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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 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%) • Unemployment rate 7.8% (SL 4.5%)
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
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.”
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
Best Fed Babies: The Aim • To maximise the health potential for both mother & baby, addressing the social inequalities associated with low birth weight babies
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
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
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
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
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)
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
Evaluation: Qualitative • Mothers: 4 focus groups (n=16) plus 10 face to face interviews • Health professionals • Retailer • Health Development Officer SIP/Regeneration Partnership
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
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
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”
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”
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
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
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
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
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