Empowering communities: Partnership approach to enhancing breastfeeding awareness and culture in low-prevalence socially deprived areas.
Rachel Evans (Public Health Wales) Eleanor Johnson and Bronwen Clatworthy (Breastfeeding Network) Rosy Phillips, Fay Fear, Claire Turbutt, Sarah Jenkins (Cwm Taf Morgannwg University Health Board) Carla Baldwin, Bethan Thorn, Joanne Foley, Florence Beach, Eryl Powell (Aneurin Bevan University Health Board) Amy Brown , Karen Hall (Swansea University)
Background & Aim
”Breastfeeding is… linked to the prevention of major health inequalities. The provision of human milk is the most accessible and cost-effective activity available to public health.” Child Poverty Strategy for Wales 2024
- Babies in the lowest quintile according to the Welsh Index of Multiple Deprivation (WIMD) are the least likely to be breastfed.
- This gap has been persistent over time.
- PHW research shows to improve rates we need to shift social norms in these communities.
Three interventions delivered in parallel in two identified target communities with characteristics of deprivation and low breastfeeding prevalence. A short term project funded by Welsh Government’s Child Poverty: Innovation and Supporting Communities Grant.
Partnership working
“Each partner brought specific knowledge and skill [enabling] goals to be achieved in a rapid timeframe… the strongest breastfeeding support is delivered by… different skills and experiences coming together.”
Elements and outcomes of the project
Elements and outcomes of the project
| Element |
Reason |
Outcome |
"Ripple effect" |
| Peer support training- two cohorts of Breastfeeding Helpers and one of Breastfeeding Supporters. |
- Fill gaps in breastfeeding support in target communities.
- Recruit volunteers reflective of their communities.
- Provide opportunities for accredited qualifications.
- Increase Welsh speaking capacity on the NBH.
|
22 Breastfeeding Helpers trained, 17 from target communities of Newport and Rhondda. Breastfeeding Supporter cohort included Welsh speakers. |
- Five volunteers have gone on to training or employment within the NHS.
- Breastfeeding group established in Rhondda, where there was no group previously.
- Local politicians attended celebration events, further raising awareness of breastfeeding as a public health priority..
- Volunteers attending postnatal wards.
|
| Recruitment of short term part time posts for promotion of the National Breastfeeding Helpline (NBH). |
- Call data from the BfN demonstrated lower than expected use within the target areas.
- Increased use could reduce calls to local NHS services.
|
BfN data demonstrated an increase in calls over the six month period of the project. |
- Promoters raised awareness of BfN Breastfeeding Friendly Scheme and signed up local facilities.
- NBH to be included in future parent information produced by Public Health Wales.
|
| Delivery of First Milk Matters training to non health staff working with families. |
- To provide access to training for staff outside the health system.
- To increase community knowledge of and support for breastfeeding.
|
35 staff attended training and post course evaluations showed increased knowledge and confidence around infant feeding. |
- A community baby bank changed the way formula was distributed.
- A local family hub created breastfeeding friendly space.
|
Evaluation
- Measurable outcomes noted above demonstrate successful delivery of individual project elements.
- Interviews with participants in different roles were also undertaken, demonstrating benefit to the project partners, volunteers, families and First Milk Matters attendees.
- All groups involved reported an impact on breastfeeding culture in the target communities, and families now had access to support in those areas where bottle feeding was the norm.
- It was a limitation of the project that the funding was short term. The evaluation report noted that breastfeeding interventions take time to embed and impacts e.g. on breastfeeding rates are incremental over time.
- ABUHB has funded a further year of training and supervision for peer support, aligning with focused work on breastfeeding as part of a whole system approach to a healthy weight.
“Over time it is likely that this will increase perceptions of breastfeeding in these communities where bottle feeding is typically the norm. This will filter through into increased breastfeeding initiation and visibility, shared experiences where breastfeeding is now included and more common, and ultimately enhanced breastfeeding rates.”
“People are starting to be a bit more intrigued about breastfeeding and want to find out a little bit more.” Infant feeding lead
“I’m not alone and have people to go to when I need support.” Mother, who accessed new support group
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