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Expanded service provides support to breastfeeding mums

The benefits of breastfeeding are well documented. Breastfeeding protects babies from infections and diseases such as diabetes and gastroenteritis. It also reduces the risk of cancers and osteoporosis in women. It promotes a loving bond between mum and baby which is a key factor in healthy brain development. Breast milk contains all the necessary components for healthy growth and development and it protects against overfeeding and overweight.

Breastfeeding rates in Wiltshire are above the national average, but our commissioned service is keen to ensure that more women are able to breastfeed and for as long as they want to. During the Covid-19 pandemic support for breastfeeding was affected as services were reduced and in-person support was limited. In many cases help and support for new mums was given online in a video consultation. The good news is that, despite the change in service delivery, our breastfeeding rates continued to rise.

The demand for the specialist infant feeding service doubled during the Covid-19 pandemic. Our team of specialist infant feeding health visitors increased their availability during the lockdown so that breastfeeding support was given timely and to more women. This included one to one support for new mums and support for colleagues working with families on complex feeding issues.

The specialist infant feeding service was launched in 2018 to ensure as many mothers as possible could access expert help and advice when they needed so that they could continue to breast feed for as long as they wanted to.

The team comprises health visitors with extra training in human lactation and infant feeding to help mums who are experiencing complex problems and having difficulties with feeding. This innovative service has been continually building links with other agencies including GPs and maternity services, which are able to refer mothers to us. The service adds an extra level of support, complementing basic health visitor services and voluntary help in the community.

This new offer of 1-1 expert advice helps to build confidence in mothers who have feeding problems such as persistent mastitis or a baby with tongue tie, and enable them to continue breast feeding for as long as they wish.

We are currently training more health visitors in this specialist role so that we can continue to support mums in this way.

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The Challenge

Before the Covid-19 pandemic health visitors assessed all new babies face to face in homes. Then, as Covid-19 struck and we went into lockdown and everything changed. Due to safety restrictions home visits continued but with PPE and for a shorter duration as health visitors did some of the family health needs assessment virtually. This meant that the time health visitors were spending face to face with mothers and babies was reduced. Furthermore, those mothers who were having difficulties with feeding were not able to have the level of support they needed from family and the community support groups due to the lockdown. As restrictions lifted in the summer, health visitors went back to visiting all new babies where it was safe to do so.

The impact on mums not being able to get out and access our services in clinics has resulted in a sense of isolation and worry. It has been an anxious time for new parents. Fake news and social media compounded the problems for some young mothers who were left being unsure of whether to breast feed or not.

As a result, referrals to the specialist breast feeding service almost doubled during the pandemic from around 15 per month in autumn 2019 to around 26 per month in spring 2021.

The Solution

The expanded specialist infant feeding service offered support and expertise to breastfeeding women against a backdrop of isolation and reduced face to face services.  It was not always possible to see the mums and babies in-person, but video consultation and regular telephone support facilitated ongoing advice and solutions to difficult and worrying breastfeeding situations.

Mums needing advice or support could be referred to the team directly and they would speak on the phone either the same day or following day.  Initially, video consultations or home visits were offered but following easing of restrictions since the third lockdown, clinic appointments have returned.

Breastfeeding rates have continued to rise in Wiltshire since 2018 despite the Covid-19 pandemic.  Infact, we have seen a consistent 10% rise on our month on month target.

Originally the team had just three members but during 2021  a further 6 people are being trained in human lactation over a six month period by health visitor Amy Clarke to provide an enhanced service to Wiltshire and BANES.

In September 2021, Wiltshire achieved accreditation by UNICEF as baby friendly demonstrating that high standards of care for women and babies in infant feeding are being met across the health visiting teams.

The specialist infant feeding team work closely with infant feeding teams in the local hospitals, The Great Western in Swindon, Royal United in Bath and Salisbury District Hospital.

Marian Judd, Practice lead/health Visitor said: “A lot of what we do is to help mums find a way through when they are having problems with their feeding. We help them decide what option to go for and steer them through the minefield of information.  Sometimes they are under a lot of pressure to breast feed and we can talk it through with them to help them to make an informed choice.

“There is massive pressure from social media but we can talk to them 1-1 and help them put things into perspective. It is believed that around 12% of breast feeding mothers will experience some difficulties and if they do not get extra support, they may not continue to feed so being able to talk to these mums and discuss their individual problems is very important.”

The Difference

The difference of having an extended team of experts available to support young families during the pandemic been considerable.

The team of specialist infant feeding health visitors have been on hand to help new mums with their feeding difficulties when services have been unable to carry out the usual face to face visits in the normal way. This has meant that far from falling, breast feeding rates in Wiltshire actually went up.

Marian said: ”A lot of women would have probably given up breast feeding when the usual forms of support became unavailable during the pandemic but because we were on hand to help them they kept on feeding. This is something our commissioners have been very keen to promote and we are very pleased we have been able to maintain and improve our breast feeding rates.

“Another advantage has been that mums have had the opportunity to discuss just breast feeding with someone. When they talk to midwives and health visitors there are a range of other issues in having a new baby which they need to discuss. The feedback we have had is that mums really appreciate being able to speak to a specialist.

“As many fathers and partners have been at home during the pandemic, it has given us a chance to talk to them too and have a three way discussion about what they want as a family.

“The enhanced service has also proved popular with other health colleagues such as health visitors, GPs, paediatricians and dieticians. They are all really busy, often working with complex cases and they have told us they really appreciate having access to expert advice or the option to refer people to us.

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