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Principles

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Brent tPCT believes that breast-feeding is the healthiest way for a woman to feed her baby and important health benefits exist for both the mother and her

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    Breast feeding Policy

    Breast Feeding Policy

    Policy History Document Information Issue PNF Approval PEC Approval Author: Breastfeeding working group 1.0 Review Date: May 2007

     Reviewer:

    Last edit date:

    File Reference: NP 22

     Brent tPCT Professional’s Policy on Breastfeeding Jan 2005 NP22 1

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    Breast feeding Policy

Professional’s Policy on Breastfeeding in Brent tPCT

Policy Statement

    Brent tPCT believes that breast-feeding is the healthiest way for a woman to

    feed her baby and important health benefits exist for both the mother and her

    baby. 1)

Brent PCT supports breastfeeding for all babies wherever possible.

    All mothers have the right to make a fully informed choice as to how they feed

    and care for their babies. The provision of clear and impartial information to all

    mothers at an appropriate time is therefore essential. Health care staff will not discriminate against any woman in her chosen method

    of infant feeding and will fully support her when she has made that choice. This

    policy is designed to ensure good professional practice, not to dictate the

    choices of mothers.

    All PCT staff are expected to support breast-feeding.

Aims

    To create an environment where more women choose to breast-feed their

    babies, and where more women are given sufficient information and support to

    enable them to breast-feed exclusively for 6 months, and then as part of their infant's diet for as long as they both wish. (2) To enable all health care staff that has contact with breastfeeding women to

    provide full and competent support through specialised training in all aspects of

    breastfeeding management. To encourage liaison with other health care

    facilities and delivery of a seamless service, together with the development of a

    breastfeeding culture throughout the local community.

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    Breast feeding Policy

In Support of This Policy

    It is crucial that staff of all disciplines adhere to this policy to avoid conflicting

    advice. Any deviation from the policy must be justified and recorded in the

    mother's and/or baby's health care records. This should be done in the context of professional judgement and codes of conduct. A parent’s guide to breast-feeding has been drawn up in support of this policy (See appendix 1)

It is the responsibility of all health care professionals to liaise with others eg GP

    should concerns arise about the baby's health. Guidelines for the support of

    breastfeeding in special situations and the management of common

    complications has been drawn up and agreed by a multi-disciplinary team of professionals with clinical responsibility for the care of mothers and babies. (See Appendix 2)

Vitamin drops are recommended for all breastfed babies after six months to

    ensure proper growth and development and to help prevention of rickets.

    Vitamins are also recommended for babies who are being exclusively breast- fed from one month if they fall into an at-risk group. These are babies of black

    or Asian origin or from a mother who covers herself for religious or cultural

    reasons.

    The policy and guidelines will be reviewed annually. Compliance with the policy will be audited on an annual basis.

No advertising of breast-milk substitutes, feeding bottles, teats or dummies is

    permissible in this Trust. The display of logos of manufacturers of these

    products on such items as calendars and stationery is also prohibited (3) No literature provided by manufacturers of breast-milk substitutes is permitted. Educational materials for distribution to women or their families must be

    approved by the lead professional.

    Parents who have made a fully informed choice to feed their babies artificially

    should be shown how to prepare formula feeds correctly, either individually or

    in small groups, in the postnatal period. No routine group instruction on the

    preparation of artificial feeds will be given in the antenatal period, as this has

    the potential to undermine confidence in breastfeeding.

THE POLICY

    Communicating the Breastfeeding Policy

    1.1 This policy is to be communicated to all health care staff working in

     Brent tPCT who has any contact with pregnant women and mothers. All

     staff will receive a copy of the policy.

    1.2 All new staff will be orientated to the policy as soon as their employment

     begins.

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    Breast feeding Policy

    1.3 The policy will be displayed in all areas of Trust premises/clinics/parts of

     the health centre. (Where an interpreter is needed every effort will be

     made to ensure one is provided) 1.4 All staff involved in support women breast-feeding must ensure that

     there is no disadvantage to them because of race, culture, age,

     disability, sexuality, economics or refugee and political status

Training Health Care Staff

    2.1 Midwives and health visitors have the primary responsibility for

     supporting breast-feeding women and for helping them to overcome

     related problems.

    2.2 All professional, clerical and ancillary staff that has contact with pregnant

     women and mothers will receive training in breastfeeding management

     at a level appropriate to their professional group. New staff will receive

     training within six months of taking up their posts.

    2.3 The responsibility for providing training lies with the lead professional,

     who will audit the uptake and efficacy of the training and publish results

     on an annual basis.

Informing Pregnant Women of the Benefits and Management of

    Breastfeeding

    3.1 Every effort must be made to ensure that all pregnant women are aware

     of the benefits of breastfeeding and of the potential health risks of

     formula feeding.

    3.2 All pregnant women should be given an opportunity to discuss infant

     feeding on a one-to-one basis with a midwife or health visitor. Such

     discussion should not solely be attempted during a group parent

     education class.

    3.3 The physiological basis of breast-feeding should be clearly and simply

     explained to all pregnant women, together with good management

     practices and some of the common experiences they may encounter

     Egg engorgement, sore nipples and mastitis .The aim should be to give

     women confidence in their ability to breast-feed.

    3.4 All materials and teaching should reflect the WHO/UNICEF Ten Steps to

     Successful Breastfeeding and the Seven Point Plan for the Protection,

     Promotion and Support of Breast-feeding in Community Health Care

     Settings.

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    Breast feeding Policy

    Supporting the Establishment and Maintenance of Lactation

4.1 Midwives and health visitors should ensure that mothers are offered the

     support necessary to acquire the skills of positioning and attachment

     and hand expression of breast milk

    4.2 Handover of care from midwife to health visitor will follow established

     procedure.

    4.3 Health professionals should ask about the progress of breastfeeding at

     each contact with a breastfeeding mother. This will enable early

     identification of any potential complications and allow appropriate

     information to be given to prevent or remedy them. 4.4 It is the responsibility of those health professionals caring for her to

     ensure the mother is given help and encouragement to express her milk

     and to maintain her lactation during periods of separation from her baby.

    4.5 Mothers will be encouraged to keep their babies near them and to

     practise baby-led feeding. They will be given appropriate information

     about the benefits of and contraindications to bed sharing. 4.6 Health care staff should not recommend the use of artificial teats or

     dummies during the establishment of breastfeeding. Parents wishing to

     use them should be advised of the possible detrimental effects on

     breastfeeding to allow them to make a fully informed choice. 4.9 Nipple shields will not be recommended except in extreme

     circumstances and then only for as short a time as possible. This is

     because nipple shields can interfere with the amount of milk the baby

     receives.

Supporting Exclusive Breast-feeding

    5.1 For the first 6 months, no water or artificial feed is to be recommended

     for a breastfed baby except by a professional trained in lactation

     management (2) Parents who elect to supplement their baby's

     breastfeeds with formula milk should be made aware of the health

     implications and of the harmful impact supplementation may have on

     breast-feeding to allow them to make a fully informed choice.

    5.2 All mothers should be encouraged to breastfeed exclusively for the first

     6 months and to continue breast-feeding for at least the first year of life.

     All weaning information should reflect this ideal (2) 5.3 Data on infant feeding showing the prevalence of both exclusive and

     partial breast-feeding will be collected at birth, at discharge from the

     hospital and whenever else is customary.

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    Breast feeding Policy

5.4 Formula milk will not be sold by Brent tPCT staff or on health care

     premises. (Formula milk may be exchanged for welfare tokens

     (including Family Credit) if there is no other local outlet providing this

     facility.)

A Welcome for Breast-feeding Families

    6.1 Breastfeeding will be regarded as the normal way to feed babies and

     young children.

    6.2 Mothers will be enabled and supported to feed their infants in all public

     areas of Trust premises.

    6.3 We aim to provide comfortable facilities for mothers who prefer privacy.

    6.4 Signs in all public areas of the facility will inform users of this policy.

    6.5 Special support will be offered to young teenage / single parents in age

     appropriate surroundings.

    Encouraging Community Support for Breast-feeding 7.1 Brent tPCT supports co-operation between health care professionals

     and voluntary support groups whilst recognising that health care facilities

     have their own responsibility to promote breastfeeding. 7.2 Telephone numbers for community midwives, health visitors and

     voluntary breast-feeding counsellors should be issued to all mothers and

     will be routinely displayed in all public areas. 7.3 Breast-feeding support groups will be invited to contribute to further

     development of the policy through involvement in appropriate meetings.

    7.4 Members of the health care team should use their influence wherever

     and whenever possible to encourage a breast-feeding culture in the local

     community.

    7.5 Brent tPCT will work with local breastfeeding support groups to raise

     society's awareness of the importance of breast-feeding and to

     encourage the provision of facilities for breast-feeding mothers and

     infants through liaison with local businesses, authorities, community

     groups and the media.

    7.6 Opportunities to influence or take part in educational programmes in

     local schools (e.g. as part of the role of school nurses) will be explored.

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    Breast feeding Policy

    References

    1. Standing Committee on Nutrition of the British Paediatric Association

    (1994): Is breast- feeding beneficial in the UK? Arch Dis Child, 71: 376-

    80.

    2. In May 2003, the Department of Health adopted the World Health

    Organisation's recommendation that babies be exclusively breastfed for

    the first 6 months of their lives.

    3. The Infant Formula and Follow-on Formula Regulations 1995 stipulate a

    legal requirement that infant formula advertising should be restricted to

    baby care publications distributed through the health care system. There

    is no legal requirement for Trusts in the UK to comply with the

    International Code of Marketing of Breast-milk Substitutes (WHO,

    Geneva, 1981). However, the requirements of the Baby Friendly

    Initiative are based on the International Code, which aims 'to contribute

    to the provision of safe and adequate nutrition for infants, by the

    protection and promotion of breast-feeding, and by ensuring the proper

    use of breast-milk substitutes, when these are necessary, on the basis

    of adequate information and through appropriate marketing and

    distribution.' Articles 5 and 6 of the Code state that no promotion of

    breast-milk substitutes, bottles or teats should occur.

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    Breast feeding Policy

Local Support Groups/ Breast-feeding Cafes

    Wembley Locality: 0208 795 6030 Kingsbury: 0208 206 1130

    Kilburn: 0208 459 1359

    Harlesden: 0208 965 0151

    Willesden: 0208 208 2565

    Please phone your health visitor or any of the above numbers for individual

    advice or for the times of local groups.

    National Breast-feeding Help lines

Association of Breastfeeding Mothers:0870 401 7711 www.abm.me.uk

    Breastfeeding Network BfN: 0870 900 878

     www.breastfeedingnetwork.org.uk

    BfN Drug Helpline: 02392 598 604 (For medications in mother’s milk) La Leche League 0845 120 2918 www.laleche.org.uk

    National Childbirth Trust: 0870 444 8708

    www.nctpregnancyandbabycare.com

NHS Direct 0845 4647

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    Acknowledgements

    Thanks to Dr Judith Stanton, Joint Director of Public Health Brent tPCT Ruth Tamir - Breastfeeding Network

    Carys Grewcock - UNICEF, Baby Friendly Initiative

    Carole Bellringer - Chair, Professional Nurses Forum Brent tPCT

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     Appendix 1

    Parents Guide to Breastfeeding Policy

    Breastfeeding is the healthiest way to feed your baby. There are many benefits to you and your child. We will do all we can to support you in your decision to breastfeed.

    1. All midwives and health visitors have skills to support you in

     breastfeeding. Some health visitors and midwives have extra training.

     Please ask to speak to them if you wish.

    .

    2. During your antenatal care you will be given ample opportunities to

     discuss breastfeeding with a midwife or health visitor who will be able to

     give you up to date information about the benefits.

    3. We encourage and support you to hold your baby in skin-to-skin contact

     straight after birth. This is your first chance to see your new baby and

     staff will not interfere or hurry you as long as your baby’s condition

     allows. This could be something you include in your birth plan.

    4. You are encouraged to offer the first breastfeed at this time so your baby

     can benefit from the important antibodies in your colostrum.

    5. It is important for your baby to be with you all the time and your baby will

     want this too. Once you start breastfeeding we will encourage you to

     feed your baby whenever he/ she is awake and looking for the breast.

     Research shows that night feeding is essential for establishing

     breastfeeding. This way you can be sure your baby is getting enough

     milk.

6. Correct positioning and attachment is the key to successful

     breastfeeding. Breastfeeding should not be painful. It might take a few

     breastfeeds before you feel completely comfortable. Do not feel

     embarrassed to ask for help.

    7. You may also be shown how to hand-express your milk if you wish. This

     will be useful if you want to leave the baby with someone or if you are

     planning to return to work .You can ask for written information on hand

     expressing.

    8. Normal healthy babies do not need to receive anything other than breast

     milk for the first six months. If there is some medical reason why your

     baby has to receive some other form of milk this will be explained to you

     by the staff before you are asked to give your permission. Breast milk

     should always be the preferred milk.

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