Luton and Dunstable Hospital NHS Trust

Luton and Dunstable Hospital NHS Trust

Luton and DunstableHospital NHS Trust - Baby Feeding Care Pathway

Standard / Rationale/Evidence / Care given/Local Guidance
Inform all women about the benefits and management of breastfeeding /
  • NICE, 2008. Antenatal Care, NICE Clinical Guideline No 62
  • UNICEF Baby Friendly Initiative
  • Healthy Child Programme, 2008
  • Newborn Feeding: Promoting, Protecting and Supporting Breastfeeding at the Luton and DunstableHospital NHS Foundation Trust
  • Healthy Weight, Healthy Lives, 2008. Breastfeeding promotion and importance of marketing breastfeeding.
  • NICE, 2008 Improving the nutrition of pregnant and breastfeeding mothers and children in low income households – raising awareness of benefits of breastfeeding.
  • High quality care for all – operating framework, 2009/10, Develop approaches to promote breastfeeding initiation.
  • Dept of Health, 1995, Breastfeeding: Good practice Guidance to the NHS
  • Ip S et al, 2007, Breastfeeding, maternal health and infant health outcomes in developed countries. AHRQ Publication No 07-E007, April, Rockville, MD: Agency for Healthcare, Research and Quality.
  • DH 1995, Breastfeeding: Good Practice Guidance to the NHS.
/ 32 – 34 weeks
  • All women to receive information about the benefits, management of breastfeeding, skin to skin contact and health risks of artificial feeding by 34 weeks of pregnancy.
  • All women to have completed Infant Feeding Checklist in their handheld records.
  • All women to have the NHS Pregnancy Book, DH breastfeeding booklet – ‘Off to the Best Start’ and the DVD ‘From Bump to Breastfeeding’, or details of how to obtain/view.
  • All women offered the opportunity to attend a baby feeding workshop.

Help mothers initiatebreastfeeding soon after birth /
  • NICE, 2007, Intrapartum Care. NICE Clinical Guideline No 55
  • UNICEF Baby Friendly Initiative
  • Newborn Feeding: Protecting, Promoting and Supporting Breastfeeding at the Luton and DunstableHospital NHS Foundation Trust, 2010.
/
  • All mothers to be offered unhurried skin to skin contact for a minimum of 1 hour at birth prior to any procedures, unless medically indicated, or until after first breastfeed.
  • Reinstate skin to skin contact if interrupted for medical reasons.
  • Every mother and baby to be offered a first breastfeed in the immediate period after birth.

Show mothers how to breastfeed and how to maintain lactation even if they are separated from their babies. /
  • NICE, 2006. Routine Postnatal Care of Women and their Babies. NICE Clinical Guideline 37.
  • UNICEF Baby Friendly Initiative
  • Newborn feeding: Protecting, Promoting and Supporting Breastfeeding at the Luton and Dunstable Hospital NHS Foundation Trust, 2010.
/ Within 6 hours of birth:
  • Offer further help with breastfeeding.
  • If baby unable to feed within first 6 hours, offer information and support with hand expression.
Within 24 hours of birth:
  • If mother and baby are separated, encourage early expressing, a minimum of 8 – 10 times in 24 hours.
  • Facilitate rooming-in of babies with their mother.
  • Discuss baby led feeding with all mothers, and its necessity for successful breastfeeding.
  • If mother makes an informed choice to feed her baby artificially, written and verbal information will be given to ensure this is done safely.
Prior to discharge home:
  • Show all mothers how to hand express their breastmilk.
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Ensure details of support for successful breastfeeding after discharge from hospital, are given to all mothers /
  • Newborn Feeding: Protecting, Promoting and Supporting Breastfeeding at the Luton and DunstableHospital NHS Foundation Trust, 2010.
  • NICE, 2006. Routine Postnatal Care of Women and their Babies. NICE Clinical Guideline 37
  • Baby Friendly Initiative
/
  • Details of infant feeding progress to be recorded in the handheld notes.
Prior to hospital discharge:
  • All mothers to be given details about breastfeeding support in the community.
Around Postnatal Day 5:
  • Undertake a feeding assessment, using UNICEF assessment form, to ensure effective breastfeeding. Appropriate action taken if required.
Around postnatal Day 10
  • Ensure all details of the infant feeding checklist are complete.
  • Ensure mother has details of local and national breastfeeding support in the community.
  • Weigh baby. If required appropriate action taken.
  • Complete the handover of care form, and communicate to HV and/or 0-19 team.

Data collection to meet Dept of Health targets / PSA target to reduce the levels of obesity, DH / By 48 hours after birth
  • Hospital staff to record the initiation of feeding status of each baby within 48 hours of birth on CMIS

September 2011

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