Infant Feeding Strategy

Baby nutrition and the protection, promotion and support for breastfeeding are vitally important to public health. Human milk promotes health, prevents disease, and provides a best start in life for both parent and baby.

Many women/birthing parents who want to breast/chestfeed their baby experience various challenges in doing so. Evidence shows that eight out of ten people stop breastfeeding before they want to. The reasons for the steep drop off in breastfeeding in the first weeks after birth are complex, but likely include a lack of support for breastfeeding at a societal level, as well as from family, peers and healthcare professionals. Often employers have not got adequate support provision for parents returning to work and expressing breast milk, or pressure from wider society as breastfeeding is not necessarily seen as the norm. This strategy sets out the direction to support agencies and the public, to protect, promote, support, and normalise breastfeeding.

The strategy intends to offer all pregnant women and people and partners a clear pathway of care throughout pregnancy and during the postnatal period to ensure consistent, evidence-based information in support of their feeding journey. This will include all chosen feeding methods in recognition that individual choices are respected, with the strategy focused on providing personalised care for all infant feeding journeys.

• Infant feeding decisions are personal and made for a variety of reasons but should be based on evidence to ensure that the choices made are informed.
• To date in the UK, there has been no scrutiny of the extent to which foods and drinks given to babies, infants and young children are processed, and the implications of their diets on long term health.
• Latest research tells us that by the first year of school, more than a fifth of children in England are living with overweight or obesity. We know that good nutrition starts early in pregnancy for the parents, as we understand that maternal nutritional status can influence the development of childhood weight.

• Breastfeeding contributes to reducing infant mortality.
• Breastfeeding contributes towards reducing childhood obesity.
• Breastfeeding contributes towards reducing a broad range of inequalities.
• Breastfeeding contributes to a reduced risk of infections and allergies.
• Bottle fed babies (breast milk and formula) need to be fed safely.

• Our vision is to create a supportive and inclusive culture where everyone feels supported to feed their baby. We would like breastfeeding to be seen as the norm, and for it to be recognised as the key component to long term health and reducing health inequalities.
• Our culture and attitudes will value and respect individual choice. We will offer personalised care that helps develop close and loving parent-infant relationships.
• We want to ensure all pregnant women and people are offered individualised, timely and consistent access to infant feeding support throughout the antenatal period and beyond.
• Families will have the knowledge to get their feeding journey off to the best start and know where to access support should issues arise.

• To increase the awareness of parents and in the general population of healthy and safe feeding practices for babies and infants.
• To promote a positive breast/chest feeding culture which increases the numbers of babies and infants who are breast/chest fed and supports feeding for longer.
• Address inequalities especially in our Black, Asian and mixed ethnicity community, our young parents and those living in areas of deprivation.
• Support co-parents/partners in giving the right practical and emotional support.
• To provide effective professional support, enabling staff to empower families.
• To extend training and education into community services ensuring the most vulnerable are offered accurate consistent information.
• We recognise that breastfeeding is not possible for everyone. We will support parents in making an informed decision on whichever method they choose to make it a success.
• Achieve the standard of the UNICEF UK Baby Friendly Initiative (BFI) for infant feeding, or an equivalent initiative, by March 2027

Data about infant feeding is recorded by the health visiting service and submitted to NHS England.

How a baby is fed is recorded at a 6 to 8 week check by the health visitor when they carry out a health review.

Feeding status is defined as

• Fully breastfed – where a baby receives only breastmilk
• Partially breastfed – where a baby is fed breast milk and formula milk
• None – where a baby receives only formula milk.

The NHS Long-Term Plan asked for maternity units to commit to achieving the
UNICEF Baby Friendly Initiative (BFI) standards by 2027

Maternity services submit data to NHS England via the Maternity services Data set (MSDS)

Data is submitted to NHS England’s Community

Services Data set (CSDS) by health visitors. NHS England links CSDS with MSDS to allow the inclusion of disparities such as ethnicity and deprivation.

Not all births are included in the records, and some births are missing.

Separately, health visiting services send data on infant feeding to local commissioners and local authorities submit data to The Office for Health Improvement and Disparities (OHID). This is published data.

Cultural and social attitudes play a role in the decision on how people feed their baby/s and we understand the importance of providing information that is evidence based and culturally appropriate to support parents in their choices.

Data tells us that factors that influence someone’s feeding decision can be impacted by deprivation, ethnicity and age.

Our local communities tell us that feeding is influenced by:

• Cultural pressures
• Trust between the community and health professionals
• Continuity of information
• Access to feeding support in already established community hubs
• Information on nutritional quality of snacks and portion sizes

We will continue to use feedback from our community partners to understand and shape services, offering support in the places where it is most needed.

• All three hospital sites have an infant feeding specialist midwives in post.
• All three sites have a Neonatal Infant feeding lead Nurse in post
• There is an infant feeding lead for Suffolk health Visiting team.
• There is an infant feeding lead for Northeast Essex Pre-birth to 19 years.
• The number of hours and positions varies between the counties.
• Each of the hospital infant feeding leads have gained at least 1 midwifery support worker (MSW) support within their infant nutrition team. This role will support drop-in clinics, audits, tongue tie clinics and breastfeeding assessments. There are also ambitions for all members of the team to be lactation consultants.
• The Northeast Essex Child and Family Wellbeing Service has a staff member assigned daily to conduct the 48-hour phone call to all women. This call is a holistic assessment of the infants feeding, maternal wellbeing and to offer additional support and contact. There is also a contact number for staff to use to gain additional feeding support to assist in advising their clients.

• West Suffolk maternity service offer antenatal infant feeding education across all teams. They also offer 1:1 antenatal feeding support for those with specific needs.
• Postnatally everyone is offered support from midwives, care assistants and/or peer supporters to get their feeding journeys off to the best start. Community feeding support is tailored to each person and they can self-refer to the infant feeding team for 1:1 support if needed.
• There is also a midwife led tongue tie clinic. This runs weekly and is supported by experienced maternity support workers.
• Additional support on the postnatal ward, neonatal unit and children’s ward is provided by the infant feeding team when required

ESNEFT offers weekly antenatal education groups for feeding and support which takes parents through the postnatal journey.

They will offer extra support for those who have experienced previous complex feeding issues or are wanting additional support antenatally. During the postnatal period families can refer themselves or be referred by a health care professional for additional infant feeding support. This includes phone calls and one to one support with a midwifery support worker with follow up support as needed.

ESNEFT offers an infant feeding clinic which runs Monday – Friday by an Infant Feeding Support worker. This offers support for those who have experienced previous feeding problems, or who have complex medical needs and need feeding plans put in place.

Feeding support is offered to all women and people within the area up to 28 days and occasionally after discharge from midwifery care.

Infant feeding teams at both Colchester and Ipswich have fully qualified lactation consultants offering support.

The infant feeding team provide support on the postnatal ward, Intensive Care Unit (ITU), children’s ward and neonatal unit if required.

Outside of the hospital they regularly link in with local community groups, offering support and advice.

Suffolk wide support includes:

• Infant feeding support groups
• 2-hour virtual breastfeeding workshop for parents running from family hubs.
• Introducing solids’ sessions
• Sleep baby and you’ virtual workshops.

Essex wide support includes:

• ‘Preparing for baby’ workshop
• ‘Baby beginnings’ workshop which includes infant feeding and development.
• 6-week program for first time parents in some locations.

One to one feeding support is offered and prioritised for all new families by the health visiting service.

• Families will report improved satisfaction levels with support for their feeding journey, with the information they received, including in the antenatal period.
• Audits will show improvements against this, and we will use service user feedback from MNVP, the iMatter forum and Healthwatch.
• More families will report introducing healthy and nutritious solid food at the recommended time.
• For those who are experiencing infant feeding problems, they will report accessing timely and effective support suited to their level of need. There will also be a reduction in inappropriate referrals to specialist services, including tongue tie.
• Specialist infant feeding antenatal education will be standard across our system.
• Families using formula milk will report feeling confident in safe preparation of appropriate formula suited to the infants needs and using responsive feeding methods
• We will ensure that families are provided with clear and consistent information on introducing complimentary solid foods which are healthy and nutritious for baby and family.
• We will support families to delay introducing solid foods until around 6 months of age, with continued breastfeeding advised for the first year and beyond.