Anybody Can Cook! designed the Feeding Your Baby Sessions to deliver oral health messages required, in the most practical format possible, engaging and empowering parents attending to make more informed and healthier choices for both themselves and their families and to ensure the development of the skills required to facilitate this.
The sessions are based on recommendations of the NICE guidance PH11 (Maternal and Child Nutrition) with particular reference to 16, 19 and 22. PH55 (oral health) especially recommendation 7, 8, 12 and 13 as well as using oral health strategy and policy etc to inform delivery and PH49 Behaviour change, recommendations 6-10.
The Feeding Your Baby sessions embed within delivery and support principles contained within Public Health England’s 2014 documents: “Local authorities improving oral health: commissioning better oral health for children and young people” and “Delivering Better Oral Health: an evidence-based toolkit for prevention”.
We were encouraged to submit our own learning experience having seen another shared learning example for PH49.
Aims and objectives
The ABC Cook mission is to encourage families and children to make healthy choices by developing a passion for cooking, infusing memories of food and food preparation that are both positive and fun.
The Feeding Your Baby Sessions aim to demonstrate how quick, simple and fun weaning and cooking and eating together as a family can be. Promotion of good oral health (PH 55), primarily in young children, but within families in order to reduce the number of children suffering from dental decay and requiring extractions under general anaesthetics.
To support parents to identify strategies that would support both their child and their own good oral health. Promotion of improved nutrition and diet (PH11) through developing parental confidence and knowledge of weaning and provide practical ideas for strategies and foods to support this.
To increase parental confidence to cook food from scratch and minimise the effort involved in doing so. Effective interpretation of food labelling which would facilitate improved oral health as well as diet and nutrition thus resulting in behaviour change. The Feeding Your Baby sessions have been developed from continuing and close partnership working with the Oral Health Promotion teams since ABC Cook’s inception 12 years ago, alongside local and national guidance cited above.
This guarantees that messages delivered are consistent and that principles of good oral health are relayed with the same degree of importance as other health promotion ideas. In many other projects and even national health campaigns there is definite disparity and are inconsistencies which parents and individuals find confusing.
Reasons for implementing your project
Tooth decay/extraction remains the most common reason for children to be admitted to hospital for a general anaesthetic, over 180 a day, costing the NHS £205 million and causing upset and trauma for the children and their families and yet it is completely preventable.
Based on the local health intelligence and in-line with national public health policy, NICE Guidance on the promotion of good oral health and the Public Health Outcomes Framework Indicator 4.02 (Tooth Decay in Children aged 5) , and following the success of sessions in Wiltshire we had delivered in partnership with the Oral Health Promotion Team at Great Western Hospitals as a part of their “Big Project For Little Teeth” to try and reduce dental decay rates in Wiltshire further, this was then replicated in Somerset more recently.
Evidence shows it is to develop good habits from birth than to try and change established habits, although weaning can be a catalyst for family members to make changes, so the target audience for the project is families with babies under 6 months who have not started to wean. Health visiting teams continue to provide infant feeding information but we have found by partnering with them the sessions become more effective and we can show very easily how quick and simple weaning can be in a very practical and visual way.
Feeding Your Baby workshops are designed to have flexibility within their delivery to ensure they meet the individual needs of parents attending, the group and partner requirements (linked to identified needs from parental feedback, local JSA and community priorities) and to be easily adaptable dependent on facilities available and group with whom we are working. Any Body Can Cook! currently works across Wiltshire, Swindon, BANES, parts of Hampshire, Swindon and Bristol but there is scope and potential for scaling of delivery, funding permitting.
How did you implement the project
On each occasion that we have provided these sessions Any Body Can Cook has sought to ensure high levels of partnership working. Since 2008 ABC Cook has closely partnered with Wiltshire’s Oral Health promotion team and the sessions became more strategically delivered as a part of their Big Project for Little Teeth, 2015-16.
Health visiting teams and children’s centres have been central to the community provision of all projects. ABC Cook has since delivered projects in Somerset and continues to provide sessions there with the health visiting teams, linking into the post-natal groups and providing sessions to new parents roughly every 6 weeks where funding permits.
During the session participants gain knowledge of appropriate foods for the weaning process and how to prepare them. Topics covered: portion sizes/balanced diet, food hygiene and safety, deciphering food labels and promoting good oral health and protecting baby’s teeth.
All sessions support other areas of health promotion like obesity and salt reduction, 5-a-day and cooking and eating more healthily as a family - using weaning as a starting point to motivate this. The workshops deliver both in-depth knowledge and practical hands-on experience of the ingredients and methods, parents develop skills to prepare healthy and nutritious meals in an informal environment.
Providing a forum for plenty of individual questions and opportunities for both parents and children to taste the foods/dishes. Recipes created demonstrate how quick and easy it is to prepare and cook food for their baby and family from basic ingredients.
The practical, visual and multi-sensory delivery ensures the learning and recall of session content is more meaningful and memorable. Health visiting teams were initially concerned that sessions would compete with theirs, but we always invite a team member to attend the session, so they can answer parental concerns alongside the more practical session. We have found working together the session offers parents a one stop shop which they value. The costs average around £12-15 per family, so for every 400 families we work with if we stop a single child being admitted to hospital for tooth extraction, we will have saved the NHS money. Funding is our biggest issue to more strategic rollout as at present delivery exists where funding is available. Follow up impact is collected via a third party such as the health visiting teams or in the past children’s centre outreach, as this provides ABC Cook! with less biased results.
(Reports are attached to this submission, but key findings were that: Parents were keen to start with good practice when feeding. Most felt confident that they knew what to do, but reported after the sessions they had learned much more than anticipated both about infant feeding and oral health.
Parents were shocked to discover that they did not understand as much of the food labelling on packaging as they had thought and felt much more confident to interpret labels more effectively following the session. Parents had not realised that sugar could be called different things on packaging and so were surprised to find out how much sugar was actually in food items.
We have found over the 2,500 parents we have worked with since 2015 that parents when they convert sugar to teaspoonfuls has much greater meaning for them than reading the amount present in foods in grams or even sugar cubes. This has also been supported by other projects in schools ABC Cook! have run looking at food labels and sugar in lunch box items with over a further 2,500 families.
We have had follow up reports from attendees of parents and other family members diet improving and weight loss even as much as a stone in 4 weeks from better food label interpretation and choosing healthier items that are cooked from scratch.
Key learning points
- That a short session of 90mins-2hours can deliver greater long-term impact than other interventions if delivered in the right way. Of all the sessions and courses Any Body Can Cook! provides this workshop has consistently demonstrated higher levels of long-term behaviour change than anything else, which was unexpected.
- Once engaged parents are keen to continue and learn more, we have set up and delivered cookery courses following the workshops where demand has been present. Partnership working is crucial to recruit those who will benefit most and to ensure consistency of messages being shared, it also helps with reinforcing those messages as we are all saying the same thing.
- It also means that parents only have to attend 1 session to gather all the information they are looking for, To involve parents in the sessions by promoting a relaxed, safe and non-judgmental environment where they feel they can ask anything at any point of the session.
- To ensure there is time for people to digest what they have learned and opportunities for 1-1 questions or contact via email after the sessions is available.
- To collect evidence and impact especially follow up impact as this can support future funding requests and demonstrates to funders and stakeholders that sessions are valued and making a difference to communities.
- To use a third party to do so as results have shown to be less biased and more reliable. If I ask a learner what they thought about a session or have they used things covered in sessions they will report what I want to hear rather than what has actually happened and so we always use others to ask these questions – usually someone working with the family so they trust them and are confident to share their true feelings and information.
- To listen to everyone involved – partners and attendees to ensure that the sessions are still meeting the individual and group needs.
- To share what is working/has worked and what hasn't with other partners and professionals.