Improving UK breastfeeding duration:salutogenic evaluation of English regional success to codevelop community-based breastfeeding support intervention
Lead Research Organisation:
Swansea University
Department Name: College of Human and Health Sciences
Abstract
What is the issue?
Breastfeeding helps to protect the health of mothers and babies and the World Health Organization recommends that babies just have breastmilk until they are six months old, with breastfeeding continuing alongside solid food for at least two years. Although 80% of mothers breastfeed their baby when they are born, many stop in the early days and weeks meaning that the UK has some of the lowest breastfeeding rates in the world. As well as affecting health outcomes, many women are not ready to stop breastfeeding when they do and this experience can negatively affect their mental health.
Understanding how to better support breastfeeding mothers is therefore important, but although lots of research has been done to understand the barriers to breastfeeding very little has been undertaken to focus on what works well to support them. Some areas in the UK have much higher breastfeeding rates than others and if we better understood why this is happening, we could change support in other areas too.
One example of this is North Somerset Local Authority which has some of the highest breastfeeding rates in the UK. This includes in areas of deprivation, which usually have lower breastfeeding rates. Our project will explore what is happening in North Somerset that helps mothers to breastfeed for longer. We will use this information to create guidance for other areas around the UK to try to help mothers meet their breastfeeding goals.
How can we understand success in North Somerset?
To understand what is working well in North Somerset, we will speak to those with experience of breastfeeding and breastfeeding support in the area. This will include staff and breastfeeding peer supporters (mothers who have had some training in how to support breastfeeding) and carry out a survey of local mothers. Alongside this, we will examine local policies, data and spend time in Weston-Super-Mare, a large town in North Somerset, to see how the environment supports breastfeeding.
What will be done with the findings?
When we have our initial findings of what we think works well in North Somerset we will share them with people who work in public health, breastfeeding peer supporters and mothers from the rest of the UK (ie: not from North Somerset) to see whether they think these ideas would also work well in their areas to help improve breastfeeding. This is because sometimes things that work well to support health behaviours in one area might not work well in other areas due to areas being different and having different people living there. We will make a list of all the things that people in different areas agree are important for supporting breastfeeding and share this tool with those in charge of designing breastfeeding support in the UK.
We hope that this tool will be used in the future for projects to improve breastfeeding support. For this reason we will also ask our participants what they think a measure of successful breastfeeding should look like. Should it simply be how many women are breastfeeding their baby or should it include wider measures such as how well supported they feel and how happy they are with how long they breastfed their baby for?
Breastfeeding helps to protect the health of mothers and babies and the World Health Organization recommends that babies just have breastmilk until they are six months old, with breastfeeding continuing alongside solid food for at least two years. Although 80% of mothers breastfeed their baby when they are born, many stop in the early days and weeks meaning that the UK has some of the lowest breastfeeding rates in the world. As well as affecting health outcomes, many women are not ready to stop breastfeeding when they do and this experience can negatively affect their mental health.
Understanding how to better support breastfeeding mothers is therefore important, but although lots of research has been done to understand the barriers to breastfeeding very little has been undertaken to focus on what works well to support them. Some areas in the UK have much higher breastfeeding rates than others and if we better understood why this is happening, we could change support in other areas too.
One example of this is North Somerset Local Authority which has some of the highest breastfeeding rates in the UK. This includes in areas of deprivation, which usually have lower breastfeeding rates. Our project will explore what is happening in North Somerset that helps mothers to breastfeed for longer. We will use this information to create guidance for other areas around the UK to try to help mothers meet their breastfeeding goals.
How can we understand success in North Somerset?
To understand what is working well in North Somerset, we will speak to those with experience of breastfeeding and breastfeeding support in the area. This will include staff and breastfeeding peer supporters (mothers who have had some training in how to support breastfeeding) and carry out a survey of local mothers. Alongside this, we will examine local policies, data and spend time in Weston-Super-Mare, a large town in North Somerset, to see how the environment supports breastfeeding.
What will be done with the findings?
When we have our initial findings of what we think works well in North Somerset we will share them with people who work in public health, breastfeeding peer supporters and mothers from the rest of the UK (ie: not from North Somerset) to see whether they think these ideas would also work well in their areas to help improve breastfeeding. This is because sometimes things that work well to support health behaviours in one area might not work well in other areas due to areas being different and having different people living there. We will make a list of all the things that people in different areas agree are important for supporting breastfeeding and share this tool with those in charge of designing breastfeeding support in the UK.
We hope that this tool will be used in the future for projects to improve breastfeeding support. For this reason we will also ask our participants what they think a measure of successful breastfeeding should look like. Should it simply be how many women are breastfeeding their baby or should it include wider measures such as how well supported they feel and how happy they are with how long they breastfed their baby for?
Technical Summary
Background: Breastfeeding rates in the UK are some of the lowest in Europe. North Somerset has the highest breastfeeding rates in the UK, including within deprived areas, where rates are usually lower.
Aim: to co-develop an affordable community-wide approach to supporting breastfeeding that maps out the resources, activities, and context required to enable women to breastfeed for longer, following MRC intervention development guidance.
Design: Mixed methods evaluation of North Somerset breastfeeding context and intervention co-development with public health staff, breastfeeding peer supporters and mothers.
Methods: The North Somerset context will be explored using: documentary analysis of policies and reports; descriptive analysis of quantitative service level data; individual interviews with local authority staff involved in service design and delivery; online focus group with breastfeeding peer supporters; urban ethnography of Weston-Super-Mare, the largest town in North Somerset; and a survey of mothers.
Intervention co-development will take place through nine consultation events: three each with three groups of stakeholders (public health staff and breastfeeding peer supporters from North Somerset and mothers from around the UK). This will enable us to establish a list of essential elements; a self-assessment tool and toolkit of resources; and a suite of outcome measures for a future trial.
Next steps: Following this intervention development study, we will seek funding for a feasibility trial with an inbuilt process evaluation to assess the feasibility of (i) utilising the toolkit in practice and (ii) research procedures and outcome measures necessary for a larger-scale effectiveness trial.
Aim: to co-develop an affordable community-wide approach to supporting breastfeeding that maps out the resources, activities, and context required to enable women to breastfeed for longer, following MRC intervention development guidance.
Design: Mixed methods evaluation of North Somerset breastfeeding context and intervention co-development with public health staff, breastfeeding peer supporters and mothers.
Methods: The North Somerset context will be explored using: documentary analysis of policies and reports; descriptive analysis of quantitative service level data; individual interviews with local authority staff involved in service design and delivery; online focus group with breastfeeding peer supporters; urban ethnography of Weston-Super-Mare, the largest town in North Somerset; and a survey of mothers.
Intervention co-development will take place through nine consultation events: three each with three groups of stakeholders (public health staff and breastfeeding peer supporters from North Somerset and mothers from around the UK). This will enable us to establish a list of essential elements; a self-assessment tool and toolkit of resources; and a suite of outcome measures for a future trial.
Next steps: Following this intervention development study, we will seek funding for a feasibility trial with an inbuilt process evaluation to assess the feasibility of (i) utilising the toolkit in practice and (ii) research procedures and outcome measures necessary for a larger-scale effectiveness trial.
