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Best Fed Babies

Best Fed Babies. Ruth Campbell Public Health Nutritionist. Area Profile. North Hamilton/Blantyre Social Inclusion Partnership status April 1999, Community Regeneration April 2005 25% pupils eligible for FSM (SL 20%) 38% pupils eligible for clothing grant (SL 31%)

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Best Fed Babies

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  1. Best Fed Babies Ruth Campbell Public Health Nutritionist

  2. Area Profile • North Hamilton/Blantyre Social Inclusion Partnership status April 1999, Community Regeneration April 2005 • 25% pupils eligible for FSM (SL 20%) • 38% pupils eligible for clothing grant (SL 31%) • Unemployment rate 7.8% (SL 4.5%)

  3. Baseline Health Indicators • Low birth weight babies (<2.5kg) in area 11.1%, compared to 6.4% in Lanarkshire • Breastfeeding rate at 6 weeks 12.4% in area, compared to 22.7% in Lanarkshire

  4. Acheson Report: Inequalities in Health (1998) “We recommend further reductions in poverty in women of childbearing age, expectant mothers, young children & older people should be made by increasing benefits in cash or in kind to them.”

  5. Best Fed Babies • Partnership between SIP/Community Regeneration, NHS Lanarkshire & Asda (2 stores), launched Oct ‘01 • Grocery vouchers provided to value of £50 per month for expectant mothers for maximum of 6 months • If mother chooses to breastfeed, vouchers continue for additional 3 months

  6. Best Fed Babies: The Aim • To maximise the health potential for both mother & baby, addressing the social inequalities associated with low birth weight babies

  7. Objectives • A reduction in the number of low birth weight babies in the area • An increase in the number of women breastfeeding in the area • An increased maternal awareness of the factors influencing health in pregnancy • Client empowerment through informed decision making

  8. Best Fed Babies: The Process • Expectant mothers living in designated area recruited at booking appointment with midwife, followed up postnatally by health visitor • Info also collected on smoking, alcohol, medication/drugs • Photographic ID card issued to be presented at checkout with vouchers

  9. Best Fed Babies: The Process • Booklet containing information on scheme, healthy eating, smoking cessation services, breastfeeding support groups & Community Mothers peer support programme • ‘Healthy eating’ groceries emphasised (no alcohol, tobacco, clothing or audio/visual goods) • Asda staff trained on scheme & to ‘police’ to a degree

  10. Best Fed Babies: Post Natal • Notification of birth & feeding method by midwife to regeneration office • If breastfeeding, 1st payment sent • Feeding update form at first visit by health visitor which triggers 2nd payment • Feeding update form at 6/8 weeks triggers 3rd payment

  11. Best Fed Babies: To Date • 1514 women on programme so far • 1358 births • 8.2% babies born with low birth weight (compared to 11.1% in ’99) • 27.8% babies on programme breastfed at 6 weeks v 21.6% in regen area (compared to 12.4% in ’99)

  12. Evaluation of first year • Quantitative: questionnaire sent to approx 200 mothers, 53% (n=93) response • No. of children, shopping habits, food habits e.g. changes in food purchases, did these continue, impact on rest of family, feeding method, influences on chosen method, impact of vouchers on feeding decision

  13. Evaluation: Qualitative • Mothers: 4 focus groups (n=16) plus 10 face to face interviews • Health professionals • Retailer • Health Development Officer SIP/Regeneration Partnership

  14. Survey Findings The Vouchers • 53% received vouchers antenatally, with 42% receiving them both antenatally & postnatally • Vast majority received their vouchers each month (91%), with 90% reporting no problems in using them at the 2 stores Shopping Habits • 92% already shopped at the 2 stores

  15. Survey Findings: Eating Habits • Vast majority (99%) bought more of the same foods (fruit & veg, followed by meat, dairy & fish) • Just under two thirds bought less of same foods (sweets, chocolate, crisps, ready made, processed frozen meals) • 43% added foods in (fruit, new “more expensive, healthier” foods they hadn’t tried before) • Just over a third left some foods out (foods not allowed during pregnancy & crisps, sweets etc

  16. Survey Findings: Eating Habits 2 • Although positive changes to eating habits made, some said they “always eat more fruit & veg when pregnant” • 42% of mothers who had a previous pregnancy said they had changed their eating habits this time. The vouchers had allowed them to “afford more fresh fruit” & one mum wrote “If you have more money to spend on healthier foods, you’ll buy them”

  17. Survey Findings: Eating Habits 3 • 58% had continued with some of the food changes since having their baby, although 24% had returned to their previous habit • Just over half said others in the household had changed their eating habits during the scheme. Majority was husband/partner, although changes were also reported in children (32%) “the kids eat more fruit instead of crisps and sweets”

  18. Survey Findings: Feeding Choice • 51% chose to breastfeed, within this group, more were first time mothers • Main influence on feeding came from midwife & previous experience • Availability of the vouchers influenced 22% of mothers • 46% of mothers who breastfed, did so for up to 12 weeks • Of those who breastfed, almost all would do again

  19. Survey Findings: Overall Effects Mothers • Ability to eat healthier food, raised awareness “It showed me how to choose the best foods for me & my family”, benefit to household budget Health • Weight, sleep, less financial worries, varied & higher quality diet

  20. Survey Findings: Overall Effects Baby • “Nourishment”, “goodness” while in the womb • Effect as having delivered “a healthy baby” which for many meant a good weight “As a result of the vouchers I think it made my daughter more healthier as I was 4 weeks early & she was 5lb 4oz” Family • Financial boost, encouraging healthy eating

  21. Recommendations for further development • Improving targeting criteria • Empowering a healthy food culture • Fine tuning nutrition information for mothers • Increasing scheme’s visibility in store • Developing breastfeeding • Beyond Best Fed Babies

  22. Where are we now? • Means testing introduced Jan ’06 • Broader ‘early intervention programme’ includes introduction of nutrition education to BFB, peer support for breastfeeding, breastfeeding support groups, healthy weaning initiative, Health promoting Nursery Award scheme • Further evaluation planned summer/autumn

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