Enhancing our Infant Feeding Pathway

Annette Algie, Strategic Services Manager at Blackpool Better Start, and Vicki Morgan, Service Manager at Start for Life, Blackpool Council, describe the support put in place to improve infants’ early nutrition.

The challenge

There is clear evidence that breastfeeding and feeding with breastmilk has many immediate and long-term benefits. Supporting women and their partners with their breastfeeding journey increases the likelihood of breastfeeding continuing beyond the first six weeks following birth.

Some mothers are unable or choose not to breastfeed and providing non-judgemental, sensitive support to help formula feed babies responsively and safely, and help reduce the likelihood of over-feeding, is also a critical part of the infant feeding pathway.

There is also compelling evidence that shows waiting to transition babies to solid foods at six months can also have positive long-term impact on the health and wellbeing of babies and their mothers.

In 2012/13 only 52% of women breastfeed at birth, and 27% at 6-8 weeks highlighting the need to support this area. The Blackpool Better Start Partnership talked to hundreds of local parents and found that while they had been encouraged to breastfeed by health professionals, there was little support in introducing solids to their children, and information on formula feeding was not covered supportively leaving parents feeling judged and inadequate.

What We Did

We used a process called ‘implementation science’ to design a new ‘Learning to Feed’ volunteer service that helped turn public health messages that weren’t resonating into an easy-to-understand format. We did this at pace, changing wording and framing, and testing the messages until we got them right. These were tested with the community who reported that they understood the messages and found them supportive.

The Learning to Feed messages are:

• However you choose to feed your baby; always hold your baby close when feeding them milk so they feel loved and safe.
• Your baby will tell you when their tiny tummies are full with their signs and signals.
• Breastmilk is human milk for human babies. It’s free of charge and helps protect you and your baby from infection.
• Most brands of formula milk are made the same way from treated cows’ milk (or goats’ milk). High cost does not mean better quality.
• It’s important to take extra care making up formula feeds to protect baby against tummy infections.
• Babies will wake up a number of times a night for feeds and comfort.

The Community Consultation highlighted the need for community-based support for infant feeding and starting solids. As a result, the infant and young child feeding service (HENRY - Blackpool Welcome | HENRY) was commissioned in 2019 to deliver an evidence-based infant feeding programme. This service includes a telephone advice line, home visits and drop-in sessions in community venues. In addition to this, training for the early years workforce and helpline support ensured that professionals were also equipped with the right knowledge and skills.

Henry also forms part of Blackpool’s antenatal educational course – Baby Steps. One of the eight sessions offered as part of the course helps parents understand what to expect with infant feeding and supports parents to explore both breastfeeding and formula feeding options.

The pathway provided much needed support for professionals and families, however with the Start for Life funding allocated to Blackpool the offer had the opportunity to be further enhanced. This was achieved by increasing the contact points where families were able to seek infant feeding support. This included increasing support antenatally at all Baby Steps groups and within Baby Friendly Initiative Infant Feeding Workshops.

There was also an increased presence on delivery, maternity, and neonatal wards to offer support within the first few critical hours of birth, and again at day-5 clinics where parents may need the most support. This additional Start for Life funding enabled the community venue presence to be increased with more drop-in sessions being offered at Family Hubs. The enhancement from Start for Life funding also supported virtual and digital support via the ANYA app. ANYA is commissioned by Blackpool Council and offers all expectant and new parents’ access to evidence based articles, real in app specialist support and chat rooms to meet with other parents 24 hours a day, 7 days a week.

To support the sustainability of this work Blackpool have initiated the training and auditing of over 150 members of the Early Help and Support Service and community workforce by rolling out Baby Friendly Initiative training. Additionally, the funding also enabled a volunteer development pathway to be established. Moving the Learning to Feed volunteers into the HENRY service has supported the individuals to develop alongside the service and ensure that the Blackpool Learning to Feed messages are embedded in the HENRY approach.

Our Impact

Rates of breastfeeding showed that by the end of 2022/23 68% of mothers were initiating breastfeeding and at 6-8 weeks 31.3% were continuing to breastfeed exclusively or partially.

Although there are still opportunities to improve take-up, the impact has been noticeable and the enhanced infant feeding service has led to a steeper increase in the number of parents both initiating and sustaining breastfeeding. There has also been an increase in babies that are partially or exclusively breastfed at both the 14 day and 3-5 week Health Visitor check. Additionally, following the enhancements of the service, we have seen a significant reduction in the number of families introducing solids prior to 6 months, falling from 26.4% at the of Q4 22/23 to 17.1% at the end of Q3 23/24.

Data from parents who have completed Baby Steps antenatal education course shows that more parents are likely to initiate breastfeeding, a rise of 17% over a three-year period. More parents are also likely to maintain breastfeeding at 6 months, a rise of 10% over a three-year period.

Parents in Blackpool are now supported at every step of their baby’s feeding journey, and the development of this comprehensive pathway has had a systemic impact on how infant feeding is delivered in the town.

See a Professionals guide to HENRY

About A Better Start

A Better Start is a ten-year (2015-2025), £215 million programme set-up by The National Lottery Community Fund, the largest funder of community activity in the UK.

Five A Better Start partnerships based in Blackpool, Bradford, Lambeth, Nottingham and Southend are supporting families to give their babies and very young children the best possible start in life. Working with local parents, the A Better Start partnerships are developing and testing ways to improve their children’s diet and nutrition, social and emotional development, and speech, language and communication.

The work of the programme is grounded in scientific evidence and research. A Better Start is place-based and enabling systems change. It aims to improve the way that organisations work together and with families to shift attitudes and spending towards preventing problems that can start in early life. It is one of five major programmes set up by The National Lottery Community Fund to test and learn from new approaches to designing services which aim to make people’s lives healthier and happier

The National Children’s Bureau is coordinating an ambitious programme of shared learning for A Better Start, disseminating the partnerships’ experiences in creating innovative services far and wide, so that others working in early childhood development or place-based systems change can benefit.

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Visit the A Better Start website to find out more.