Breastfeeding in South Gloucestershire: Mothers' early experiences of infant feeding

Executive SummaryIntroduction• This research about mothers’ early experiences of infant feeding was developed following discussions about South Gloucestershire’s public health priorities for breastfeeding; current services supporting breastfeeding; and relatively low breastfeeding continuation rates.Background and context• Breastfeeding is recognised as the optimal way to feed infants from birth and exclusive breastfeeding is recommended until about six months of age, with the introduction of complementary feeding when babies are developmentally ready, usually around six months. • The support, promotion and protection of breastfeeding is a national and local priority. In 2014/15, initiation of breastfeeding in South Gloucestershire, was 77.1% while continuation was 47.8%. The Joint Strategic Needs Assessment in 2016, highlighted the need to obtain the views of mothers on their experience of support for breastfeeding. Research question• The research question was: What are the experiences of mothers (with a focus on support) in South Gloucestershire in relation to infant feeding in the first 6-8 weeks? Methods• The research design adopted a purposive sampling strategy, based on criteria sampling, with mothers that had; experience of breastfeeding in the first 6-8 weeks of their baby’s life, a baby up to 6 months of age and were engaged with a Children’s Centre. We recruited mothers who met all three criteria. • Support for the research was obtained from Midwifery, Health Visiting and Children’s Centres managers. Baby and Me groups were visited to invite participation; 53 mothers expressed an interest and 24 mothers selected randomly were interviewed. An information sheet, consent form and interview schedule were developed.• NVivo was used to support data management and analysis in which themes were identified. Data protection requirements were adhered to throughout the research. The research had ethical approval from both South Gloucestershire Council and the University of the West of England. The findingsFindings from this project suggest that there are three ‘critical stages’ in supporting a mother to breastfeed and in her experience of breastfeeding; within these the main themes emerging from this research are discussed: • Support before birth: o Preparation antenatally for breastfeeding does not prepare women for the reality.o Many mothers would have liked information about expressing milk and bottle-feeding before they become mothers. • Support around the time of the birth:o In hospital, after the birth, some mothers receive conflicting messages and don’t always feel supported.o Birth experience can influence early experiences of breastfeeding.• Support once at home:o On return home, Health Visitors are generally perceived as supportive although contact can be minimal.o Breastfeeding support groups suit some women but are not available when needed.o Family, friends and other networks are a key source of support and advice for many motherso Many women seek support from other sources including online groups and apps although telephone helplines were not much used.Recommendations A number of recommendations are made; these are mainly directed towards South Gloucestershire Council but are also of relevance to the wider partnership of health and community and voluntary sector agencies. Recommendations concern the promotion and protection of breastfeeding; the mental and emotional health and wellbeing of women; consistent evidence-based personal and timely support; mothers awareness of differing professional roles; evaluation of breastfeeding groups and; consistent approach to signposting women to websites, apps and social media; and quality assurance of resources and workforce development

Association between food for life, a whole setting healthy and sustainable food programme, and primary school children’s consumption of fruit and vegetables: A Cross-Sectional study in England

© 2017 by the authors. Licensee MDPI, Basel, Switzerland. The promotion of dietary health is a public health priority in England and in other countries. Research shows that the majority of children do not consume the recommended amount of fruit and vegetables (F&V). There has been relatively little research on the impact of programmes, such as Food for Life, that (a) integrate action on nutrition and food sustainability issues, and (b) are delivered as commissions in a local authority area. The study sought to assess pupil F&V in schools engaged with the Food for Life (FFL) programme. The design was a cross-sectional study comparing pupils in FFL engaged (n = 24) and non-engaged (n = 23) schools. A total of 2411 pupils aged 8-10 completed a validated self-report questionnaire. After adjusting for confounders, pupils in schools engaged with FFL consumed significantly more servings of F&V compared to pupils in comparison schools (M = 2.03/1.54, p < 0.001). Pupils in FFL schools were twice as likely to eat five or more portions of F&V per day (Odds Ratio = 2.07, p < 0.001, Confidence Interval = 1.54, 2.77). Total F&V consumption was significantly higher (p < 0.05) amongst pupils in schools with a higher level FFL award. Whilst limitations include possible residual confounding, the study suggests primary school engagement with the FFL programme may be an effective way of improving children’s dietary health

Food for life: A social return on investment analysis of the locally commissioned programme. Full Report

A Social Return on Investment Analysis of two locally commissioned Food for Life programme

Evaluation of Food for Life 2013-15: Summary and synthesis report

This is the final report of the phase two evaluation of Food for Life undertaken by the University of the West of England, Bristol 2013-15. The research encompassed five workstreams: 1.Long term impacts and durability - understanding how and why the Food for Life approach is embedded in schools for the medium to long-term. 2.Review of local commissions - understanding strategic support for Food for Life, and recommending monitoring and evaluation systems.3.Cross sectional study of pupils’ diets in Food for Life local commissions - evaluating Food for Life’s impact on healthy eating behaviours in schools in local commission areas. 4.New settings - exploring innovative approaches to extending the Food for Life whole setting approach beyond schools.5.Social value of Food for Life in local authority commissions – understanding the social, health, economic and environmental value of Food for Life commissions. The report presents summaries of the findings of each workstream, discusses themes emerging across the research, and sets out recommendations for Food for Life and associated evaluation activity

Communication, Collaboration and Enhancing the Learning Experience: Developing a Collaborative Virtual Enquiry Service in University Libraries in the North of England

This paper uses the case study of developing a collaborative ‘out of hours’ virtual enquiry service by members of the Northern Collaboration Group of academic libraries in the north of England to explore the importance of communication and collaboration between academic library services in enhancing student learning. Set within the context of a rapidly changing UK higher education sector the paper considers the benefits and challenges of collaboration and the contribution of library services to the student experience. The project demonstrated clear benefits to student learning and evidence of value for money to individual institutions as well as showing commitment to national shared services agendas. Effective communication with students, with colleagues and stakeholders in our own and other Northern Collaboration member institutions, and with OCLC, our partner organisation, was a critical success factor in the development, promotion and uptake of the new service

Important times for breastfeeding support: a qualitative study of mothers’ experiences

Breastfeeding rates in the UK remain persistently low, with a rapid fall off during the first 6–8 weeks. The work of healthcare and public health practitioners impacts on mothers’ experiences of infant feeding. Support, promotion and protection of breastfeeding are a national priority. Semi-structured qualitative interviews were undertaken with mothers who had experience of breastfeeding. Participants were engaged with a local Children’s Centre (indicating engagement with public health provision) and their babies were up to 6-month old (to increase recall of early experiences). Twenty-four participants were recruited and interviews thematically analysed. Mothers identified matters significant in relation to public health provision for breastfeeding, including three stages of time of significance for breastfeeding impact. These interlinked critical stages impact on a mother’s experiences. Joined up public health practice providing breastfeeding support and information before birth, around the time of the birth, and once home is significant in mother’s accounts. Breastfeeding support, in both healthcare and public health contexts, needs to be highly attuned to different stages in the experiences of mothers. Breastfeeding continuation is influenced by support experienced antenatally, perinatally, and in early weeks. To enhance the initiation and retention of breastfeeding, public health practice must pay attention to these stages. Breastfeeding support needs to begin prior to birth and be given throughout the postnatal period and beyond

Dataset of primary school pupil self-reported fruit and vegetable consumption in Food for Life commissioned local authorities.

This dataset was developed as part of the Food for Life evaluation 2013-15. It records the results of the use of a questionnaire on fruit and vegetable consumption with over 2400 primary school children