Assumptions used in estimating a population benchmark
The assumptions used in estimating a population benchmark for a peer-support programme of 85% per year of women who breastfeed are based on the following sources of information:
- epidemiological data on the incidence of breastfeeding
- current initiation rates of breastfeeding
- published research on peer-support programmes
- expert opinion of the Topic-specific Advisory Group, based on experience in practice.
The Office for National Statistics report Birth statistics: births and patterns of family building England and Wales (2005) indicates that there were 649,318 maternities in England and Wales in 2005. This suggests that there were 605,535 maternities in England, based on proportion of population (maternities includes live and still births.)
For the purpose of this benchmark we have used the number of maternities from the report from the Office for National Statistics, rather than data on maternities submitted as part of breastfeeding initiation local delivery plan return. This is because these data are likely to underestimate the number of maternities in England.
Incidence of breastfeeding
Incidence of breastfeeding refers to the proportion of mothers who breastfed their baby initially. According to the 2005 Infant feeding survey around three quarters of all mothers interviewed in the UK had breastfed at some point.
The highest incidences of breastfeeding were found among mothers from managerial and professional occupations, those with the highest educational levels, those aged 30 or over and first-time mothers.
To provide a more timely and geographic breakdown of the percentage of mothers initiating breastfeeding than the Infant feeding survey, local delivery plan return breastfeeding initiation data have been collected for 4 years to help PCTs measure progress in meeting the Priorities and planning framework target. The target is to increase the breastfeeding initiation rate by 2 percentage points per year.
The published results of the local delivery plan returns for breastfeeding initiation can be seen here. There are a small number of PCTs that do not have breastfeeding initiation data published for data quality reasons.
There is wide variation in the initiation of breastfeeding rates across the country. The rate of breastfeeding initiation among the bottom quartile of PCTs (excluding those with no published data) is around 50%, compared with around 80% among the top quartile.
The number of maternities in a locality and the number of women wishing to continue to breastfeed after initiation are likely to affect the demand for services offering peer support.
Not all women wish to breastfeed, and of those who do, not all want peer support. It was not possible through published research to find the proportion of women who would take up the offer of peer support.
The consensus opinion of the Topic-specific Advisory Group is that commissioners should ensure that peer-support programmes are available to all women who require help and support with breastfeeding. Commissioners will need to ensure that services actively engage with women who are least likely to start and continue breastfeeding, for example young mothers and women from low-income households and/or disadvantaged groups.
The proportion of women who initiate breastfeeding and who will take up the offer of peer support in the postnatal period is likely to be subject to local variation. However, based on practice, it is anticipated that 80-90% of women who initiate breastfeeding will take up the offer of peer support. This estimate takes into account the likely decrease in breastfeeding in the immediate post-discharge period.
Based on practice it is estimated that the number of peer supporters required for an effective peer-support programme is around 4 whole-time equivalents per 1000 women who breastfeed and require peer support.
Based on the epidemiological data and other information outlined above, it is concluded that 85% of women who initiate breastfeeding will take up the offer of peer support. This is based on the midpoint of the estimated take-up of peer support by women who initiate breastfeeding that was suggested by the Topic-specific Advisory Group (80-90%).
Therefore the benchmark rate for breastfeeding women taking up the offer of peer support is estimated to be 85% per year.
Use the peer-support programme commissioning and benchmarking tool to determine the level of service that might be needed locally and to calculate the cost of commissioning the service using the indicative benchmark and/or your own local data.
This page was last updated: 02 March 2012
- Commissioning a peer-support programme for women who breastfeed
- Specifying a peer-support programme for women who breastfeed
- Determining local service levels for a peer-support programme for women who breastfeed
- Assumptions used in estimating a population benchmark
- The commissioning and benchmarking tool
- Ensuring corporate and quality assurance