A final letter to your councillor

We may have thought the fight was over, but apparently there’s actually one final chance to get the message across that the proposed changes to Kent’s currently excellent breastfeeding support services are truly short sighted.

You can write to your councillor using the website https://www.writetothem.com/

Please see below the amazing letter to a Sevenoaks Councillor, sent to me by ‘Karen’. It’s packed full of information and is poignant and evocative of a mother who wants the best for breastfeeding women in Kent. ‘Karen’ says she’s happy for anyone to use any of its content if they can contact the councillor this week.

This really is the last stand.

I understand that Kent Councillors are making some tough decisions over the next week or so to balance the budget. I don’t want to make things more difficult for you, but I would like to bring some information to your attention about why the proposed changes to specialist breastfeeding services across Kent would affect families in a negative way, and affect the families with the least the hardest.

1. The current service is a specialist service receiving referrals from health.

2. Replacing 17 paid breastfeeding specialist groups with 36 health visitor groups is not cost cutting.

3. Replacing 17 paid breastfeeding specialists with 36 health visitors is a reduction in the availability of expertise.

4. Offering only 100 appointments with a Lactation Consultant each month instead of the 450-550 families who currently access a Lactation Consultant each month just doesn’t add up.

5. Replacing 20 volunteer-led social breastfeeding groups with the above mentioned 36 health visitor-led groups is a waste of low cost resources and has no evidence basis.

· I’ve heard a lot in the news from KCC about how the current providers are only seeing 20% of families, yet the consultation documents suggest that the current service is over-providing services. The current service was commissioned to provide specialist breastfeeding support to families across Kent. A service for families once all other levels of breastfeeding support had been exhausted, and a service that midwives, doctors and health visitors could refer to when families needed support beyond their knowledge and expertise. It was never commissioned to provide a universal service, that has always been the remit of midwives and health visitors.

· I feel that if a specialist service is receiving referrals and self referrals from 20% of all births across Kent, then something is really missing in the current midwifery and health visiting knowledge and experience base. The consultation documents state that 93% of all health visitors have attended the 2 day Baby Friendly training (BFI), yet referrals and attendance at specialist breastfeeding groups has not dropped.

· You may be interested to know that Lactation Consultants are internationally recognised and have to complete numerous university level courses in addition to at least 90 hours of high level breastfeeding education and 1000 supervised contact hours with breastfeeding families before passing an exam. Breastfeeding Counsellors also receive a high level of training in breastfeeding and counselling skills over 1-2 years before qualifying. Both specialists continue to attend continuing education and can only recertify upon completion of a large number of continuing education hours. A typical health visitor has attended a 2 day BFI training in the last year.

· The current 17 breastfeeding specialist drop in clinics across Kent each week will be replaced with 36 health visitor run drop in groups. A health visitor not only costs more than a Lactation Consultant or Breastfeeding Counsellor, but they have only attended a 2 day training and do not have the same expertise as a Breastfeeding Counsellor as the consultation documents suggest.

· The current 20 social breastfeeding groups led by trained volunteer breastfeeding peer supporters that run weekly across Kent will be replaced by the same 36 health visitor run drop in groups. A health visitor is a highly paid resource. Once trained, a volunteer is a huge resource, and a much more cost effective resource. From reading the consultation documents, I believe the understanding of the role of a peer supporter is very limited in the proposals. Peer support works because families feel, act and respond differently to a peer versus a health professional.

· Access to specialist breastfeeding support will be greatly reduced if the proposed changes go through. The consultation describes an appointment based system for families to access Lactation Consultants, with families triaged by phone based on need. 6 appointments have been suggested at 4 clinics across Kent each week. Not only will this mean that countless families could be denied access to a specialist, but it will also mean more travel for families leading to greater expense, and a delay in access to specialist services.

1. Families in Sevenoaks District, Dartford District and Gravesham District will share 6 appointments with a Lactation Consultant each week (26 per month). Current attendance data from the current provider shows that there are currently 5 specialist drop in clinics running weekly in these areas, and that in August 140 families attended.

2. Families in Tonbridge and Malling Borough, Tunbridge Wells District and Ashford will share another 6 appointments each week (26 per month). Current attendance at the 4 drop in specialist clinics that run weekly in these areas was 194 in August.

3. Families in Swale, Maidstone and Canterbury Districts will share another 6 appointments each week (26 per month). Current attendance at the 5 drop in specialist clinics that run weekly in these areas was 157 in August.

4. Families in Thanet, Dover and Shepway Districts will share another 6 appointments each week (26 per month). Attendance at the 3 drop in specialist clinics that run weekly in these areas was 62 in August.

· At the moment, if I woke up on a Monday morning and felt I needed to see a breastfeeding specialist. Perhaps I had received help from a midwife and a health visitor and still the pain had become more intense I could take my older child to school and have the option of seeing a specialist in Tonbridge from 9:30-11:30am. If I had only one child, and I wasn’t very good at getting up and out quickly I could have the option of attending a specialist group in Dartford or Maidstone in the afternoon. If I couldn’t drive, and my husband was back at work, I could access Dartford by train with a short walk from the station to the Children’s Centre. I could arrive at any time during the advertised opening hours and stay as long as I needed. If my baby was asleep, I could wait for my baby to wake up. If I needed additional help, or wanted to go to a group closer to home, I could wait 2 days for the Sevenoaks group on a Wednesday morning or catch the train to Maidstone on a Wednesday afternoon if baby had a difficult morning and we were too late for Sevenoaks. In the proposed changes, I could only access 1 of 6 appointments each week, which could be located in Dartford, Gravesham or Sevenoaks, and I would have to attend at a specific time and would need to end that visit when the next person arrived.

· The current service has tried an appointment based system. It was not an efficient system due to cancellations and time constraints. It also lacked a flexibility that drop-in groups provide which is important for families during the first few weeks with a newborn baby. Families can arrive and leave as needed. If baby is asleep, the specialist can come and go as needed to help multiple families at once over the course of the group, and families can attend as often as they feel they need to. The current service ends a drop in group when all families have been seen.

· Evenings and weekends are times when isolation and anxiety make feeding problems feel more urgent. The proposed services offer a phoneline for questions about feeding Monday to Friday from 9-5 with a call back within 24 hours. The current service offers contact with a breastfeeding specialist 5 days a week face to face across the County. In addition to this, contact can be made online via the website, email and Facebook messaging, as well as by phone 7 days a week. All families who have contact with a specialist at a drop in group are given a phone number from the specialist, and contact can be made using that number at any time. Specialists often follow up with families for days and weeks after a visit, as needed by the family.

There seems to be a misunderstanding in the consultation documents that suggests that families are seeking specialist help because they can and not because they need to. I’d like to correct this assumption. Families go to see a breastfeeding specialist for many reasons, and none of them are for fun, or for the excellent drinking water that is provided. Families go to group when they are on their way home, sent by the midwife. They go to group on day 2 when their baby has never latched. They go because they have had problems with their first child and want to make sure they don’t go through hell a second time. They go to see a specialist because they are so determined to breastfeed and haven’t received the appropriate help from a health professional and have found the group on Google. They go because a friend, family member or health professional has told them their child has a tongue-tie and only a breastfeeding specialist can assess and make a referral. They go because everyone has suggested formula and they want to continue to breastfeed.

I ask you to consider encouraging KCC to NOT accept the proposed changes laid out in the infant feeding consultation which closed December 3rd, and instead offer a new contract with the existing service requirements or better service requirements for public bid.