Point 3 Standards
- Before 34 weeks of pregnancy all pregnant women served by the facility should receive full and clear information about the health benefits of breastfeeding and the importance of:
- rooming-in
- avoiding supplements and teats
- feeding on demand
- positioning and attachment
- skin contact after delivery.
- All written materials intended for pregnant women should be accurate and effective, and free from the promotion of breastmilk substitutes, bottles, teats and dummies.
- Pregnant women should not be given instruction on how to prepare bottles of infant formula as part of antenatal group sessions.
- One or more interventions should be in existence, targeted at pregnant women in the areas or groups of the local population that have the lowest breastfeeding prevalence rates and with a realistic potential to increase the overall rates in the locality. The nature of the intervention(s) should be determined using knowledge of the local context and may consist of peer support, telephone contact, informal groups or one-to-one support (or a combination of any of these).
NB: Health benefits should include evidence-based information on the specific protection from illnesses to mother and baby, but do not need to include ‘common knowledge’ benefits such as better for baby, right temperature, cheaper, antibodies, etc.
Routine demonstration of how to make up bottles of formula milk as part of antenatal classes normalises bottle feeding and conveys the message that health professionals do not expect mothers to breastfeed successfully. It is also unlikely to be useful even for women who intend to bottle feed, as such information will be difficult to retain fully until after the baby is born.
It is important to note that this standard is not intended to deny women information or to undermine safety. Other impartial information on formula milk can be given in antenatal classes. It is also expected that all postnatal mothers who have chosen to bottle feed will be shown how to make up a bottle correctly before discharge from hospital, and that community staff will check to ensure that mothers have received and understood this information.
Point 3 Assessment
Requirements at Stage 1:
- The written minimum standard of information provided to all pregnant women served by the facility.
- A written description of how, where and when all pregnant women served by the facility are to be informed of the benefits and management of breastfeeding.
- A written description of the planned antenatal intervention(s), defining:
- the targeted population;
- why this area/group was chosen;
- how the targeted population’s needs will be met by the intervention, taking into consideration the views of the women themselves.
- A written description of the mechanism for auditing and evaluating the antenatal intervention(s), which should include:
- breastfeeding prevalence rates;
- numbers accessing the intervention;
- what difference the intervention made to those attending (qualitative data).
- Written information intended for pregnant women must be accurate and effective, and free from the advertising of breastmilk substitutes, bottles, teats and dummies.
NB: The written minimum standard of information is a list of the topics discussed with all pregnant women. Many trusts choose to have an antenatal infant-feeding checklist kept in pregnant women’s hand-held records. This provides staff with a reminder of what to discuss and a space to sign when the discussion has taken place.
Requirements at Stage 3:
- Pregnant women served by the facility over 34 weeks gestation to confirm that the health benefits and management of breastfeeding have been discussed with them.
- Pregnant women served by the facility over 34 weeks gestation to recall at least two health benefits of breastfeeding and basic information about at least two management topics.
- Evidence that the antenatal intervention(s) has/have been effectively audited and evaluated with action taken as required, based on the result.
