We are a small team made up of breastfeeding peer support workers, an infant feeding specialist midwife, health visitor, peer support co-ordinator and baby friendly implementation officer. We wanted to change the culture surrounding infant feeding so that every mom, baby and family has the support and informed choice about feeding their baby. We have worked hard and overcome many challenges to become an integrated service – as validated by our service specification - and provide support antenatal, on delivery suite, postnatal and paediatric wards, neonatal and then in community up until the mother and baby choose to wean off the breast. Doing so has meant patients receive continuity of care with a friendly face they recognize.We work closely with many wonderful hospital staff as well as health visitors, family partnership nurses, community nursery nurses and children’s centre designated breastfeeding leads. It has taken a long time to build up trust in our team and is now regarded as part of the wider NHS and council generic services.
Despite the challenges we have seen great successes. We have helped increase breastfeeding initiation rates in Walsall by 11.5% in the 5 years since the service was first implemented–from 52% in 2008/9 to 63.5% in 2013/2014 and seen our 6/8 week breastfeeding prevalence rates significantly increase by 10% too-from 25% in 2008/9 to 35% in 2013/14.
Within our clinical care pathways our specialist midwife supports families struggling to breastfeed with clinical challenges and complex issues. This includes many babies in neonatal care. Our specialist health visitor has established a nurse-led tongue-tie division clinic, which has meant many moms and babies now getting remedial treatment plus positioning and attachment support at the time of the frenulotomy, instead of general surgery appointments where peer support is not also available at the time of the procedure. This has meant integrated services operating as part of wider teams and departments.
Our integrated services have meant that in 2013/14 we had the 16th lowest repeat re-admittance rate in England to the paediatric ward for babies 28 days and under, for breastfeeding related conditions. For a locality such as Walsall’s which has a high level of socio-economic deprivation this data is distinct from the usual trends in Public Health indicators for our area.
In community we are working hard towards full UNICEF UK Baby Friendly Initiative accreditation.
Our pledge for next year is to work in a targeted way with vulnerable families least likely to breastfeed and low birth weight, premature babies.
As a team we want families to have the very best care, we want them to feel listened to, supported, empowered and for them to know that each and every one of them matter to us. We make sure that families feel welcomed, cared for and in safe hands. We do not judge but treat everyone with respect and make sure the care and support we provide is individual to them and their own feeding goals and journeys. As a team we do not solely provide breastfeeding support but help families build close loving relationships that encourage bonding and positive, responsive parenting.
When a patient consultation was done in June 2014, 97% of mothers said that the integrated breastfeeding support service was the key that helped them continue to breastfeed. Words about the service such as 'amazing', 'beautiful', 'needed' and 'wanted', showed the deep gratitude and affection felt. In fact we were cited in the consultation as: ‘the amazing purple t-shirt ladies’. Many tears were shed in our office when we read the difference we had made to many moms and babies! Have we made a change? Yes for those moms and babies we have supported. We too have seen a change in the culture with staff working alongside us to support moms in their breastfeeding journey and the performance outcomes our service is measured against.
For a template of Walsall’s service design please see: www.unicef.org.uk/BabyFriendly/Commissioners/Making-it-happen.