Improving UK breastfeeding duration:salutogenic evaluation of English regional success to codevelop community-based breastfeeding support intervention

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What is the issue? Breastfeeding helps to protect the health of mothers and babies and the World Health Organization recommends that babies just have breastmilk until they are six months old, with breastfeeding continuing alongside solid food for at least two years. Although 80% of mothers breastfeed their baby when they are born, many stop in the early days and weeks meaning that the UK has some of the lowest breastfeeding rates in the world. As well as affecting health outcomes, many women are not ready to stop breastfeeding when they do and this experience can negatively affect their mental health. Understanding how to better support breastfeeding mothers is therefore important, but although lots of research has been done to understand the barriers to breastfeeding very little has been undertaken to focus on what works well to support them. Some areas in the UK have much higher breastfeeding rates than others and if we better understood why this is happening, we could change support in other areas too. One example of this is North Somerset Local Authority which has some of the highest breastfeeding rates in the UK. This includes in areas of deprivation, which usually have lower breastfeeding rates. Our project will explore what is happening in North Somerset that helps mothers to breastfeed for longer. We will use this information to create guidance for other areas around the UK to try to help mothers meet their breastfeeding goals. How can we understand success in North Somerset? To understand what is working well in North Somerset, we will speak to those with experience of breastfeeding and breastfeeding support in the area. This will include staff and breastfeeding peer supporters (mothers who have had some training in how to support breastfeeding) and carry out a survey of local mothers. Alongside this, we will examine local policies, data and spend time in Weston-Super-Mare, a large town in North Somerset, to see how the environment supports breastfeeding. What will be done with the findings? When we have our initial findings of what we think works well in North Somerset we will share them with people who work in public health, breastfeeding peer supporters and mothers from the rest of the UK (ie: not from North Somerset) to see whether they think these ideas would also work well in their areas to help improve breastfeeding. This is because sometimes things that work well to support health behaviours in one area might not work well in other areas due to areas being different and having different people living there. We will make a list of all the things that people in different areas agree are important for supporting breastfeeding and share this tool with those in charge of designing breastfeeding support in the UK. We hope that this tool will be used in the future for projects to improve breastfeeding support. For this reason we will also ask our participants what they think a measure of successful breastfeeding should look like. Should it simply be how many women are breastfeeding their baby or should it include wider measures such as how well supported they feel and how happy they are with how long they breastfed their baby for?