QOF Plus Year 1 - Imperial College London

Local contextIn 2006/7, the percentage of mothers initiating breastfeeding within 48 hours was 79% (Zeuner,2008). The Food & Health Strategy developed by NHS Hammersmith and Fulham, in collaborationwith the London Borough of Hammersmith and Fulham, includes the following recommendationsfor infant care services:1 Promoting breastfeeding, especially to vulnerable young mothers, through Health Visitorante-natal support.2 Community breastfeeding support groups, run in conjunction with Children’s Centres byHealth Visitors, Midwives, Childcare Advisors and Family Support Workers.3 Breastfeeding advice and support given in child health clinics, post-natal/baby massagegroups, parenting groups, home visits and by telephone.4 Healthy weaning advice groups provided by Childcare Advisors to all parents and carersof babies from 17 weeks of age. Sessions also included in six-weekly parenting groupprogrammes. Support and information provided in Child Health Clinics, individual homevisits and by telephone.5 Training sessions on practical nutritional guidelines for people working with infants andyoung children.Review of evidence to support the proposed indicatorThe National Institute for Health and Clinical Excellence’s Public Health Briefing ‘Promotion ofBreastfeeding Initiation and Duration’ (2006) includes a comprehensive review of the currentevidence base for supporting the initiation and continuation of breastfeeding in the UK. ThePublic Health Briefing recommends that there should be provision of a ‘best package’ to suit localneeds that is informed by practitioners and service users and that targets areas where rates arelowest. It also recommends implementation of the UNICEF Baby Friendly Initiative in hospital andcommunity settings.The introduction of the Baby Friendly Initiative in the UK was launched in 1994. It provides aframework for both implementation and audit of best evidence based practice. It includes aSeven Point Community Plan which aims to promotes, protect and support breastfeeding incommunity health care settings. Facilities that meet the required standards can apply foraccreditation as Baby Friendly.47