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6 Recommendations: National Infrastructure
Scotland already has an existing infrastructure to support breastfeeding. It is important that we ensure these systems are fit for purpose and include all aspects of infant feeding. Our health care systems deliver high quality support to families and we need to ensure that this continues. However, there is a growing need to challenge public perceptions which will only be achieved with multi-agency effort. As such we recommend that:
Recommendation 1:
It is recommended that the role of National Breastfeeding Adviser is reviewed to fit the changed environment. This post could be less clinically driven and more strategic than the traditional NBA role. Their remit could be to advise the Scottish Executive and ensure that infant feeding is reflected in all relevant policy and publications; to develop networks and external infrastructures to support infant feeding across a range of bodies, with a particular focus on the non-health sector; to develop and deliver a yearly work-plan for national activity to support infant feeding, from maternal nutrition through to weaning, and to chair the new National Infant Feeding Advisory Group (see below).
Q1: Do you agree with the recommendations concerning the possible new role and work of the National Breastfeeding Adviser? Are there other areas that you think their work should cover?
Recommendation 2:
It is recommended that the Scottish Breastfeeding Group is re-launched as the National Infant Feeding Advisery Group to work with the National Infant Feeding Co-ordinator to advise on national policy and resource development. Its remit could be to develop a 5 year action plan and from this a yearly work-plan, agreed across agencies. It would appoint and monitor working groups as necessary; ensure ongoing dialogue with the Scottish Infant Feeding Adviser Network; support the development of local multi-agency infant feeding networks and local integrated infant feeding plans; improve and facilitate communication between agencies and individuals, and ensure appropriate involvement of service users.
Q2: Do you agree with the proposed role and work of the National Infant Feeding Advisory Group? Are there other areas that you think they should cover?
Recommendation 3:
It is recommended that individuals are appointed to the National Infant Feeding Advisory Group who are impartial and represent others in their field. They should be leaders and influencers in their field, and link into appropriate networks. They should be able to both collate and disseminate information relating to policy, performance, best practice and research, and have communication skills which allow them to stimulate debate about, and raise the profile, of infant feeding.
Q3: Do you agree with recommendations concerning National Infant Feeding Advisory Group membership? Are these other skills or attributes that members should have?
Recommendation 4:
It is recommended that the Scottish Infant Feeding Adviser Network continues as a health-focused sub-group of the National Infant Feeding Advisory Group and the Breastfeeding Expert Group continues as a research-focused sub-group.
Recommendation 4:
Do you agree with the proposed roles of the Scottish Feeding Adviser Network and the Breastfeeding Expert Group?
Recommendation 5:
It is recommended that national and local breastfeeding targets are agreed, from the five-year plan, and a tool developed for monitoring their progress. These targets should consider the particular needs of vulnerable groups - including those experiencing social deprivation, minority ethnic mothers and older mothers.
Q5: Is this an appropriate way to develop national and local targets? Do other groups need to be considered in setting such targets?
Recommendation 6:
It is recommended that the Scottish Executive and the National Infant Feeding Advisory Group works with Learning Teaching Scotland and others to develop multi-sectoral training packages for all early years staff concerning infant feeding. It is recommended that the Scottish Executive and the National Infant Feeding Advisory Group work with the Scottish Qualifications Authority to consider how issues around breastfeeding and infant feeding are incorporated into national curricula in subjects such as English, Modern Studies, General Science, Domestic/Environmental Science. Other opportunities to raise awareness of infant-feeding issues within schools should also be considered.
Q6: Do you agree that multi-sectoral training for early years staff should be developed? Are there other partners that need to be included in its development and implementation? Should issues around breastfeeding and infant feeding be incorporated into national curricula? What other ways could breastfeeding and infant feeding be incorporated into the national curriculum? Do other agencies need to be involved?
Recommendation 7:
It is recommended that the Scottish Executive and the National Infant Feeding Advisory Group work with NHS Education for Scotland to ensure core curricula for health professionals that include infant feeding particularly frontline health staff, GPs and pharmacists.
Q7: Are there other staff that should be involved in such training? Are there other agencies that need to be involved?
Recommendation 8:
It is recommended that the Scottish Executive and the National Infant Feeding Advisory Group consider findings of the UK-wide Infant Feeding Survey, and identify priority areas for action and possible research gaps.
Q8: Is this an important source of information, and are there other data sources that you consider especially valuable?
Recommendation 9:
It is recommended that the Scottish Executive and the National Infant Feeding Advisory Group work with local groups and business interests to consider options to support breastfeeding in public, including support of Breastfeeding (Scotland) Act and participation in Breastfeeding Welcome/Healthy Choice Schemes.
Q9: Are there other groups that should be involved in developing such action? Are there any examples of good practice that you are aware of?
Recommendation 10:
It is recommended that the Scottish Executive and the National Infant Feeding Advisory Group work with Local Authorities to consider options to support breastfeeding in public, with particular reference to licensing and planning of public spaces.
Q10: Do you have any ideas about how this would be achieved? Are there any examples of good practice that you are aware of?
Recommendation 11:
It is recommended that the Scottish Executive and the National Infant Feeding Advisory Group work with UNICEF Baby Friendly Initiative to promote maternity unit, community and educational awards.
Q11: Are there other ways that maternity units, community settings and educational establishments can encourage breastfeeding and infant feeding awareness? Are there other potential partners?
Recommendation 12:
It is recommended that the Scottish Executive and the National Infant Feeding Advisory Group consider the role of the voluntary sector in supporting appropriate infant feeding.
Q12: How can the voluntary sector support appropriate infant feeding Are there any examples of good practice that you are aware of?
Recommendations: Local Infrastructure
We need to continue the excellent work that is already happening at a local level. To deliver change it is important to strengthen local infrastructures through involving key influencers in integrated action. Community Planning systems already exist across Scotland which bring together NHS Boards, local authorities, businesses, the voluntary sector and service users. These systems should be better utilised.
Recommendation 13:
It is recommended that multi-agency Local Infant Feeding Groups are established to reflect interests within community planning partnerships, work across agencies and lead by example. They would feedback to the National Infant Feeding Strategy Group on local issues requiring national action and support. They would foster good interagency relationships and set local priorities.
Q13: Do you think this is the way to ensure local multi-agency action? What sort of agencies should be included? Are these the right remits?
Recommendation 14:
It is recommended that the multi-agency Local Infant Feeding Groups ensure infant feeding priorities are reflected in local plans, including Children's Services Plans, Joint Health Improvement Plans and oversee effective use of local resources through Community Planning Partnerships.
Q14: How would this work in practice? Do you see any barriers? Are there other interagency plans that should be included?
Recommendations: NHS Boards
Although we need multi-agency action to drive forward the infant feeding agenda, the majority of direct support for pregnant women and new mothers will come directly from NHS Boards and it is important that their expected role is clear.
Recommendation 15:
It is recommended that all women have a named midwife in the antenatal period and that every pregnant woman and new mother receives copies of Ready, Steady, Baby; Off to a Good Start and Breastfeeding and Returning to work. All women should have the opportunity to speak to a health professional about nutritional guidance and infant feeding - antenatally and postnatally.
Q15: How do we ensure that these publications are appropriately used? Is this a useful way to ensure the uptake of appropriate infant feeding?
Recommendation 16:
It is recommended that NHS Parent Education Programmes include information and advice on infant feeding and nutrition during pregnancy. Boards should encourage women to join breastfeeding support groups in the antenatal period.
Q16: Do you think that these are good ways to pass on information? Are there other similar structures that could be considered? Do they meet the needs of all parents? Will women join local breastfeeding groups? What can ensure good uptake?
Recommendation 17:
It is recommended that all NHS Boards develop and implement strategies for supporting breastfeeding including considering the implications for staff training and support. All NHS Boards should have a named lead for Infant Feeding co-ordination. Health professionals should support the formation and continuation of breastfeeding and peer support groups and keep up-to-date contacts.
Q17: What sort of NHS staff are the most important to be trained? Is an Infant Feeding lead an important role for NHS Boards? What do you feel should be their remit? How can health professionals best support local breastfeeding and peer support groups?
Recommendation 18:
It is recommended that all NHS Boards adopt the principles of the UNICEFUK Baby Friendly Community Initiative and that all Maternity Units work toward the UNICEF Baby Friendly Initiative 10 steps. It is recommended that all women are respected and supported regardless of their choice of infant feeding.
Q18: Do you consider that these important principles and markers encourage appropriate infant feeding? What do they mean in practice?
Recommendations: Final Comments
The sections above have set out a range of questions which we hope have prompted you to think about what a Scottish Infant Feeding Strategy would be like and how it would be implemented. It has set out ways to ensure an integrated multi-agency approach to support infant feeding and has indicated ways to measure success and suggested structures that would be needed to ensure that infant feeding becomes an even more accepted and adhered-to practice for mothers across Scotland. We hope that this has been an informative and inspiring read, and we would very much appreciate your comments on these questions as well as to the following
Q19: Did you find the document helpful? Did you like the format? Was it easy to read? Are there other areas that should be included?:
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