UNICEF UK Baby-Friendly webchat

Sue Ashmore and Carmel Duffy of the UNICEF UK Baby-Friendly Initiative.

UNICEF Baby-Friendly Initiative has helped improve breastfeeding rates in the UK. Look up your local hospitals here - how well-qualified are they?

A webchat at Mumsnet, Monday 8^th November, 2010 - here I've just plucked out a few comments relevant to Peer Support. Questions are in italics, answers follow them.

TigerFeet: Hi, I'd be really interested in your views on the role of peer supporters.
Myself and many of the other mums from our local group recently completed training and are now active peer supporters at our weekly support group. We now outnumber the non-peer supporters attending the group and w're really struggling to recruit new members. We are working hard to publicise the group but we seem to be finding it very hard to overcome the breastfeeding=boob wielding nutter myth.
Do you have any ideas that might kick start our recruitment drive?

Hi tigerfeet - Gaelic and Tiger mentioned the importance of meeting women in the antenatal period as it is good to have a friendly face when you first turn up at a new group. I have found this to be useful in the past. Hopefully your local midwives and health visitors can also help promote your groups and give out friendly fliers. My experience is that these groups do tend to start off slowly but feedback from people who have attended is the best publicity there is. I am not sure how long you have been running but be patient and they will soon see you as the measured sensible people that you are and be queuing up outside your door!

Also – part of an answer to LovebeingaMummy:

“The research shows that mothers are more likely to breastfeed if there is one person in their lives who believe that they can do it, that is why peer support programmes, support groups etc are so important, especially for women who live in areas where few people breastfeed.”

Flyingzebra: Do you have any tips to help us distinguish the midwives who think they know something about breastfeeding from the midwives who actually know something about breastfeeding?
That's not meant to be a facetious question, btw, but I've been badly letdown on the breastfeeding front by midwives who are absolutely confident that they know what they're talking about, even though they are wrong!

Hmmm, you could politely ask them? I appreciate that this would have to be sensitively done though.
What to look out for - UNICEF Baby Friendly run a breastfeeding management course designed to give midwives and health visitors the basics they need and we also run a train the trainer course to help trusts develop their own staff training. Obviously in- house training is only as good as the person running it, but in many places it is fantastic. Some of the voluntary organisations run very good training too. Baby Friendly also have an accreditation programme for university courses, so you could ask newly qualified staff if they trained in an accredited university.

Remember though that acute staff shortages leave many midwives and health visitors very, very pressured and that it isn’t their fault as individuals if they have been given no opportunity for training, many would dearly love to attend.

If you are not happy with the standard of care you receive, could we make a plea that you let the organisation know. I know this is hard when you have just had a baby, but it is really important. We at Baby Friendly spend a lot of time trying to persuade reluctant NHS managers to take this seriously. Some are fantastic, but I can’t remember the number of times we have been told that it is not a priority. The profound effect of poor care for breastfeeding on mothers, babies and their families is often not understood higher up the hierarchy.

Letters of complaint from mothers are taken very seriously and are responded to and monitored. You could ask what training the staff have had, what progress has been made towards Baby Friendly accreditation and what plans there are get the unit to full accreditation. If you go to the awards section of the Baby Friendly website you can see what progress has been made in individual units and there is a mechanism by which you can write a letter to the Chief Executive. If the unit is fully accredited please can you let us know and we will take it forward.

SparklePFFtBANG:  My question is, since most women do start breastfeeding but then the figures fall off at 6 weeks. What do you think the main reason for that is - lack of support to people who want to bf, or people placing more emphasis on the first couple of feeds, either because they are in hospital with expectations to fulfil, or because they believe the benefits of colostrum are worth it, but then don't want to continue? What can be done about it?
Also, what can I do, as a breastfeeding mum, to help?? I have trained as a peer supporter, don't think I would be much good as a counsellor, but would love to get involved somehow?

Indeed SparklePFFtBANG It is really sad to see such a huge drop off in breastfeeding at 6 weeks and even sadder to know that many of the women who stop breastfeeding did not want to but were forced to because of problems such as pain or poor milk supply which could have been prevented had they received the right support. As Sue said in response to an earlier question – women will succeed if just one person really believes they can do it and that belief along with skilled and knowledgeable support is often sadly missing. It is wonderful that you have trained as a peer supporter because just by believing in women you can do so much to help. Go for it!

GaelicSheep: A number of NHS areas are training groups of peer supporters. Is there any evidence as to how effective these peer supporters are wrt improving breastfeeding rates/success in those areas?

There is evidence that peer support programmes can work really well and we do know that health professional input alone is not enough to give mothers all the support they may need to continue breastfeeding. The evidence suggests that it is a ‘package’ of care that is needed – good hospital care, good NHS community care and then interventions to provide mothers with on-going support. Peer support programmes are primarily designed to provide the on-going support. Their success depends on how they are run. Some have been extremely successful, while others less so. The Baby Friendly Initiative for the community requires that the programmes are audited and evaluated regularly and then changed if they are not meeting mothers’ needs.

We do have some concerns about the fact that there is no national standard for either the training provided for peer supporters or the remit they have within their role. We worry that in some areas there is a huge amount of responsibility placed onto peer supporters and there may not be the support available for them should things go wrong. Health professionals should have ultimate responsibility for women in their care and if peer support is provided there should be robust systems in place to protect everyone involved including the peer supporter. We also worry that in the current economic climate health chiefs could see peer support as a cheap option which could potentially leave them more vulnerable.

Thanks, that's interesting. When we were trained as peer supporters, we assumed to begin with we'd be there to provide some advice. We were told very early on that that wasn't the case and that we were there to listen and not to judge (obviously, not debating that), or really make any comments about the decisions the mother makes.
However, from what you say, our roles should be to be encouraging and believing in women (and to know when to stop) and to be able to help women get the relevant advice from professionals.

I went to a breastfeeding group soon after training ended, where a new mum came in who was having major problems. The leader of the group said "You've trained as a peer supporter, you'll be able to help her"
So it seems even the professionals don't know what our role is.

& Interesting to see this....

I am sorry that you accessed some outdated material from our website. we are currently revamping the entire website and hope to make it the best breastfeeding website in the world :-) so hopefully all outdated material will be removed when we make the change over.