Brighton & Hove City Council: encouraging breastfeeding

Brighton City Council runs a comprehensive breastfeeding support programme, involving drop-in clinics and a network of peer supporters. Targeted work to provide extra help to communities with the lowest rates of breastfeeding has also been carried out. It has helped the city achieve some of the best breastfeeding rates in the country.


The challenge

Breastfeeding is good for both baby and the mother. The evidence suggests any amount of breast milk has a positive effect. The longer a woman breastfeeds, the longer protection lasts and the greater the benefits. It reduces the baby’s risk of infections, diarrhoea and vomiting, childhood leukaemia and obesity. Breastfeeding has also been found to lower the risk of certain cancers and osteoporosis.

As a result, giving nothing but breast milk is recommended for the first six months of a baby’s life. After that, giving a baby breast milk alongside family foods is recommended.

But while three-quarters of new mothers start breastfeeding, fewer than half are still doing it by the two-month mark. It leaves the UK with one of the lowest rates of breastfeeding in the developed world.

The solution

Brighton has a dedicated breastfeeding support team. It is part of the 0 – 19 Healthy Child Programme and is run by breastfeeding coordinator Clare Jones, who oversees support coordinators Dawn Kielty and Zoe Faulkner.

For women with the most complex challenges, the team offers a breastfeeding drop-in that health visitors, midwives and GPs can refer women to. The women who use this service experience issues such as severe pain and low milk supply or have babies who have been ill.

This drop-in is held every week at a children’s centre and normally attract between six to 10 women every time. Each woman has an indepth assessment carried out and a support plan is then put in place to help them. Regular contact is maintained until the woman is happy and confident about breastfeeding.

The team also coordinates a volunteer peer support programme. Breastfeeding peer supporters work with women to normalise breastfeeding, boost the confidence of new mothers and signpost them on to other services where needed. The volunteers are given training by the team and there are normally around 30 volunteers at any one time.

Coleen White, one of the volunteers, said the quality of the training is key to the support she is able to provide. She completed a 10week training programme and spent time in hospital.

“It has equipped me with the latest research, challenges and benefits of breastfeeding, as well as the knowledge and confidence to support women on good positioning and attachment. As a result, I feel confident supporting new mums on the labour and postnatal wards, as well as in the community.”

The team also runs a Facebook page which offers information about breastfeeding, shares inspiring and affirming messages and links to media stories.

Ms Jones said: “We offer a wide range of support – so there is something for everyone whether they are experiencing complex challenges or common breastfeeding issues. Not every woman finds it easy to breastfeed so it is important there is someone there who you can talk to, who can offer you reassurance and advice when you need it.”

The team also organise the Brighton Breastfeeding Initiative, which is a network for health professionals and voluntary sector groups. The network meets quarterly, although there is also regular contact via a closed Facebook group. It provides a forum for the team to give information about the latest advice and discusses individual cases in confidence.

The impact

The breastfeeding team have been going for 10 years. During that time they have overseen a steady rise in breastfeeding rates.

The latest quarterly figures show between 65 and 70 per cent of local mothers are breastfeeding at the six to eight-week mark.

That compares to a national average of under 50 per cent and means Brighton are among the best performers in the country.

One mother who was helped said: “As the mum of a premature baby I can’t express what huge importance breast milk and breastfeeding takes on - particularly when you are separated from your baby for so long, so I just wanted to let you know how much your help meant.” 

Lessons learned

While Brighton has enjoyed great success in helping women breastfeed, there are still some areas of the city that have relatively low rates. In some neighbourhoods breastfeeding at the six to eight-week mark drops to below 50 per cent.

To combat this the team has organised targeted interventions in these areas. This has included having two employed support workers who have been proactive at encouraging breastfeeding to local mothers. They have worked closely with local midwives to identify women who need extra support and also reached out to new mothers via phone calls shortly after birth.

Ms Jones said: “We know in the most socially deprived areas women are less likely to breastfeed. There is a pressure on women to use formula and bottle-feed. As well as providing the universal help, it is important to target your support too.”

How is the approach being sustained?

Funding for the two support workers was withdrawn last year because of funding cuts. But now the team is looking at alternative ways to provide that targeted support. One option under consideration is training nursery nurses in how to help new mothers.

“That could provide an alternative option,” said Ms Jones. “You have to be flexible. But overall we want to keep building on the progress that we have made. The city’s breastfeeding strategy is in the process of being updated and we are constantly looking at new ways to support women.”

Contact

>Clare Jones Breastfeeding coordinator, Brighton City Council
Email clare.jones9@nhs.net