The Health Roundtable Introducing the role of the Breastfeeding Advocate on the Maternity Ward Presenter: Debra Fenton Hospital Code Name: Fury Innovation Poster Session HRT1104b – Maternity March

The Health Roundtable KEY PROBLEM  Our struggle to achieve BFHI  Diverse population where many of our mothers have English as a second language  Low breastfeeding profile within Maori and Pacific communities  Workforce shortages/High acuity ward  Very short postnatal length of stay  Minister of Health intent on increasing length of stay for women with specific needs

The Health Roundtable AIM OF THIS INNOVATION  To ensure that women receive the essential basic breastfeeding information required to meet BFHI standards prior to discharge  That mothers (particularly Maori and Pacific mothers) felt supported by the staff in the Maternity Ward in their decision to breastfeed their baby  To provide all new mothers with consistent information on infant feeding

The Health Roundtable BASELINE DATA  Our struggle to become Baby Friendly Women still complained about inconsistent information and lack of support from staff when trying to establish breastfeeding. Jul-08Nov-09 Excusive breastfeeding:60%75% Fully breastfeeding:9%3% Partial breastfeeding:23%17% Artificial feeding:8%5%

The Health Roundtable KEY CHANGES IMPLEMENTED  Breastfeeding Advocates of Maaori/Pacific origin, were employed and trained to support all new mothers during their inpatient stay on the Maternity Ward at Middlemore Hospital.  The Advocates provided additional education, information and support to assist women to gain confidence in infant feeding prior to discharge. The role was piloted for one year with review after 1 year to determine ongoing needs of the service.

The Health Roundtable OUTCOMES SO FAR Nov-09Jun-10 Excusive breastfeeding:75%74% Fully breastfeeding:3% Partial breastfeeding:17%18% Artificial feeding:5%

The Health Roundtable OUTCOMES SO FAR  Breastfeeding advocates visited 532 new mothers in the three months evaluated  Breastfeeding stats for women that the advocates visited: Exclusive78% Fully 6% Partial `13% Artificial3% Feedback from mothers:  What did the Breastfeeding Advocate do differently from the nurse/midwives on the ward? Benefits of breastfeeding 25% Positioning and latching 34% Support and time 19%

The Health Roundtable OUTCOMES SO FAR  What do you remember the BFA discuss with you?  What did you find helpful? “The information that was provided was really helpful I manage to breast feed my baby without getting the pains on my breast that I had before talking with the breastfeeding advocate” Positioning/latching baby at the breast 100% Feeding cues 99% Rooming In 99% Hand expressing 99% BF support in the community 99%

The Health Roundtable OUTCOMES SO FAR What did you not find helpful?  Nothing I’m so thankful she cam because I was about to give up cause it got painful  Nothing, nurse just came talk very fast, then left me. Advocate she took time to sit down and talked to me nicely

The Health Roundtable LESSONS LEARNT  “Very nice to see someone going around the ward helping and showing people what to do as when I had my son 3 years ago I was not shown what to do and ended up with very sore blistery nipples and almost gave up breastfeeding altogether. This time with knowing what to do I’m going to try keep at it longer.”  “Having the advocates working their rounds in the hospital is a blessing. It can be very stressful when your not feeding baby the right way and its stresses mum and baby out. But with the one on one help it’s priceless.”