'Holding Time' - opening conversations around breastfeeding.

Creation
Pending
More Info is needed
Approved
Case Study Summary
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Overview summary:
There is a wide disparity between the emphasis on breastfeeding in culture and the support for mothers attempting to breastfeed for the first time.

Funding for Health Visitor run baby groups & drop-ins throughout the UK have been cut in past 2 years due to budget constraints, leading to increasing social isolation of new mothers.

Young mothers in particular may not have ever encountered another breastfeeding mother, given that the last generation was largely encouraged to bottle-feed.
Challenge identified and actions taken :
Our target - Mothers who may not have access to current research and/or may be unduly influenced by cultural barriers to breastfeeding.

c 700,000 newborn babies born in UK each year. A high proportion will be to new mothers with no experience or understanding of breastfeeding.

Funded by ACE from 2017-18, ‘Holding Time’ a series of photographic portraits of mothers breastfeeding was shown at Fabrica Gallery, ONCA Gallery and Royal Brompton Hospital in London, in print, video and installation formats, accompanied by talks and workshops. ONCA featured a Breastfeeding Hub where comfortable seating encouraged mothers to stay longer and talk with other mothers.



A project website ( www.holdingtime.org), and YouTube channel promoted 5 min Podcast interviews with participating mothers from the photographic series. A BLOG written by Dr Newell explored issues surrounding the cultural barriers to breastfeeding. Facebook promotions and postcard campaigns at GP surgeries drew visitors to the website and exhibitions.
Impacts / outcomes:
Findings / Outcomes:
  1. Exhibition audience was more mixed in gender and age than anticipated
  2. Workshops and talks were attended by many academic, medical and health researchers/practitioners
  3. The ‘Holding Time’ slideshow drew audience to the Youtube channel
  4. YouTube recommendations helped to attract many thousands of visitors to the channel.
  5. The Breastfeeding Hub resulted in longer visits to exhibition
  6. Interviews/talks/workshops revealed structural barriers within health practice where policy and practice are not meeting.
Exhibitions x 10 days/ 435 visitors
Website: 1,000 users/ +67%
Talks x 2: 70 attendees
Facebook fans 303 posts/+91 fans/ +695 engagement
YouTube Analytics: 36,400 Views/ +6,710/60 Likes/+179 Subscribers
Supporting quote for the innovation from key stakeholders:
National Strategy:
Include actions to promote, protect and support breastfeeding in all policy areas where breastfeeding has an impact. This includes: obesity, diabetes and cancer reduction; emotional attachment and subsequent school readiness; improved maternal and child mental health; wellbeing in the workplace; and environmental sustainability.

Priorities
Good practice guidance identifies that breast milk is considered the physiological norm of nutrition for infants and can provide wider benefits to further promote the bond between mother and baby. Some of the key evidence based benefits of breastfeeding are summarised below:

Baby
• Children who are breastfed for longer periods have lower infectious morbidity (including diarrhoea and vomiting) and lower risk of infant mortality
• Less risk of constipation
• Reduced likelihood of becoming obese or developing type 2 diabetes or other obesity related conditions later in life

Mother
• Reduced risk of developing breast and ovarian cancer
• Reduced risk of diabetes
• Develops stronger relationship bonds through skin touch between mother and baby
• It is a free resource and readily available
To gain the maximum benefits of breastfeeding the World Health Organization recommends an exclusive breastfeeding period for the first six months of life and continuing to breastfeed for at least two years.

West Midlands
• Breastfeeding initiation is significantly lower in the West Midlands compared to the England averages between 2010 and 2015
• Initiation rates between Local Authorities within West Midlands range from 48% to 77% out of all maternities during 2014/15

Key risks of lower breastfeeding uptake:
• Younger age of mother with those aged under 20 years the least likely to breastfeed.
• Mothers who are from a white ethnic background.
• Mothers who have never worked or employed in a routine or manual occupation (classified as lower socio-economic status).
• Younger age left full time education with mothers who left at or before 16 years least likely to breastfeed.
• Mothers in the most deprived quintile of society (classified as being in quintile 1 of the Index of Multiple Deprivation IMD calculation).

Patterns and associations of breastfeeding prevalence:
• Breastfeeding prevalence rates in England in 2010 were higher for each risk factor group compared to 2005 data for each reported period from time of birth to nine months.
• Breastfeeding prevalence dropped at an increased rate after two weeks from birth for all key risk indicator groups. At six months, roughly one third of mothers were still breastfeeding.
• The largest difference in breastfeeding prevalence is associated with age of the mother followed by age the mother left full time education and then socio-economic status and deprivation respectively.

Awareness of health benefits of breastfeeding:
• An inverse association is demonstrated between awareness of the health benefits of breastfeeding and younger age of mother, mothers classified as Asian or black, those in a lower socio-economic status and mothers who were intending to only formula feed or who had not yet made a decision.
• Mothers from a white ethnic background reported the most awareness but are the highest ethnic risk group to not breastfeed.

Information sharing:
• The groups least likely to receive information about the health benefits of breastfeeding include mothers aged under 20 years and those who have never worked.
• There is no significant difference between ethnicity and receipt of breastfeeding information.
• For all groups there are a low proportion of women who reported attending antenatal classes where infant feeding was discussed.

Please see https://www.youtube.com/watch?v=DjCeenfwBxQ
A film made by rb&hArts – the Charitable trust an partner at Royal Brompton Hospital.
Which local or national clinical or policy priorities does this innovation address:
Public Health England - Health matters: giving every child the best start in life; Public Health England Commissioning Infant Feeding Guidance; NHS Start4Life; UNICEF; Every child matters
Plans for the future:
Proposal:
A three year campaign of exhibitions/web content creation/printed book to stimulate and curate conversations around breastfeeding between the public and medical professions addressing the discrepancy between research and practice in order to inform research communities and the general public.

Outputs:
  • 10 new exhibitions of Holding Time at community, health and art centres, birthing units and hospitals across the country.
  • 10 x Postcard campaigns of 1000- 1500 (e.g. 25 cards x 50 surgeries per exhibition) leading public to online content
  • 20 mother stories Podcasts
  • Expansion of Mother Stories section of website
  • Transcripts/closed caption subtitles for all Podcasts
  • 20 guest BLOG posts: Academics/medical researchers to write on subjects raised by women in workshops and interviews e.g. the struggle to feed in the early stages, the establishment of lactation, post partum care, expressing, breastfeeding in public, looking at how current research can help parents make informed choices in these areas.
  • 10 Podcasts with Academics/medical researchers/health professionals
  • Facebook Q&A sessions with guest researchers/practitioners and participating mothers
  • Breastfeeding Hubs/workshops/talks where possible/appropriate delivered by Dr Lucila Newell and Lisa Creagh
  • Facebook/Instagram channels to promote the above.
A limited edition book featuring Holding Time with an introduction by Dr Debra Bick, essay by Ruth Stirton/Lucila Newell/Erin Barnett. Schilt publishers have confirmed they will produce and distribute this book across Europe and North America using their existing channels.
Tips for adoption:
Any Community health space can host the exhibition, promote the exhibition using the tested method of GPs surgeries locally and linking to the online content. They can also suggest researchers and mothers to interview or write BLOG posts. I have applied to Wellcome for a budget to cover ten exhibitions in areas with low breastfeeding rates nationally.
Contact for further information:
For more information please contact Lisa Creagh
Project Web: www.holdingtime.org
Artist site: www.lisacreagh.com
Email: lccreagh@icloud.com
Tel: 07816 577140
See additional 'Links' document attached
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