Agenda item

Dr Eugenia Cronin explained the aims, methodology and outcomes of the Breastfeeding Pathway Review.  As part of the review interviews had been held with health professionals, new mothers and support providers to ascertain why mothers were not breastfeeding.  Dr Cronin stated that breastfeeding had undisputed health benefits, in both the short and long-term, for baby and mother and breastfeeding also produced lower risks than formula feeding for the vast majority of mothers.  Although there had been some improvement towards the England average since 2008, the initiation and sustained breastfeeding rates in the Borough were the second lowest in outer north east London. 

Dr Cronin indicated that ten peer support volunteers had been identified and these volunteers were dedicated and of good quality.  However, the service support for these had recently transferred to Children’s Services and there were still some issues to be resolved in regards to management structure and reporting mechanisms to enable this peer support service to be more effective.  The decision to bottle or breastfeed was often taken long before pregnancy had occurred.  Dr Cronin stated this decision appeared to be associated with the lack of knowledge or perceived support for breastfeeding due to cultural pressure or conflicting / outdated information from friends and family. 

A more joined up approach between antenatal and health visitors was also required, which together with peer support networks could encourage and support more mothers to choose the breast over bottle.  Dr Cronin also cited the local infant feeding scheme, such as that operating in Redbridge, as a potential option for the future.

Anne Bristow, Corporate Director of Adult and Community Services, asked what the current status was in regard to midwives to UNICEF accreditation standards.  Dr Burgess, Interim Medical Director, BHRUT, advised that training within health and maternity services is progressing and staff were very keen to undertake the training and to press the breastfeeding benefits to clients.  Dr Burgess confirmed that he had spoken to the Director of Nursing and the issue was lack of funding at the present time, not lack of will, and he and Matthew Cole would report back on what actions would be needed to resolve this.

Councillor Turner asked if the data was available on a ward level so that services could see if there were particular GPs or Clinics that could be targeted with extra support.  Dr Cronin advised she would be happy to provide the local data she held.

Dr Goriparthi suggested that as there needed to be a generational shift in attitudes and suggested that the possibility of including the benefits of breastfeeding as part of school’s education / PHSE may need to be explored Dr Goriparthi also felt that training to UNICEF standards would be welcomed GPs and Practice Nurses.

The Chair asked if there was a timetable or action plan to look at the issues around breastfeeding.  Sharon Morrow advised that breastfeeding had been discussed at an away day in April and would become a prime issues for the Children and Maternity Sub-Group from September.

The Board received and noted the contents of the report and the recommendation contained within it and in order to progress this issue agreed:

 (i)  A refresh of the CCG commissioning plan must include greater emphasis on support for breastfeeding.

(ii)  A breastfeeding strategy should be developed and this would be owned by the Children and Maternity Sub-Group.

(iii)  The employment of an Infant Feeding Coordinator should be explored.

(iv)  Improved training was desirable and supported the review and up-skilling of relevant staff, in particular training for midwives should be refreshed and in place by September, with a view to obtaining UNICEF accreditation for local maternity services.

(v)  The Chair of the Children and Maternity Sub-Group should work with key stakeholders to improve data collection across the pathway.

(vi)  Improved antenatal education was needed.

(vii)  To expand and improve coordination and change the management configuration of maternity and maternity support services, including the Peer Support Workers programme.

(vii)  The Board also requested that the Children and Maternity Sub-Group should report to the 9 September Health and Wellbeing Board on the Action Plan and timetable that the Sub-Group would be working to.

(ix)  The Chair of the Children and Maternity Sub-Group will lead the implementation of the recommendations and to update the Board on progress over the next 12 months. 

The Chair advised that the BAD Youth Forum had indicated an interest in health projects and she would approach them to see if they may wish to include potential consultation work on this issue in their work plan.