: “[Day 6 after the birth, 4am] Me – sobbing: I don’t think this latch is right. It hurts. No, it really hurts. It’s not supposed to hurt. I’m sure it’s not supposed to hurt. But he’s hungry. I have to feed him. I need help. I’m tired, and I’ve got no idea what I’m doing. Who can I get help from?
First time breastfeeding mums the country over will recognise this. The pain of a poor latch, a hungry baby, knowing you need help and not knowing where to get it. At 4 AM, in a state of nearly delirious sleep deprivation. I hung on until the morning, when my dad brought my ex-midwife grandma to help me. She showed me how to relieve my engorgement and soften my nipples so that my baby had something to latch on to. Though it wasn’t totally plain sailing from there. The several days of poor latching had given me a badly cracked nipple, and then I got mastitis. But it healed, and I went on to breastfeed for 2 years. If I hadn’t had my grandma’s support at that moment, I would have stopped breastfeeding.”
So how exactly do we – in England – support breastfeeding mums? There is support available. They can access support from midwives, health visitors, lactation consultants, breastfeeding counsellors and peer supporters. This might be through the NHS, or via third sector organisations such as the Association of Breastfeeding Mothers, the Breastfeeding Network, La Leche League and NCT. (Indicator 6 in the WBTi report, Part 1 and Part 2) There have, however, been significant cuts to many of these services, particularly peer support and drop-ins (part 2, page 30) and there was already a huge postcode lottery in the services available. This is compounded by the fact that there is no national information and communication strategy in England (Indicator 7). There is no centralised database of breastfeeding drop in support (the NHS Choices “find local support” (http://www.nhs.uk/service-search/Breastfeeding-support-services/LocationSearch/360) service uses information held by Netmums) So while there is support available, it can be difficult to find and difficult to access, and in many areas there is just not enough. And it’s certainly very difficult at 4 AM in the middle of a feeding crisis.
Commissioners to ensure there is a range of integrated postnatal services that include both health professional and voluntary-sector breastfeeding support, meet local needs and provide clear access to specialist support.
Government to implement existing NICE guidelines on antenatal and postnatal breastfeeding information and support.
Government to make Baby Friendly accreditation in all maternity and community settings mandatory.
Commissioners to maintain the full range of health-visiting services, and maintain health visiting as a universal service.
Funding for public health to be protected.
PHE to explore options to enable families to access information about local services.
Governments to improve data collection to aid evaluation of services.
Government needs to create a national communications strategy to:
provide accurate information in publications and online sources, liaising more with relevant organisations;
include WBW/National Breastfeeding Celebration Week;
launch a public information campaign aimed at wider society (family, community, workplaces).
DH to update the NHS Choices website to provide accurate information and details of breastfeeding support organisations.
A joined up service which meets the individual needs of each mother is essential to properly support mothers to breastfeed. Different mothers need different levels of support and their needs vary during their breastfeeding journeys. On some occasions an understanding friend is enough, sometimes a peer supporter and on others a highly skilled lactation specialist is needed. When we fail to meet these needs, we fail families. It is time for this to stop. It is time to properly support women in their choice to breastfeed their babies. Who was YOUR #bffriend17?
Post your own selfie with YOUR #bffriend17 on Twitter, Instagram, or facebook!
If you attended the 2015 Unicef UK Baby Friendly conference you may have noticed, or taken part, in the informal World Breastfeeding Trends Initiative (WBTi) competition to guess the final assessment score. Sue Ashfield is the winner as her estimate was closest to the actual score of 50.5 out of 100 for Indicators 1-10.
The score is a measure of how the UK is performing against the implementation of key policies and programmes to support mothers who want to breastfeed and the healthcare professionals who help them.
Sue is the lead and Specialist Health Visitor (Infant Nutrition) of First Community Health and Care in East Surrey. Sue is a winner in a much bigger way than the WBTi competition because her community team was reaccredited by Baby Friendly earlier this year and they also supported 10 local children centres in achieving full BFI accreditation in one year. The formal presentation of the award was on March 14th. Sue pays tribute to the hard work of her colleagues for the achievement but it also reflects her commitment and leadership. Read more here.
Her team is a brilliant example of what the WBTi UK report recommends for Indicator 6 (community-based support). There is close, integrated working between 0-19 public health team, breastfeeding counsellors, peer supporters and children centres at the three Baby Cafes, which have been runnning for 10 years.
Practitioners from the 0-19 team work at the Baby Cafes on a rota basis, alongside the breastfeeding counsellor. When they see mothers at home or at drop-in clinics they encourage them to attend the Baby Cafes for social support or more specialised support or just to chat to one of the peer supporters. The breastfeeding counsellors at the Baby Cafes have now trained over 200 peer supporters and this has increased the breastfeeding knowledge and skills within the local community.
The photo above shows Sue holding the Baby Friendly Initiative (BFI) accreditation plaque along with some members of the 0-19 team, some senior managers and their BFI Guardian. Since April, all three community services in Surrey have come together as Children and Family Health Surrey to deliver children’s services.
Sue comments that she found particularly useful the information in the WBTi report about interventions and investment offered in the past and also Report Cards and the summary gaps and recommendations. She will use the findings in the report to inform local commissioners and disseminate information to staff and other stakeholders.
An integrated service like this is needed in all areas, yet in so many places services are being cut, particularly peer support programmes and breastfeeding support drop-ins.
Many congratulations Sue.
Cover photo credit: Paul Carter
Patricia Wise is an NCT breastfeeding counsellor and a member of the WBTi Steering Group
The inspiring story of breastfeeding support in a London borough
I have been reflecting recently on my experiences as a specialist health visitor and infant feeding lead in an outer London borough. The story began twelve years ago, in 2005, when there was a lack of confidence among mothers and staff about the reliability of breastfeeding, which was hidden and rarely seen in public. Over the next eight years, the initiation rate increased from 67% in 2005 to 86% in 2013, and the continuation rate at 6-8 weeks from 50% to 75% (52% breastfeeding exclusively). Breastfeeding became the way most mothers fed their babies. Gradually breastfeeding mothers became visible in cafes, shopping centres, supermarkets, streets, GP surgeries and children’s centres. The Unicef Baby Friendly Initiative assessors stated in a report that, in this borough, breastfeeding had become ‘the normal way to feed babies’.
How did it happen?
How did this change come about in a relatively short period of time? It began in 2005, as a joint project between the NHS and NCT, which secured local health authority funding to set up a breastfeeding support group in an area of social deprivation with low breastfeeding rates. This group became very well attended and was facilitated effectively by two NCT breastfeeding counsellors and a health visitor. A similar group was set up in another part of the borough and was run by me, together with other health visitor colleagues. Many of the mothers were very grateful for the support they received in the groups and some of these women expressed the wish to train as volunteer peer supporters, so that they could help other mothers enjoy breastfeeding their babies, as they had. Two training courses were organised and, that year, 20 peer supporters were trained, registered by the voluntary services of the local Primary Care Trust (PCT), and started working in breastfeeding support groups, in the children’s centres and health service clinics. The news of the training spread rapidly and soon there was a waiting list of mothers wishing to train!
The numbers of groups expanded to be easily accessible to mothers across the borough, running every weekday, in children’s centres, cafes, and health premises. The new peer supporters brought fantastic skills with them, one setting up a website, another a mothers’ Facebook page and another designing our leaflets and posters! One had breastfed twins and set up antenatal sessions for parents expecting multiple births plus a weekly support group for mothers with twins and more. She also visited these mothers at home and lent them cushions, which helped them tandem feed. Soon the exclusive breastfeeding of twins and even triplets became common. A group of Somali mothers was trained and an outreach peer supporter started seeing Somali pregnant women in the hospital. A teenage ‘buddy’ scheme was also started by some of the younger peer supporters, working with the specialist midwife and running antenatal sessions and postnatal support for young mothers. Two peer support co-ordinators were employed to job-share this important role and to deal with concerns of the peer supporters as well as helping with training and supervision. Over the next ten years, more than 200 voluntary peer supporters were trained in the borough and the training continues until the present day.
Public Health prioritises breastfeeding
In 2006, under the government scheme of “Every Child Matters’, the Director of Public Health made breastfeeding the top priority for all children in the borough with accompanying ‘stretch targets’ and funding.
London services are monitored through the ‘Good Food for London’ report on their Baby Friendly status, with details on how each borough is achieving and sustaining the Baby Friendly standards
Baby Friendly accreditation
In 2012 Unicef UK Baby Friendly Initiative carried out a major review that resulted in new, more holistic, child rights-based standards relating to the care of babies, their mothers and families, with a strong emphasis on building responsive loving relationships. A new award has also been introduced to encourage a focus on sustainability after the accreditation.
In parallel with the rapidly increasing numbers of peer supporters, the journey in the borough to become Unicef Baby Friendly (BFI) accredited started and professional training in the community and local hospital began with the two health trusts starting their journeys jointly. A model of multidisciplinary training of midwives, maternity assistants, neonatal nurses, nursery nurses and health visitors began initially with BFI-facilitated training. This enabled hospital and community staff not only to improve their breastfeeding knowledge and skills, but also each other’s roles, co-operate on work challenges and break down any barriers which may have existed previously. Communication skills and talking about their own life experiences, in order to gain an understanding of their impact, especially with infant feeding, became an important part of the in-service training. Interactive group exercises on different breastfeeding situations became an integral part of the training, emphasising the importance of empathy and seeing the problems through the eyes of the mothers. A neonatal breastfeeding co-ordinator was appointed and started training all the neonatal staff in the hospital, including the doctors, and by 2014, Unicef had awarded both the community and hospital trusts their Baby Friendly accreditation.
Peer supporters were also employed by an adjacent borough to work in the hospital, supporting mothers on the postnatal ward, one even working all night once a week; others taught hand expressing and colostrum harvesting in the antenatal clinic, especially for mothers with diabetes.
Achieving cultural change
Within ten years, breastfeeding became a normal and accepted way to feed babies in the borough. Mothers, fathers, and grandmothers-to-be came in large numbers to the twice monthly breastfeeding workshops, gaining confidence and information, with the expectation of the support that would be available to them to help them achieve their goals. A mother said ‘the session expelled myths and I now know how milk is made and transferred to my baby. I am looking forward to skin-to-skin contact after the birth and will follow my baby’s instincts’. Parents meet peer supporters in the support groups, at toddler groups, in the school grounds, in cafes, at sports events, in churches, temples, synagogues and mosques. Peer supporters live and work in the community and spread their knowledge through everyone they meet. Even when they move away from peer support, they take their embodied knowledge into the work place and support their colleagues there. Cultural change can happen through peer support, resulting in breastfeeding becoming embedded in a community. This change is sustainable over time and in future generations, as it spreads through different social groups. Voluntary peer support and informed, professional support is capable of changing attitudes and behaviour within a community to make breastfeeding ‘normal’ in a very cost-effective way. Commissioners need to be aware of how health outcomes can be improved through breastfeeding, for mothers and children, in the immediate and long-term, and it is essential to protect and increase future funding for midwives, health visitors and peer supporters, in order that vital programmes like this can continue.
The World Breastfeeding Trends Initiative UK report in 2016 affirmed the borough’s actions as it recommends in Indicator 6 (Community-based support) that ‘commissioners ensure that there is a range of postnatal services that include both health professional and voluntary-sector breastfeeding support to meet local needs and provide clear access to specialist support’ and that they ‘maintain the full range of health visiting services, and maintain health visiting as a universal service’. Indeed, the borough’s transformation in breastfeeding support is used as a case study in Part 2 of the report.
One mother with an eight-month old baby told me:
‘I so much wanted to breastfeed, but found it incredibly hard at the beginning. I was convinced that it wouldn’t work and it was such a lonely feeling, like I was failing where other mothers were succeeding. Getting support made all the difference- having someone to listen to me and give me confidence to carry on. Suddenly, I didn’t feel alone any more and it changed everything. I know that I would not be breastfeeding now if I hadn’t got help in those crucial first weeks.’
What one London borough has achieved shows what is possible. Unicef UK Baby Friendly Initiative’s Call to Action spells out four key actions to create a supportive, enabling environment for women who want to breastfeed, ranging from national strategy and legal protection from harmful commercial practices to the local implementation of evidence-based practices, as described
This week, support is the theme of Breastfeeding Celebration Week
There’s so much to celebrate about breastfeeding, and for me one of the most special things is how much we can learn from each other as mothers.
Of course there is information everywhere, often far too much of it, and there are medical professionals to give technical support, check our babies’ health, and prescribe any treatments that are needed. But in my time as an LLL (La Leche League) Leader, I’ve noticed that passing on pure information is a tiny part of what we do. What brings mothers to our meetings, and turns them into loyal regulars, is the talking – the chance to share their strong feelings about their unique developing breastfeeding relationships.
The simplest of questions: “how do you know when your baby wants to nurse?”; “what surprised you most about breastfeeding?” can easily set off half an hour of discussion. Dazed new mothers with tiny newborns share their shock and wonder; seasoned mothers on their third child talk about how still, every day, there’s something new.
And of course mother to mother conversations like these provide a safe space for complaining. As one mother put it to me: “LLL meetings are the only place where I can sit and moan about breastfeeding without being instantly told to wean”. When a group starts from a safe shared understanding that breastfeeding matters, and a shared knowledge of its many joys, this gives a context that makes it acceptable to explore the lows, too.
The support of peers can also give a rich source of alternative methods and ways to approach breastfeeding-related problems. A mother suffering through a nursing strike can find a “standard list” of solutions online easily, but there’s a whole extra dimension when she can describe it to other mothers who are right there with her. She can show her child other busily nursing babies, and can talk about any mixed feelings she has – perhaps she’s wondering if this might be a chance to wean that she’ll later regret not having taken, or she might be wondering what effect this will have long term on their breastfeeding relationship. Finally, she might return to the next month’s meeting glowing with happiness as she and her baby are back in tune, all is well, and she has added to her stock of experiences to share with the next mother.
Support from medical and lactation professionals has a crucial place; in times of serious need, specialist help from a lactation consultant can be literally life-saving. And sometimes, in the middle of the night, reaching out to strangers on the internet can be enough to get through.
But for everything else, there’s mother to mother support. It’s embedded in its community, and forms a community of its own within that. Mothers come to LLL meetings nervous, uncertain, clutching newborns and wondering what to expect; sometimes they’re still with us years later, bringing all their successive children, perhaps becoming LLL Leaders themselves, or perhaps just carrying on the conversation, and passing on the support to new versions of themselves.
To recognise the importance of support, mothers are invited to share their photos and stories of support from their own “breastfeeding best friend” on social media, using the hashtag #bffriend17.
Post your own selfie with YOUR #bffriend17 on Twitter, Instagram, or Facebook!
You can find the findings from the WBTi assessment of mother support in the community in “Indicator 6” in our 2016 report
With further details on mother support in the community in Part 2
Helen Lloyd is a Leader with La Leche League GB, and fits in as much time supporting breastfeeding as she can around the needs of her own young children
I received too much breastfeeding support – said no mother ever!
Your vibe attracts your tribe
I did not realise the power of that statement until I became a breastfeeding mother. Nursing my child became a life philosophy, a kaleidoscope lens, spinning my family, bringing like-minded people together and painting the colours of my parenting. About 3 years ago there was a story all over the media about a mother who was asked to leave a certain store because she chose to breastfeed openly in there. Breastfeeding mothers on social media were furious. Simultaneous protests in branches of that store were set up and I organised one of them. Some great friendships were born out of that movement. This simple act sparked a discussion about the needs of the breastfeeding community. This could not end there.
Protest was the beginning.
We wanted to make sure mothers knew their rights. We wanted to educate, empower and bring families together. Slowly a community has been born. It kicked off with a picnic to celebrate National Breastfeeding Week, followed by some meetings in a children’s centre. A year passed and having my third baby gave me a huge boost of confidence to put my peer support training into practice. After another season of outdoor gatherings, I hired a room in a community centre. One of the mothers got inspired and started another group in a nearby town, followed by more of them. All were hosted by mothers who breastfed their own babies and felt they could support others and offer a safe space for befriending.
A few months later we decided to organise peer support training. The services offered by the local health visiting team and children’s centres were not sufficient at the time. And there definitely was a niche for peer support. Having experienced first hand how unique it is having another mother support you through hardships, I fell in love with the idea. We approached other service providers using the Maternity Services Liaison Committee. At first, not many believed in us but, as time passed, we proved to be worthy of their trust. We asked for help from generous friends, who delivered the training at no charge, and we found a venue for free thanks to a children’s centre manager. But mostly we were incredibly lucky to recruit, through our groups, amazing women who agreed to offer their time to volunteer in the local hospital.
We decided it was the right time to create something more formal. West Herts Breastfeeders community came to life thanks to the many mothers who nurtured it deeply. This ‘baby’ was very lucky. It was a firstborn who had all the attention and support from local Infant Feeding teams and the Children’s Services department of Hertfordshire County Council. We came a long way. It took us just over a year to train 18 peer supporters, establish six monthly regular meetings in the West Herts area, recruit nearly 550 members to our virtual community to provide them with 24 hour support through Facebook and all that with no official funding. We are all volunteers. You could be too!
Be the Change
As mentioned in the Open Letter of February 2016, organised by the WBTi UK team, a woman’s ability to breastfeed is often determined by the support she receives and the environment in which she lives. While we cannot change everything, we try to help normalise breastfeeding out and about. We also play an important role in normalising feeding older babies and encouraging mothers to carry on, while often dealing with family pressures to wean or the challenges of returning to work. Most children’s centres provide breastfeeding support only in groups for babies under one year, and health visitors do not see mothers as often as they would like. Not having a healthcare professional label also changes the balance of the dialogue and helps mothers to open up.
Together we can do more
What we strive for in the face of recent cuts and challenges is the partnership between all local services. Our success is owed largely to the power of networking. We can see where we are needed most and what else can be done to make sure no woman is left alone at any stage of her nursing journey. You can help to be part of the change, by simply sharing your thoughts with your newly elected MP. Use the WBTi sample email to tell them what breastfeeding mothers need in your local area. Ask them to use their influence on the Local Authority to showcase the importance of breastfeeding to public health and safeguard their budget for health visiting and breastfeeding support.
Your voice matters.
Please sign up HERE to receive email updates on our WBTi work!
Olga Danyluk –Singh, Chairperson, West Herts Breastfeeders
NHS Breastfeeding Peer Supporter and mother of three breastfed children
Following The Lancet’s series on breastfeeding, published on 30 January, reports in the press largely focused on Britain having “the worst breastfeeding rates in the world”. We knew that wasn’t quite right – rates of starting breastfeeding are relatively high, but they drop off rapidly. Yet, at the same time, the UK is experiencing profound cuts to breastfeeding support services – one of the very things needed to get those breastfeeding rates rising.
So, we organised an Open Letter calling on all four governments of the UK to safeguard public health budgets and end those cuts. The letter also outlines the series of measures needed to improve breastfeeding – rates, duration, and experiences. We are delighted that the letter has been signed by midwives, health visitors, lactation consultants, infant feeding leads, GPs, paediatricians, breastfeeding counsellors, peer supporters, university researchers, and others working in the area of baby feeding and health.
74 percent of mothers initiated breastfeeding 44 percent of mothers were still breastfeeding at 6–8 weeks
– Public Health Outcomes Framework (England) 2014/15
90 percent of women who stop breastfeeding in the first six weeks report giving up before they wanted to
– David Bull, Executive Director UNICEF UK
Most mothers in the UK want to breastfeed, yet most mothers stop breastfeeding before they want to. Why?
The fact is that while breastfeeding is natural, mothers need skilled support to be able to breastfeed. Yet many of the health professionals who work with mothers and babies do not have the knowledge or skills to help them.
Indicator 5 of the WBTi examines how well healthcare systems support breastfeeding. It looks in detail at the training of all health professionals who interact with mothers and babies – midwives, health visitors, GPs, paediatricians, lactation consultants and others – both before and after they qualify in their profession. You can see the full education checklist here.
Support for mothers comes from many sources, not just health professionals. It can come from family, friends, the community at large, and particularly breastfeeding peer-support groups. In the UK, these are run by organisations like the Association of Breastfeeding Mothers, Breastfeeding Network, La Leche League, NCT, as well as by the NHS itself. Mothers who have breastfed their own babies – and who have received training to provide breastfeeding support – are able to provide valuable help to new mothers.
In the UK, just 1 percent of babies are exclusively breastfed for the recommended six months. Common reasons that mothers give for stopping breastfeeding include:
finding breastfeeding painful
concerns about their milk supply
conflicting advice from health professionals
lack of support
Peer supporters are “informed friends” who can help mothers understand what’s normal and help with many common breastfeeding concerns. They offer a compassionate and empathetic ear to new mothers.
This importance of this community-level support is recognised in Indicator 6 of the WBTi, which looks in detail at access to skilled mother support and community outreach. Good peer-support programmes can increase the length of time that mothers exclusively breastfeed their babies. In other words, they can help mothers who want to breastfeed to carry on for as long they choose.