Agenda item

This report presents the 2018 Medway Infant Feeding Strategy. The Strategy has been developed by a multi-partner Infant Feeding Strategy group which has developed a wide range of interventions and projects to positively influence breastfeeding rates and infant feeding practices within Medway.

Discussion:

The Head of Health and Wellbeing Services presented the refreshed 2018 Infant Feeding Strategy as set out at Appendix 1 of the report which updated the 2011 Strategy. The Board was advised of progress made since this first Strategy was introduced and was presented with a short film which had been created as part of the 2016 ‘Beside You’ campaign, aiming to normalise breastfeeding. The Board’s attention was drawn to the priorities set out within the 2018 Strategy to positively influence infant feeding practices in Medway. Key priorities included increasing breastfeeding rates, supporting responsive formula feeding where appropriate and delaying the introduction of solid food to infants until after they are 6 months old.

A Member expressed concern that even with a number of interventions being undertaken, as set out in paragraph 3.4 of the report, the data presented in paragraph 3.1 of the report represented a decreasing trend in breastfeeding initiation rates. It was explained that breastfeeding rates in Medway had steadily increased from 67.9% in 2010/11 to 70.7% in 2016/17. The rate of increase appeared to have had plateaued at 70%. Given the challenges faced by women living in disadvantaged communities in Medway, maintaining levels at this rate could be viewed as a successful outcome. However, it was recognised that whole system changes were needed to achieve the ambitious target of a 1% uplift per year in breastfeeding initiation and continuation rates.

It was added that there had been some very good interventions since the 2011 Strategy was introduced and that as a result, the United Nation’s Children’s Fund (Unicef) Baby Friendly Initiative (BFI) stage 3 accreditation had recently been awarded to Medway NHS Foundation Trust (MFT). In addition, Medway Community Healthcare CIC had sustained their accreditation to stage 3 and the neonatal unit had achieved stage 1 accreditation for the first time.

A Member also expressed concern regarding Medway’s performance in relation to the rest of the country and noted that, in particular, breastfeeding continuation rates at 6 to 8 weeks had fallen. Recognising that no additional funding was available, he highlighted that there was a risk that the targeted increase in breastfeeding initiation and continuation rates might not be achieved and asked what further action, if any, could be taken. In response, the Board was advised that the Infant Feeding Steering Group was mindful that the target would be challenging but on balance it was considered that an aspirational target should be set. It was added that the Steering Group had been approached by Public Health England to utilise Medway’s Strategy as an example of national best practice. With respect to the target, performance would be monitored and further action would be taken as necessary.

Drawing on her experience and with reference to past examples, a Member sought an assurance that, in practice, health professionals did support breastfeeding initiation and continuation. The Board was assured that this was the case and that this could be demonstrated by the achievement of the Unicef BFI accreditations as outlined. It was explained that the accreditation process was rigorous and included assessment of practitioners as well as input from mothers regarding their personal experiences of care.

In response to a question concerning barriers to breastfeeding, it was explained that the biggest barrier was considered to be family and cultural norms which could influence mothers’ infant feeding choices. In some instances, for example, multiple generations might bottle feed and therefore this would become the accepted practice. It was added that local research had found that the lowest breastfeeding rates in Medway were among young, more socially deprived, white women. As a result, this cohort had been targeted in recent initiatives, including the ‘Beside You’ campaign.

The Board was advised that it was important for any intervention to challenge norms. This could be achieved through education in schools as part of Personal, Social and Health Education (PSHE) and through the provision of support for the family unit pre-pregnancy and throughout the duration of the pregnancy. It was considered that this would particularly encourage the 30% of mothers who had not considered breastfeeding as an option to initiate breastfeeding. With respect to educational programmes, the Children Services Director, Medway Community Healthcare, stressed the importance of explaining the benefits of breastfeeding as part of any programme.

It was outlined to the Board that another challenging area was providing dedicated infant feeding support to new mothers in the first 48 hours following the birth of an infant. The Steering Group continued to engage with the volunteer peer support network to provide this support. However, the Board was advised that the Steering Group sought the opportunity to engage with a specialist infant feeding team, if funding became available, as it was considered this would assist in achieving the target increase in breastfeeding initiation.

With regards to interventions, the Board was advised that the Steering Group had planned a new campaign, co-designed with midwives at Medway NHS Foundation Trust, called ‘Grow my Brain’. This campaign would inform expectant and new mothers how they could build a greater attachment with their babies. It was considered that this would encourage breastfeeding.

With reference to the influence of television programmes, such as soap operas, which tended to show women bottle feeding infants, the Children Services Director, Medway Community Healthcare, asked how the Board could exert a wider influence in promoting breastfeeding. The Board was advised that the Steering Group continually reviewed social media for breastfeeding role models which could be shared on their social media platforms. It was added that the well-known spoken poet, Hollie McNish, supported the ‘Beside You’ campaign. Members also considered ways to support the aims of the Strategy on social media platforms, including promotion of breastfeeding campaigns on Twitter. 

Members also considered a number of other ways that they could support the Infant Feeding Steering Group to promote breastfeeding. A Member suggested that a requirement for a premises to be breastfeeding friendly should be included within applicable Council procurement exercises. An example given was the procurement of an external operator for the cafes at Medway Park and Strood Sports Centres. It was further noted that all Council premises should be breastfeeding friendly and that, wherever possible, local businesses should be encouraged to be breastfeeding friendly.

In response to a question regarding the possibility to create breastfeeding friendly window stickers for premises, the Board was advised that caution should be taken with this approach because a premises without a sticker might still be breastfeeding friendly. A Member requested that should window stickers be utilised, consideration be given to creating a combined sticker including, for example, food hygiene and plastic free business identifiers.

It was suggested that all Councillors needed to be well briefed on the materials and support available to promote breastfeeding and in addition be provided with advice on what Councillors should be encouraged to do within their work with the community.

Members noted that some mothers could not breastfeed infants and also needed appropriate support. Clarification was sought on a recommended formula brand. In response, the Board was advised that recent evidence demonstrated that no formula product was better than the other in terms of nutritional benefit for infants. 

Decision:

The Health and Wellbeing Board:

a)    noted the Infant Strategy set out at Appendix 1 of the report and supported its implementation in Medway; and

b)    confirmed its support of the Infant Feeding Strategy Group in the delivery of the objective within the Strategy.