Biomedical subjects

Alison McFadden

Publications and source records attributed to Alison McFadden.

5 recordsLinked to original sources

PubMed2006

Exploring women's views of breastfeeding: a focus group study within an area with high levels of socio-economic deprivation.

There is ample evidence of the short- and long-term health benefits of breastfeeding for mothers and infants, yet breastfeeding rates remain low in the UK, particularly in areas of high social deprivation. It is imperative that appropriate strategies are utilized to support more women to initiate and continue breastfeeding. This study used focus group methodology to explore women's views in relation to breastfeeding. The study was conducted within an area with high levels of socio-economic deprivation in the north-east of England and aimed to identify local barriers to breastfeeding, influences on choice of infant-feeding method and strategies which might improve breastfeeding rates. Focus group discussions were conducted with low-income women, adolescent women and women from a minority ethnic group. The five key themes that emerged from the data were: society's negative attitudes towards breastfeeding; the influence of family and friends and the experience on choice of method of infant feeding; lack of knowledge of some aspects of infant feeding; perceptions of professional support; and women's positive and negative experiences of breastfeeding. Recommendations for promoting and supporting breastfeeding include improving facilities to breastfeed in public, enhancing the provision of information, addressing conflicting advice and poor professional practice and implementing support mechanisms. The findings and recommendations have been used to develop a breastfeeding strategy to meet local needs. This project was funded by the English Department of Health Infant Feeding Initiative.

Adolescent↗

PubMed2006

Developing practice in breastfeeding.

This paper reports on an approach to practice development in breastfeeding as part of a national programme of work to address inequalities in maternal and child nutrition. The production and dissemination of evidence and guidelines is necessary but not sufficient on its own to effect change in practice, particularly when dealing with complex public health issues. In the case of breastfeeding, review evidence and national guidance have shown that multifaceted changes are essential if policy aspirations are to be realized. The objectives of the programme described here were to (1) inform and enable practice development in breastfeeding in low-income areas; (2) evaluate the impact of approaches used; and (3) develop robust approaches and appropriate material for use nationally. A conceptual framework was established, and a six-stage process is outlined. The recruitment of four sentinel sites across whole health economies, involving professionals and the voluntary sector, was an essential component of the programme. The strength of the model is that it provides a structured, cross-sectoral approach to practice development in public health. A key challenge is to identify whose responsibility it is to resource practice development when a number of disciplines and sectors are involved. This question needs to be addressed if public health guidance is to be of sustained benefit.

Breast Feeding↗

PubMed2006

Addressing the learning deficit in breastfeeding: strategies for change.

This paper summarizes the findings of the learning needs assessment described in this issue. Limitations and strengths are discussed. The paper describes a national, multi-sectoral, multidisciplinary picture. Our respondents may over-represent those with an interest in breastfeeding; if so, the true picture may be even more problematic than described here. Major deficits were identified in the knowledge and skills of practitioners from all backgrounds and all sectors. Many professionals report poor knowledge about breastfeeding and have low levels of confidence and clinical competence. Organizational constraints and barriers to effective education and practice include fragmentation of care and education, lack of facilities, and a low priority being given to breastfeeding. There is a range of current educational provision, although not all is fit for purpose. Voluntary organizations seem to have higher standards than do some current professional learning opportunities. Preferred methods of training include practical observation and mentorship, volunteer counsellor involvement in training programmes, as well as self-study and online opportunities. Recommendations include: a funded, mandatory, interagency and multidisciplinary approach; appropriate content; support at local and national levels; breastfeeding education to be included in clinical governance and audit mechanisms; and further research and evaluation to examine optimum ways of providing education and training. Organizational barriers could be addressed through a public health policy and evidence-based approach.

Breast Feeding↗

PubMed2006

'Informal' learning to support breastfeeding: local problems and opportunities.

This study explored 'informal' learning opportunities in three health economies, both for National Health Service (NHS) staff and lay people wishing to promote and support breastfeeding and for new mothers wishing to breastfeed. The word 'informal' indicates local learning opportunities that are not part of recognized academic or professional training courses. Semi-structured telephone interviews were conducted with 31 key informants, including health visitors, midwives, infant feeding advisers, Sure Start personnel, voluntary organization representatives, Strategic Health Authority representatives, senior nurses and trainers. The results were analysed thematically. In each site, there were regular training events for NHS staff to acquire or update knowledge and skills. Training was provided by a small number of enthusiasts. Midwives and health visitors were the groups who attend most frequently, although many find it difficult to make time. Although many training events were multidisciplinary, few doctors appeared to attend. Individual staff also used additional learning opportunities, e.g. other courses, conferences, web-based learning, and training by voluntary organizations. Services offered to lay people by the NHS, Sure Start and voluntary organizations included parentcraft, antenatal and post-natal classes, breastfeeding support groups, 'baby cafés' and telephone counselling. Interviewees' organizations did not have a specific breastfeeding strategy, although action groups were trying to take the agenda forward. Local opportunities were over-dependent on individual champions working in relative isolation, and support is needed from local health economies for the facilitation of coordination and networking.

Breast Feeding↗

PubMed2006

Assessing learning needs for breastfeeding: setting the scene.

Breastfeeding has a major contribution to make to public health, yet the UK, like many other developed countries, has low rates of breastfeeding. A contributing factor is that practitioners are ill-prepared to support breastfeeding women. There is a mismatch between the care professionals provide and the support women desire. A national breastfeeding learning needs assessment (LNA) was carried out in England to provide a comprehensive picture of professional and practitioner learning needs and existing training opportunities and resources. The LNA comprised five elements, and sought the views of service users through consumer organizations and voluntary breastfeeding supporters. Two elements of the LNA are reported here. A search of RDLearning, a web-based national resource, provided details of existing accredited courses in the UK for practitioners. Ten short courses provided by higher education institutions were identified, along with a range of courses offered by voluntary and other organizations, such as the National Childbirth Trust and UNICEF Baby Friendly Initiative. Second, an e-mail survey of 28 key stakeholder organizations was undertaken, with a response rate of 68% (n = 18). All but one acknowledged that their members could benefit from further breastfeeding knowledge and expertise and were supportive of a national breastfeeding education initiative. The most popular forms of education provision were workshops and seminars, online and written information. The topic considered most important for all practitioners was the health outcomes of breastfeeding. Other contributions which stakeholder organizations felt they could make were the provision of information resources and setting up specialist interest groups.

Breast Feeding↗