1. Promoting and Protecting Breastfeeding Hazel Woodcock Infant Feeding Coordinator RFT Obstetrics & Gynaecology

2. Why doesn’t everyone breastfeed? Age, social class and education Age, social class and education Cultural norms Cultural norms Lack of confidence - Not enough milk? Lack of confidence - Not enough milk? Drug or medical C/I’s- rare Drug or medical C/I’s- rare Lack of information Lack of information -About breastfeeding -About breastfeeding -About the risks of not BF -About the risks of not BF -About the support available -About the support available

3. ROTHERHAM BF INITIATION 2010/11

4. South Yorkshire BF Initiation Q1 April – June 2011

5. What are we doing to implement change ? The Unicef UK Baby Friendly Initiative - BFI Recommended by: Department of Health Department of Health NICE Postnatal Care Guidance 2006 NICE Postnatal Care Guidance 2006 Nice Maternal & Child Nutrition Guidance 2008 Nice Maternal & Child Nutrition Guidance 2008

6. Department of Health Directives Healthy Lives, Healthy People, Nov 2010 Healthy Lives, Healthy People, Nov 2010 Operating Framework, Dec 2010 Operating Framework, Dec 2010 NHS Outcomes Framework, Dec 2010 NHS Outcomes Framework, Dec 2010 Maternity NSF Maternity NSF Children’s NSF Children’s NSF National Obesity Strategy National Obesity Strategy Healthy Child Programme Healthy Child Programme

7. Baby Friendly – What is it? It’s the expected minimum standard of care and health care organisations will be judged by their progress Informed choice discussion in pregnancy Best practice care postnatally Ten Steps for Maternity Units Seven Points for Community Facilities

8. So how can we protect breastfeeding? Antenatally - don’t ask intention Antenatally - don’t ask intention Promote skin to skin contact at delivery -“The golden hour” - and return baby to mum after successful resuscitation, including in theatre Promote skin to skin contact at delivery -“The golden hour” - and return baby to mum after successful resuscitation, including in theatre Offer assistance with the first feed to ALL mums discuss benefits of colostrum, mothers who intend to AF can give a first BF, some continue Offer assistance with the first feed to ALL mums discuss benefits of colostrum, mothers who intend to AF can give a first BF, some continue Kangaroo Mother Care on NNU and support for early and frequent milk expression – pump loan Kangaroo Mother Care on NNU and support for early and frequent milk expression – pump loan Plenty of support networks Plenty of support networks Supplementation only when clinically required – preferably cups not bottles Supplementation only when clinically required – preferably cups not bottles

9. WHO International Code of Marketing for Breastmilk Substitutes No advertising of breastmilk substitutes bottles and teats in the health care system and to the public No advertising of breastmilk substitutes bottles and teats in the health care system and to the public No free samples to pregnant women, mothers or health professionals No free samples to pregnant women, mothers or health professionals No contact between marketing personnel and mothers or pregnant women No contact between marketing personnel and mothers or pregnant women Appropriate labelling and information Appropriate labelling and information

10. Local Policy Strategic Plan 2010-2015: Better Health, Better Lives. Health & Wellbeing Strategy 2011 Maternity & Newborn Care Strategy 2010-2012 Rotherham Child Health Promotion Programme The Rotherham Breastfeeding Policy 2010

11. Better Health, Better Lives 2010-2015 “Increasing breastfeeding duration rates to 35% in Rotherham will reduce hospital admissions in children under one year old by 5% (225 admissions).” duration ie at 6 – 8 weeks

12. Discuss benefits, on admission, with parents of babies on SCBU, including donor milk (check local policy) Discuss benefits, on admission, with parents of babies on SCBU, including donor milk (check local policy) Consult appropriate sources if asked about safety of medication for BF mothers Consult appropriate sources if asked about safety of medication for BF motherswww.ukmicentral.nhs.uk Know how to refer to experienced BF support when there are feeding problems Know how to refer to experienced BF support when there are feeding problems Reinforce DH and WHO weaning advice - no other fluids or food till around six months Reinforce DH and WHO weaning advice - no other fluids or food till around six months What else can medical staff do ?

15. Thank you Thank you