Pollard, K., Condon, L., Warren, S., Collins, K., Tapp, A., Boyles, A. and Ricketts, A.
Social marketing to encourage initiation and continuation of breastfeeding in Penhill and Pinehurst, Swindon.
University of the West of England and Uscreates, Bristol and London.
Available from: http://eprints.uwe.ac.uk/20113
- Published Version
• NHS Swindon has targets to increase the initiation and duration of breastfeeding to 6-8 weeks and beyond. A number of interventions have been implemented to increase local breastfeeding prevalence, including the UNICEF Baby Friendly Initiative and the family nurse partnership.
• Traditional health education approaches on their own do not appear to have much impact. Our own work and indicative results elsewhere position co-creation as a potentially highly effective strategy to use within deprived communities; its potential to embed behaviour change sustainably is clear.
• Integrating programmes that address cultural perceptions of breastfeeding with targeted work aimed directly at vulnerable segments, which in turn are co-ordinated with strong ante and post-natal support, education programmes and peer supported group sessions will maximise the chances of increasing breastfeeding.
• The UWE project team recruited women and some family members to individual interviews and women from four different categories (pregnant, did not breastfeed, tried breastfeeding but gave up and breastfed beyond 6-8 weeks) to focus groups. In total, 28 individuals took part in the project. Participants were asked a range of questions designed to elicit information about norms surrounding infant feeding, how decisions about feeding were reached, individual’s knowledge concerning the benefits of breastfeeding and social and private attitudes towards breastfeeding.
• The norm in both Pinehurst and Penhill is to bottle feed babies. Mothers gained knowledge about breastfeeding for a range of sources, but the timing and volume of NHS leaflets could be problematic. The main reason given for breastfeeding was the associated health benefits for babies. The main reason given for bottle feeding were convenience and ease of feeding in public.
• Following these interviews, six professionals involved in services for mothers and babies were interviewed. This cohort was selected to include managers and practitioners from the midwifery and health visiting services for Penhill and Pinehurst.
• Lack of support for breastfeeding women is a problem. Contributing factors were thought to include lack of resources in the wider health and social care context, particularly with regard to home visits in the first month after birth. Provision of information appears to rely heavily on written literature, which women may not read. A coherent and integrated service was seen as the ideal to support and promote breastfeeding, but there was some concern expressed about how well the support workers and healthcare professionals worked together.
• The general consensus is that there is very little community engagement in these areas and many women are unwilling to access locally based groups where they might learn about breastfeeding or observe other mothers breastfeeding.
• Co-creation as an approach depends upon engaging and involving community members, and with levels of involvement and interaction in these communities so low, it was agreed to proceed with a continued focus on breastfeeding interventions, with Uscreates leading on designing and developing ideas, making and directing decisions and activity, and audience members contributing feedback and thoughts. The co-creation process was adapted to be delivered one to one with mobile researchers visiting mothers at home.
• A design exercise facilitated mothers to build up a description of the ideal support service along a number of descriptors. This activity led to the plan to re-design and re-launch the Breastmates service. This existing breastfeeding support service satisfied most of the requirements for an ideal service that mothers had described. These characteristics guided the re-design of the Breastmates offering to include home visits, and to promote both online and telephone support for urgent needs.
• Uscreates carried out a co-creation process with women in order to re-design the existing Breastmates brand and marketing materials. The marketing combined several support avenues and channels within one identity, presenting a more united front, and giving women a choice of how to access support.
• The overall recommendation after the pilot phase is to continue to use the co-created Breastmates brand, and roll this out across Swindon. With face to face engagement and promotion having the biggest impact on uptake and attendance, continue with this as the primary focus for promotion activities.
• The other attendant promotion components (Facebook, Breastmates site, Textmagic) should be tweaked as per the recommendations above, and continue as low cost methods to increase general awareness of Breastmates, and provide a professional and unified means of reinforcing messages delivered by the face to face activity.
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