10th February 2018
Dear Councillors,
Response to the Infant Feeding Debate 8.2.18
Thank you for inviting us along on Thursday to hear the Council’s response to Anna Le Grange’s petition citing our concerns over the adjustments to Breastfeeding Support Services in Kent. While we are aware that KCC have taken into account many of our initial concerns over the changes to the service, and we greatly appreciate the time that has been put in by commissioners to gaining a better understanding of the service, we still feel there are many elements that have not been explained. We have therefore detailed them in this letter.
We would firstly like to address Cllr Dawson’s comments that our concerns are simply a reaction to change, and that we are threatened by that and getting ourselves ‘stressed’. We find these comments very offensive, and frankly patronising. Our commitment to the cause is because we have all been/are breastfeeding mothers, and we understand the pain and frustration of breastfeeding not being straightforward and easy, and how vital easily accessible, evidence-based support is! We want to protect and support mothers in Kent from feeling let down, by ensuring a smooth, effective and reliable service to support them.
We would also like to address Sarah Hamilton’s point that not every woman can breastfeed and we must not exclude them, as well as her knowing people emotionally damaged by not being able to breastfeed. The fact is many women WANT to breastfeed but the lack of support lets them down. This is the point of our campaign in a nutshell! The UK has the lowest breastfeeding rates in the world: let’s invest in Kent families and start seeing those rates improve, and all the things that come as a result; healthier mums, healthier babies, and therefore healthier families. We must not fall into the trap of apologising for wanting the best for our families: yet we must apologise to those who the system has failed, and recognise how they have been left disappointed and angry they weren’t able to breastfeed their babies.
We find it frustrating we are being ‘downgraded’ to fit in with the rest of the UK. Despite Kent having better breastfeeding rates than other areas of the UK, our service is being altered to bring us more in line with a general level of service. An example of this can be found on gov.uk: a recent report on the success of HV mandated visits states “there has been some deterioration in rates of breastfeeding at 6-8 weeks”. Whereas in Kent the rates have gone UP from 38.3% in Q1 16-17 to 47.6% q1 2017-18. This does therefore certainly feel like a downgrade. The current service in Kent is being used as an example by other areas as they try and make their service like ours, we feel so strongly that it would be disappointing to see such a shining beacon of breastfeeding support dismantled.
We are concerned that Health Visitors are not in a position to effectively take over the Breastfeeding Support Services. In your report you state that 50% antenatal visits are made and 83% of New Birth visits are completed, some way off 100% – how are they therefore in a position to take over a whole new service, too? Please understand this is not an anti-HV campaign; they do a valuable job, but they are generalists, and it is simply not enough to expect one to two with a particular interest or passion to be able to provide effective, evidence-based support. Please can you clarify what qualifications these members of the team will have. If the Health Visitors truly are in a place to be able to offer this support, then that is great, but we are very worried they are not. We are concerned Health Visitors do not have the breadth of knowledge and experience to address technical breastfeeding issues, and are interested in what extra qualifications they will be undertaking to be able to offer this. We do not feel that the 2 day BFHI training is sufficient to replace the expertise of IBCLCs and Breastfeeding Counsellors. While you suggested that you would spot purchase IBCLCs to staff the clinics as needed, and while we feel encouraged KCC have recognised the value of IBCLCs, we are anxious that a wealth of experience is going to be lost, to the detriment of breastfeeding families in Kent.
We would like to know more about the exact details of the groups and clinics being offered, so we understand what is being offered, and truly how accessible they are to families in Kent who may be recently delivered, remote, or reliant on public transport. What will these groups be like, and who will run them? An integrated service is a fabulous idea, and a hopeful way forward, but it needs to incorporate all the strands that make up an effective service; HV medical input, LC/BFC specialist knowledge, and the vital mother-to-mother peer support which Kent has provided so well.
Who will be responsible for recruiting, training and managing Peer Supporters? We are also very concerned there is a misunderstanding of the peer supporter’s role. Under no circumstance can it be appropriate for a Peer Supporter to diagnose a tongue tie as is suggested in KCC’s report. KCC have mentioned a £100,000 budget as the service changes over, and we are interested in how this money will be spent.
Furthermore, how do KCC plan to monitor and evaluate the changes to the service? What are the KPIs? And how do KCC envisage the handover from PS Breastfeeding to the Health Visiting service working? It is vital we get this right! We were very encouraged to hear home visits are now part of the plan, and are interested to know how a mother would be eligible for one of these. In a similar vein, who will be triaging mothers who need extra support, and how quickly can this be offered? We are also interested in the data that has led you to the conclusions about the number of appointments being offered.
As mentioned yesterday KCC and the Health Visiting Service need to build relationships with NHS Midwifery Services to ensure a smooth handover from one service to another. Also to hold Midwifery accountable for improving breastfeeding rates in the first 10 days, as any issues experienced in that vital time period are very likely to impact an ongoing breastfeeding relationship. It is encouraging to think this level of joined up working could be achieved!
Cllr Dawson commented that we are ‘lucky to have a service at all’ which, again, is wholly offensive, and makes us question whether members of your team are aiming to provide a service simply to tick a box, as opposed to recognising its intrinsic value to families in Kent. We want to work with you to build the best service we can, which will best serve every family in Kent. We have truly shown our commitment to the cause, and how important this is to us, and to future families in Kent.
We look forward to hearing from you soon with the information we have asked for, and really hope we can then fully support the new service model.
Yours faithfully
Hannah Croft
Tannice Hemming
Anna Le Grange
Caroline Mitford
Sarah Wood
Helen Maher
Rej Cluett
Ruth Warren
Asha Crocker
And other Members of the Keep Kent Breastfeeding Campaign Team.
