Quality statement 5: Breastfeeding

Quality statement

Women receive breastfeeding support from a service that uses an evaluated, structured programme.

Rationale

Breastfeeding contributes to the health of both the mother and child in the short and longer term. Women should be made aware of these benefits and those who choose to breastfeed should be supported by a service that is evidence‑based and delivers an externally audited, structured programme. Delivery of breastfeeding support should be coordinated across the different sectors.

Quality measures

Structure

Evidence of local arrangements for breastfeeding support to be provided through a service that uses an evaluated, structured programme.

Data source: Local data collection.

Process

a) Proportion of women who receive breastfeeding support through a service that uses an evaluated, structured programme.

Numerator – the number of women in the denominator who receive breastfeeding support through a service that uses an evaluated, structured programme.

Denominator – the number of women who breastfeed (exclusively or partially).

Data source: Local data collection.

b) Proportion of women who wanted to continue breastfeeding but stopped before they had planned to.

Numerator – the number of women who wanted to continue breastfeeding but stopped before they had planned to.

Denominator – the number of women who breastfed (exclusively or partially).

Data source: Local data collection.

Outcome

a) Rates of breastfeeding initiation.

Data source: The Maternity Services Secondary Uses Data Set, once implemented, will collect data on 'baby first feed breast milk status' (global number 17205882), 'baby breast milk status (at discharge from hospital)' including exclusive and partial breast milk feeding (global number 17207550). The Infant Feeding Survey 2010 collected self‑report data on the prevalence and duration of breastfeeding in the first 8–10 months after the baby was born.

b) Rates of exclusive or partial breastfeeding on discharge from hospital and at 5–7 days, 10–15 days, 6–8 weeks and 16 weeks after the birth.

Data source: Contained within the Maternity Services Secondary Uses Data Set, the Children and Young People's Health Services Secondary Uses Data Set and the NHS England Maternal 12 week risk assessment.

c) Women's satisfaction with breastfeeding support.

Data source: The Care Quality Commission Maternity Services Survey 2010 collected information about women's experiences of maternity care and this included a section on 'Feeding your baby'.

What the quality statement means for service providers, health and social care practitioners, and commissioners

Service providers ensure that women receive breastfeeding support through a service that uses an evaluated, structured programme.

Healthcare practitioners ensure that women receive breastfeeding support through an integrated service that uses an evaluated, structured programme.

Commissioners ensure that they commission a service that delivers breastfeeding support through an evaluated, structured programme.

What the quality statement means for patients, service users and carers

Women receive breastfeeding support through a service that uses an evaluated, structured programme.

Source guidance

  • Postnatal care (2014) NICE guideline CG37, recommendation 1.3.3 (key priority for implementation)

  • Maternal and child nutrition (2014) NICE guideline PH11, recommendations 1 (key priority for implementation) and 7 (key priority for implementation).

Definitions of terms used in this quality statement

Structured programme

NICE guideline CG37 recommends that all maternity care providers (whether working in hospital or in primary care) should implement an externally evaluated, structured programme that encourages breastfeeding, using the Baby Friendly Initiative as a minimum standard. If providers implement a locally developed programme, this should be evidence‑based, structured, and undergo external evaluation. The structured programme should be delivered and coordinated across all providers, including hospital, primary, community and children's centre settings. Breastfeeding outcomes should be monitored across all services.

Breastfeeding support

All people involved in delivering breastfeeding support should receive the approriate training and undergo assessment of competencies for their role. This includes employed staff and volunteer workers in all sectors, for example, hospitals, community settings, children's centres and peer supporter services.

Equality and diversity considerations

Breastfeeding support should be culturally appropriate and accessible to people with additional needs, such as physical, sensory or learning disabilities, and to people who do not speak or read English. Women should have access to an interpreter or advocate if needed. Special consideration will be needed if the mother and baby have been separated for any reason, for example if the baby has been admitted to neonatal care or the baby has been taken into care.