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Quarterly newsletter

Issue 6 • Feb 11

Breastfeeding Bulletin

Welcome to our sixth breastfeeding bulletin... a guide to what we’re doing locally to encourage mums to breastfeed and to make Kirklees a more baby-friendly place to be. KCHS Infant Feeding and Baby Friendly Initiative Lead Jayne Heley, invites you to read the following pages and to contact her directly if you have any queries or simply would like to know more about any of the features. T: 07903 372643 E:

Volunteer texting service A breastfeeding volunteer texting service is in the process of being set up which, it is hoped, will be another way of communicating events, meetings and reminders etc to our peer supporters. If you would prefer not to be part of this service, please don’t hesitate to contact Jayne.

Committed to the highest standards The health visiting service from Kirklees Community Healthcare Services (KCHS) has been recognised for achieving the highest standards in the support and care of new mums who breastfeed. Receiving the certificate of commitment is the first step towards gaining international recognition from the UNICEF UK Baby Friendly Initiative (BFI) and we are now working towards stage one of the accreditation process and plan to be stage two assessed during 2011. During the recent visit from the BFI assessors as part of the stage one community assessment, we received excellent feedback with just a few changes to be made before we can achieve this stage. These include additions to our breastfeeding operating procedures and parents poster guide, queries with the training plans and incorporating antenatal/postnatal/breastfeeding tools onto SystmOne which will be added to each new mums universal needs assessment. To update you on progress in our area, The Mid Yorkshire Hospitals NHS Trust will retake their accreditation visit in March, Doncaster Hospital and community are going for stage two in February and Hull will be taking stage two in the near future.

8Latest Baby Bistro opens in Batley The eighth Baby Bistro in Kirklees is now up and running in Batley’s Children’s Centre offering mums support to continue breastfeeding for as long as possible. The latest bistro was officially opened by special guest speaker and breastfeeding peer support facilitator Dorothy Clayton, who has been training mums as peer supporters since the first bistro opened in early 2009.

Jayne Heley, Baby Friendly Initiative Co-coordinator, Kirklees Community Healthcare Services, said: “I’m delighted that we have been able to open an eighth Baby Bistro. The first seven bistros have been an outstanding success and we are now looking to expand the service to more Children’s Centres through the continued training of Kirklees breastfeeding volunteers.

Baby Bistros are relaxed informal sessions led by local mums who have breastfed their own children and feel passionate about helping other women do the same. The volunteer mums have all signed up to be breastfeeding peer supporters and have completed a ten-week training course to help them in their role. This involves providing one-to-one contact with mums to help iron out any breastfeeding issues and offer ongoing support to help mums with feeding their babies.

"We want all mums in Kirklees to be able to access this network of social support, friendly encouragement and signposting to health services when they are having breastfeeding issues or clinical problems.” Batley East Baby Bistro will run every Monday from 11am - 12.30pm at Batley East Children’s Centre. For more information contact Batley East Children’s Centre on 01924 392600. Discussions are now taking place with Sure Start’s Almondbury Children’s Centre to host a ninth Baby Bistro, to be opened in early 2011.

Breastfeeding peer supporters Another group of newly trained mums have proudly received their certificates after completing their 10 week breastfeeding peer support training course. Many thanks go to Dorothy, training facilitator, and Nikki Hodgson, breastfeeding peer supporter, who volunteers at Dewsbury Moor Baby Bistro, for their continued support. We now have between 50-60 Kirklees volunteers who meet up at Baby Bistro’s and/or parent craft sessions or volunteer at Dewsbury and District Hospital. We have also had recent interest from a peer supporter who would like to volunteer at the Huddersfield Birth Centre and discussions are taking place for this to happen. The next training session is planned to be held at Sure Start, Thornhill Lees Children Centre starting in March. If you know a mum/grandmother who would be interested please contact Michelle Williams 07590417906, Breastfeeding Peer Supporter Training Facilitator who is in the process of taking over the role from Dorothy Clayton.

Kirklees Breastfeeding Peer Supporter Network meeting dates 6 May 2011 at Dewsbury Moor Children's Centre from 10am-12noon 2 September 2011 at Dewsbury Moor Children's Centre from 10am-12noon 2 December 2011 at Dewsbury Moor Children's Centre from 10am-12noon

Breastfeeding Bulletin

Infant feeding practice guide

This resource will soon be made available to all health visiting bases which will help to support the breastfeeding management training and will also incorporate a community section which will help health practitioners support mums to breastfeed for longer with evidence based information and practice. Please contact Jayne Heley if you would like a personal copy. The Department of Health (DH) with support from the Baby Friendly Initiative, has produced two breastfeeding care pathways for mothers and health professionals. Visit http://comms.unicef. for more information.

Special thanks This month we would like to pass on special thanks to Dorothy Clayton who has been part of the breast feeding peer support project since it began in early March 2009. In the last two years Dorothy has helped train more than 50 mums across Kirklees and we would all like to thank her for her commitment and support to training our peer supporters. Dorothy will now be concentrating on weaning as part of her infant feeding role in public health.

Kirklees breastfeeding champions update Currently we have 12 breastfeeding champions who attend quarterly network meetings, and who are a multiprofessional group where best practice, evidence based information is shared and support is accessed through open discussion. The group began in 2007, chaired by Jayne Heley and is currently supporting the BFI community programme and some aspects of the hospital programme. Our champions are passionate about protecting and promoting breastfeeding in practice and current members are thanked for their expertise and continued support.

Across Kirklees we have the following champions: • The Valleys - Nicola Duncanson and Anita Betts • Dearne Valley - Jo Hives • Huddersfield South - Kim Garner • Huddersfield North - Sue Lister and Julie Sherratt • Batley - Una Crozier and Beth Gingoyan • Spenborough - Louise McConnell and Lisa Moreland • Dewsbury - Louise Sowerby and Allison Howitt

The 2011 champion network meetings are as follows: 9 February at Mill Hill at 10am-12 noon 4 May at Beckside Court at 10am-12noon 7 September at Mill Hill at 10am-12 noon 7 December at Beckside Court at 10am-12noon

Breastfeeding performance at six to eight weeks Quarter 2 - 2010/11 Kirklees breastfeeding initiation and six to eight week summaries.

Q2 initiation rates Kirklees initiation is 72.38% North Kirklees is 62.93% South Kirklees is 80.77%


Q2 six to eight weeks breastfeeding rates Kirklees

Coverage = 96.69% Prevalence = 42.50%

North Kirklees

Coverage = 94.60% Prevalence = 39.47%

South Kirklees

Coverage = 98.34% Prevalence = 44.90%

Breast and Breast and Bottle fed Bottle fed Breast fed Breast fed supplement supplement at six at six at six at six Total fed at six fed at six weeks weeks % weeks weeks % weeks weeks %

























Hudds N








Hudds S
















The Valleys








Actimel fussy eaters events alert

Actimel are running a ‘fussy eaters’ event to be aware of. The advertising uses the baby friendly logo and claims to be endorsed by WHO, UNICEF, Royal College etc. Anyone who becomes aware of such events, please send details to Jayne so that the regional infant feeding group can be informed. UNICEF have stated that they do not endorse any events and the only people who can use their logo are accredited units or communities.

Is breast always best? University of Huddersfield research article For years breastfeeding has been promoted to UK women as ‘Breast is Best’, and figures suggest mothers agree, with 78% initiating breastfeeding following the birth of their child. However, this figure drops to 48% after just six weeks of feeding. Dr Abigail Locke, Principal Lecturer in the Division of Psychology and Counselling at the University of Huddersfield, has embarked on research that looks into the teaching of infant feeding techniques. Alongside this Dr Locke is interested in what is happening during the six week period following birth which is making mothers abandon breastfeeding. Following analysis of antenatal classes, which she recorded four years ago, Dr Locke noticed that concerns around pain, discomfort or difficulty were not readily addressed and that breastfeeding was being taught with the focus placed upon the benefits, combined with the best methods for positioning babies for successful feeding. “The drop in breastfeeding rates is massive, something must be happening in those first six weeks which is making women stop feeding” said Dr Locke “I believe that during the first few weeks following birth, breastfeeding can be tricky and some women are hitting difficulties. Although some of those women go and seek support and carry on, many just find it too hard and stop.” Dr Locke is keen to explore alternative approaches to the teaching of infant feeding, on the premise that, if women were made aware during antenatal classes of the difficulties they may face when breastfeeding and how to deal with them, they would be more likely to carry on through. “Breastfeeding is a very emotive subject; a new mum is very vulnerable and it’s a big stress if she encounters lots of problems which she wasn’t expecting” said Dr Locke, who is also a mother of two. “I wholly believe that breast milk is the best milk a baby can have, encouraging breastfeeding is important and in an ideal world every mother would do it. But the reality is it doesn’t always work out like that and it’s about dealing with that group of women who it doesn’t work for and how we can improve things for them.”

Breast pump update and developments Work has been done in collaboration with Ardo Medical who have been invited to attend the next BFI Conference in Harrogate as a welcome provider of breast pump equipment, which also provides the Kirklees community with all their breast pumps and collection sets. Kirklees mothers have the opportunity to access these for free pending availability from all health visiting teams and Sure Start Children Centres in Kirklees. The availability of breast pumps have also been extended to the neonatal unit at The Mid Yorkshire Hospitals NHS Trust who received a number of breast pumps through funding donated through KCHS health visiting service. Ardo, who are a Swiss company, have recently introduced their new breast feeding range to the UK which has been a big success. The new Calypso breast pump, which has now replaced the Lactaline, has extra settings and now comes with a digital screen which makes the pump easier to keep clean and enables mums to see which setting they are on. The new OneMum collection set converts into a great hand pump when combined with the Kombikit hand converter which makes the whole set up environmentally friendly, when mums return the electric breast pump to the centre they have the option to purchase this item to convert the set into a pump instead of throwing it away which would enable her to pump on the odd occasion she may need to thus encouraging her to continue to breastfeed. Rachel Goddard - Ardo medical rep can be contacted on 07850 521872 if you have any queries about existing breast pumps or you would simply like to know more about the new range of breast pump/ expressing equipment.

Breastfeeding Bulletin

Breastfeeding best practice

Helping a baby with tongue tie - BFI recommendations

A tongue tie occurs when a piece of tissue bridges the gap between the underside of the tongue and the floor of the mouth. Some babies with tongue tie have difficulty breastfeeding because the tongue tie prevents the baby from attaching effectively to the breast.

How are tongue ties divided?

The future

Dividing a baby’s tongue doesn’t need a general anaesthetic, providing they are less than eight months old. It only takes a minute or so, though it might well seem longer. A trained health professional will wrap your baby up with a towel, divide the tongue tie with sterile scissors and bring your baby back to you quickly so that you can feed them

If the baby is breastfeeding or bottlefeeding well, then the tongue tie doesn’t need to be divided. Most tongue ties in newborn babies are thin, but those remaining in three year olds are mostly thick. So, the thin ones must either have been divided by the lower teeth as they come through, or they are accidently torn by a parent putting a teaspoon of food under, rather than over, the tongue, or the infant thrusts a toy into their own mouth.

Does it hurt? Logically, dividing the tongue tie ought to hurt. However a significant number of small babies are asleep when their tongue tie is divided and stay asleep during the procedure. Older babies don’t like being wrapped up so they usually cry out, and it can sometimes be quite difficult to know whether dividing their tongue tie is painful, as they are already complaining at being wrapped up.

What about the wound? A few drops of blood are normal, but this always stops quickly and is never a problem. The inside of the mouth heals much faster than most of the rest of the body because the lining of the mouth is being worn away and renewed all the time. This happens even quicker in babies, so there is no need for any form of wound management – the baby just needs to be fed.

Although some babies can breast or bottle feed well, they might have problems coping with lumpy food. They might not be able to transfer food from the front to the back of the mouth or chew properly. Tongue tie division, at any age, will help these infants. A few tongue ties do persist and can cause speech or other problems, but this won’t really be apparent until the child is at least three years old. If there is a problem, the tongue tie can be divided under a very short general anaesthetic. Most children with a tongue tie and a speech problem improve following division.

How do I get my baby’s tongue tie divided? Talk to your breastfeeding counsellor, GP or any health professional about how to have your baby referred.

Get Britain Breastfeeding From April to May 2010 NHS Kirklees in collaboration with Best Beginnings and Healthy Schools promoted breastfeeding awareness in schools and colleges across Kirklees. More than 300 students took part in a questionnaire with a free prize draw. Congratulations go to Sophie Pilcher and Gemma Brannigan from Huddersfield New College who both received a £20 HMV voucher for their entry.

Baby Friendly on Twitter The Baby Friendly Initiative now has a Twitter account, where we will regularly be letting people know about updates and news items of interest. Use this link to follow us

Latest developments Best Beginnings - Bumps to Breastfeeding DVD It has recently emerged that the DH has made the decision to discontinue the free distribution of the very popular Best Beginnings Bumps to Breastfeeding DVD breastfeeding resource which is routinely given to all mothers in the antenatal period from the midwifery service and with immediate effect it is now going to be a chargeable resource. We will keep you informed of the impact this might have and any more developments. In the first instance we would now recommend that everyone in the health visiting and Baby Bistro service have a copy to loan out to clients if copies do start to diminish. The DVD is available to view online for free at and also has clips of the DVD alongside helpful information and tips to help pregnant women and new mothers.

Breastfeeding resource file Over the coming weeks, all health visitor bases across Kirklees will be receiving a breastfeeding resource file which will hold an array of evidence-based/best practice breastfeeding/infant feeding leaflets, posters and DVDs which we hope you and your teams will find useful. Please can you make sure that this file is kept up-to-date and take copies as appropriate for individual staff. Feedback is always welcome and if you know of a resource which would be useful for all staff teams please let Jayne Heley know. The Public Health Resource Centre can also help with additional breastfeeding/infant feeding resources.

Audit and effectiveness update We are now in the process of auditing mothers perceptions of breastfeeding support in Kirklees. Over the coming weeks a random selection of mothers from across the area will be consulted with and we will let you know what they said in a future edition of this bulletin. In addition to the audits we have to carry out as part of BFI we will also be including the provision of breast pumps, breastfeeding peer supporters and Baby Bistro services in future audits.