1. Breastfeeding in Fife Belinda Morgan Gina Graham Breastfeeding Support Co-ordinator

2. 2008 Healthy Eating, Active Living – (HEAL ) Equally Well –Tackling health inequalities a priority –Improving maternal nutrition during pregnancy effective action to address future health inequalities –Improve breastfeeding rates in deprived areas and among disadvantaged groups –HEAT Targets H7

3. CEL 36 (Sept 08)– Nutrition of women of childbearing age, pregnant women and children under 5 in disadvantaged areas –Increase uptake of Healthy Start –Support delivery of HEAT target on breastfeeding –Invest in specialist nutritional services –Enable training for those involved in interventions with the target group

4. Breastfeeding at 6-8 weeks Scotland

5. Breastfeeding at 6-8 week review NHS Fife 2001-08 ISD 11 May 09

6. Breastfeeding by CHP 2001-08

8. NICE Recommendations  For Health Boards Adopt a multifaceted approach across different settings. This should include training for health professionals, peer support programmes and education for pregnant women, followed by proactive support during the postnatal period. Implement a structured programme, using BFI as a minimum standard… Subject it to external evaluation

9. Where are we? BFI accredited hospital Breastfeeding Management Training since 2002 11 Breastfeeding Groups Projects where improving breastfeeding initiation / duration is key aim –Breastfeeding Buddies –Family Health Project –VIP Project Raising Awareness of Breastfeeding in schools and via parenthood on schools Increased social marketing BF Award scheme

13. Family Health Project 6 month data 92 mothers supported via 1:1 structured midwifery led support 45% aged 15-19 years All Depcat 4 and 5 29% Breastfeeding & 20% of 15-19yrs 33% smoking & 13% of 15-19yrs

14. Challenges Resources Short-term, limited funding Service organisation / change Geographic variations / health inequalities

15. What next? Breastfeeding Support Team in Forth Park –Ongoing work to maintain BFI Standards –Initiation of breastfeeding Biological Nurturing Clip-on cots –Breastfeeding Problems Clinics –Bumps to Baby talks Bumps to breastfeeding DVD Is natural right for you? CD Rom Hospital & Community "

16. Breastfeeding Buddies 70% said seeing a buddy antenatally helped them decide how to feed their baby 80% said buddy helped them feed longer than they would have otherwise 70% named buddy in ‘Most helpful people question’

17. Breastfeeding Buddies ‘It helped knowing my buddy was at the end of a phone when I needed support’ ‘I was nervous leaving hospital as I hadn’t really mastered feeding. I came straight home and lifted phone to my buddy’ ‘Although I didn’t breastfeed for long, my buddy was there to support me to try again, give me advice and be there with me’ ‘They weren’t forceful like the hospital midwives who make you feel breastfeeding is the only way, they were also patient’

18. Breastfeeding Buddies Challenges –Part-time nature of project –Short term funding –Limited to certain areas –Referrals / engaging other Health Professionals –Reliance on volunteers –‘Nosey neighbour’

19. What next? Community Breastfeeding Co-ordinator post extended –New Breastfeeding Support Workers –Breastfeeding Buddies –Training –BFI in community Breastfeeding in schools

20. NICE Recommendations  For Health Professionals Ensure mothers who breastfeed can demonstrate how to position and attach the baby to the breast and can identify signs that the baby is feeding well Breastfeeding peer support workers should contact mothers directly within 48 hours of transfer home. –Part of multi-disciplinary team –Receive training –Offer ongoing support according to mother’s needs –Can consult a health professional for support