unmet needs: breastfeeding pilot project kim fraser breastfeeding project leader

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Unmet Needs: Breastfeeding Pilot Project Kim Fraser Breastfeeding Project Leader Slide 2 Unmet Needs Pilot Project 3 NHS boards with highest deprivation Demonstrate a link with deprivation and health gain Evidence based Innovative, sustainable, partnership working Slide 3 Infants should be exclusively breastfed for the first six months of life to achieve optimal growth, development and health and continue up to two years of age or beyond. (WHO 2003) Slide 4 Inequalities Disadvantaged areas-50% less likely B/F 1990- highest rates social class 1-3 (Dundee Infant Feeding Study) 2000s : most affluent : 68.2% Most disadvantaged: 29.4% (Health Inequalities Strategy) Slide 5 Breastfeeding by Postcode Slide 6 Evidence Systematic Review NICE 2005 Successful interventions Include both antenatal and postnatal periods One to one interventions Need further evidence especially deprived areas Slide 7 Evidence Babys age when stopped % who would have liked BF longer 6 months37 Source: Hamlyn et al 2002 Mothers Who Would Have Liked to Breastfeed Longer Slide 8 Evidence : Variables Health care factors Partner and family support Lactation knowledge and understanding Workplace environment oYears of education oParity oAge oIncome Source: Higginson 2001 Slide 9 Evidence Use of Healthcare Assistants DOH report on evaluation breastfeeding between 1999 and 2002 3 projects which explored the role of health care assistants providing extra support to breastfeeding mothers Qualitative evidence from these indicated that it was a successful way of working Slide 10 Summary Evidence Mothers wishing to breastfeed longer Mothers wish more support Initiatives that cover both the antenatal and postnatal periods are more effective Use of healthcare assistants has been successful Some factors are modifiable Slide 11 AIMS To provide women on low incomes in Dundee with additional information and support by breastfeeding support workers to improve breastfeeding initiation and duration rates Slide 12 Objectives Recruit and train BSWs Identify mothers living in deprived areas from postcode areas Provide additional support, information and practical skills in the antenatal and postnatal periods Evaluate effectiveness Slide 13 Design Non- randomised experimental design Intervention group Depcat 5,6 and 7 areas of Dundee 2 control groups Inclusion Criteria- All pregnant women living in the designated postcode areas Exclusion Criteria- none Slide 14 Recruitment System that allows information to be obtained Information when collect hand held notes Contacted by BSW Rate 1 in 4 initially increased to 40% Not persuading Slide 15 Intervention Provided by Breastfeeding Support Workers Make contact in the antenatal period Continues postnatally in hospital and home Up to 6 weeks post discharge Additional support Not problem solving Slide 16 Results ( July to December) Source ISD 2006 Source ISD May 2006 Slide 17 Results (July to March) Source ISD September 2006 Intervention 9% increase (CI 4.7-13.3) Control increase 1.8%(CI -8.8- +12.4) All points of examination statistically significant difference p


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