A study was carried out as a pilot to design and implement a feeding support team intervention integrated into routine postnatal ward care. The FEeding Support Team (FEST) intervention provided a dedicated feeding support team based on a postnatal ward that delivered proactive (feeding team-initiated) and reactive (woman-initiated) telephone support for breastfeeding women living in disadvantaged areas for up to 14 days after hospital discharge.

The FEST intervention consisted of four components. Three components are reported separately: a before-and-after study; an embedded pilot randomised controlled trial (RCT) of proactive and reactive telephone support for women living in disadvantaged areas who were breast feeding at the time of hospital discharge; and a cost-effectiveness analysis. The fourth component of FEST: a mixed quantitative and qualitative method process evaluation is reported in this paper.

In summary, there was no difference in feeding outcomes at 6–8 weeks for women initiating breast feeding 12 weeks before the FEST intervention (n=413) compared with 12 weeks after (n=388), suggesting that the dedicated feeding team on the postnatal ward had little impact. However, in the pilot, women receiving proactive calls were more likely to be breastfeeding than those asked to reactively contact the telephone helpline. The researchers found that a median of eight proactive calls per woman (n=35) with a median duration of 5 minutes occurred in the 14 days following hospital discharge, however only one of 34 control women (reactive) initiated a call to the feeding team, with women undervaluing their own needs. Proactive calls providing continuity of care increased women's confidence and were highly valued. Although the numbers in this pilot were small, the researchers conclude that proactive telephone support provided by a dedicated feeding team based on a postnatal ward shows promise as an intervention within routine postnatal care.

Hoddinott P, Craig L, MacLennan G et al (2012). Process evaluation for the FEeding Support Team (FEST) randomised controlled feasibility trial of proactive and reactive telephone support for breastfeeding women living in disadvantaged areas BMJ Open 2012;2:e001039 doi:10.1136/bmjopen-2012-001039