The value of BFI Qualifications in pharmacy practice
A case study by the Baby Friendly Initiative
BFI Qualifications in pharmacy practice
How participation in the Qualifications Framework Programme has contributed to strategic leadership in infant feeding within a pharmacy setting
A case study by the Baby Friendly Initiative
Laura Kearney BFIqA graduated from the UNICEF UK Baby Friendly Initiative Qualifications Framework Advocate Programme in 2022. As the first pharmacist to complete the programme, Laura reflects on how the knowledge and leadership skills she gained has supported her to evidence clinical practice and improve service delivery, with her ultimately becoming the first credentialed consultant pharmacist in Lactation Medicines Advice in the UK. Laura is also the clinical lead for the pharmacist led UK Drugs in Lactation Advisory Service (UKDILAS).
Bringing a strategic leadership role in infant feeding to a pharmacy setting
Baby Friendly standards exist for maternity, neonatal, community and hospital-based children’s services and university programmes, and participants of the Qualifications Framework programme are generally leading on the implementation of the standards within these settings. However, the programme is keen to see participants joining from other relevant professions. Laura’s experience has shown how this can be of benefit and how the Baby Friendly standards can be universally applied even in services for which they haven’t been specifically designed for.
Although I did not come to the Qualifications Framework Programme from the traditional service delivery angle, the programme still had huge benefits to me personally and to the wider UKDILAS service. I hope this can serve as evidence of the benefit that the programme has brought to a peripheral infant feeding service and the major impact this has had.
The journey of aligning pharmacy practice to the Baby Friendly standards
“In the undergraduate degree, pharmacists receive very minimal training on medicines use in breastfeeding and this varies dependent on the University. There is no training on wider infant feeding issues such as the impact of advising that breastfeeding can’t go ahead because of medicines exposure, responsible infant formula supply, or the International Code of Marketing of Breastmilk Substitutes (the Code), for example. This was really highlighted in the recent WBTi report.
“Although I had some understanding of the Baby Friendly accreditation programme, I did not have a detailed understanding of the Baby Friendly standards. This was part of my reasoning behind embarking on the Qualifications Framework Programme. Once I began to understand the Baby Friendly standards in more detail and the impact accreditation has on services, I realised that a process of alignment to the standards would be hugely beneficial to the UKDILAS service, providing further assurance and governance to the service we provide.
“To achieve this, we began by conducting a detailed scoping exercise to map the pharmacy service’s delivery and practice to the Baby Friendly standards, ultimately identifying the Baby Friendly Community Standards as the most relevant to emulate in a pharmacy setting. This then allowed a detailed exercise to pull out the learning needs of the team. It also enabled us to utilise the helpful tools available on the Baby Friendly website, rather than re-inventing our own. We also developed our own infant feeding policy unique to our service.
The Qualifications Framework increased my knowledge and understanding of the Baby Friendly standards and their consequences for holistic care. It opened up possibilities for our service and identified the gaps so clearly – it made me feel like I had to do something about this.
Overcoming obstacles
“I needed to get the buy in from my team and approval from leadership, but after I had presented the benefits this would bring to our service in improving patient care, this was not a hard sell.
“Resources and time are a rate-limiting factor. Not only in terms of mapping and understanding what needed to be done, but the education delivery as well – who would do this and by when, and the time requirement on the team to undertake the training.
The Qualifications Framework Programme helped me to organise my rationale for the alignment by utilising the evidence base. It also put the importance of this into the wider context of infant feeding challenges, and how as a team, we could strengthen our understanding of this.
“It was also very important to me that we understood our limitations – we are pharmacists, and we are not trying to mini-train as health visitors or midwives. Instead, our ultimate goal was achieving a wider understanding on how our advice affects the wider picture.
Outcomes and results
“With the education requirements identified, we then started to work with a neighbouring Baby Friendly accredited service to help us deliver this learning. We felt that as an ongoing programme of training, it was really important that this is delivered by the experts in this field. However, I also delivered some of the training myself, and the Qualifications Framework Programme gave me the confidence and upskilling to be able to do this.
“In November 2024, we presented a poster at the Baby Friendly Annual Conference which described the team culture change that had occurred as a result of this journey. The data highlighted just how much progress had been made: before we started on the alignment programme, 72% of the team were not even aware or unsure of the Baby Friendly standards. Only 17% had an awareness of the code. Now, this has changed to 100% awareness of both.
I used the leadership skills I developed through the programme and translated this into improved services and provision of care. We have seen positive outcomes in the patient experience and an increased understanding of how our advice can impact the infant feeding journey.
“We still have work to do, but as a team our understanding of the Baby Friendly standards, importance of alignment, and delivery of holistic care has improved as a direct result of my completion of the Qualifications Framework Programme. A very specific example of where this has had impact is with regard to the safe sleeping advice we issue if sedating medicines are being taken while breastfeeding. This made us question – when do we issue this advice? For which medicines? Does it depend on the severity of the sedation? We assessed this as part of a trainee pharmacist audit project, who had the opportunity to work with the UKDILAS service, and therefore have worked to embed good infant feeding practices in the next generation of pharmacists coming through.”
With thanks to Laura for contributing this case study.