Coventry: Delivering infant feeding services to diverse populations

Historically, breastfeeding rates in Coventry have been below the national average. The infant feeding team wanted to harness the opportunity presented by the Family Hubs and Start for Life programme to increase engagement with their infant feeding services and encourage more mothers to breastfeed. Coventry’s analysis of local data found that the local population was made up of demographic groups who are less likely to breastfeed. For example, white women living in deprived areas are the least likely to breastfeed whilst women from ethnic minority groups are least likely to engage with the infant feeding services offered within Coventry. Using both the core Infant Feeding funding and the additional Trailblazer funds, Coventry instigated an ambitious multilayered and integrated plan to encourage more mothers to try and continue to breastfeed and increase up-take of their services amongst different communities living in Coventry.

Universal and tailored offers for women from backgrounds where breastfeeding rates are lowest

1. To encourage early engagement with infant feeding services, women from areas with low breastfeeding rates are offered tailored antenatal information sessions, which focus on connecting with their unborn babies and the benefits of breastfeeding for the health and wellbeing of the baby and mother. In Family Hubs, sessions are provided on weekends and weekday evenings to offer flexibility. Co-parents are also encouraged to join the sessions. At the end of the programme, the team follow-up with each mother to explain other services available within Family Hubs so parents know how to access additional local support.
2. There is an effective MAMTA service within Coventry which supports women from ethnic minority groups antenatally and postnatally. To engage ethnic minority communities, the team have used Family Hubs and Start for Life programme funding to employ a MAMTA staff member, who focuses specifically on building relationships with Romanian families to encourage more mothers to try breastfeeding and increase engagement with infant feeding services.
3. The team also offer a number of universal services and initiatives to support mothers in meeting their infant feeding goals:

• Peer Support: Feedback from parents suggested that some mothers are more likely to connect to a peer support worker from the same background than a healthcare professional. In response, peer support training, in the form of a six-week programme, is being offered with the aim of recruiting targeted service users from deprived backgrounds and ethnic minority groups.
• Improving access: The team runs cafés where mothers can attend for support with breastfeeding their child and get one-to-one breastfeeding support with specialist health visitors. The cafes are an excellent opportunity for mothers to meet each other and benefit from peer-to-peer support. Recognising that flexibility is important when engaging with families, the team have been working closely with a charity called Coffee tops in the city centre. A room is rented from the charity, from which services are delivered. Families are able to come in, have a hot drink and some cake to welcome them.
• Equipment loans: State-of-the-art equipment, such as Medela symphony pumps, have been purchased with Family Hubs and Start for Life programme funding. A loan scheme has been established to provide pumps to families who may find them unaffordable and staff are currently being trained on how to support parents to use them.

Increasing awareness of services amongst target groups

1. Family Hubs and Start for Life programme funding has been used to offer Coventry Go CV+ to more mothers in the city, allowing them to access free scan photos at 12 and 20 weeks. This helps to strengthen the bond between mother and baby. On the back of the photos there is a Start for Life QR code, which families can scan to access the Start for Life digital offer.
2. Family Hubs and Start for Life programme funding has been used to deliver a social media advertising campaign on Facebook. The platform uses user data to advertise to new parents within the Coventry area. A new video campaign has been implemented to focus on engaging with ethnic minority communities in Coventry. The team reported that their previous promotional video was not representative of their local population. As a result, the new video has been co-produced with families from Black African, Polish and Romanian backgrounds.

Investment in UNICEF Gold Accreditation

Using the Family Hubs and Start for Life programme funding, the team have invested in achieving prestigious UNICEF Gold Sustainability Accreditation. To achieve this status, the infant feeding team underwent an audit of service users and staff members to assess the effectiveness of services and the clinical capabilities of staff. The accreditation recognises Coventry’s dedication to providing parents with the best possible care to build close and loving relationships with their baby and to feed their baby in ways which will support optimum health and development. The UNICEF standards now form the foundation of the services offered in Coventry

1. Investigate local data: The team utilised local data to identify communities where women were less likely to engage with breastfeeding support. This would serve as a focus for the design of interventions to ensure that services were accessible for all demographic groups.
2. Explore reasons for low uptake: The team explored barriers to breastfeeding and infant feeding service uptake, such as lack of familiar representation, lack of information or financial constraints. This included research and input from service users from target demographic groups and working with parent carer panels.
3. Design new and expanded services: Universal and tailored services include antenatal information sessions, peer support, MAMTA, breast pump loan scheme and the breastfeeding café network. Follow-up mechanisms have been introduced to encourage women to engage with other services on offer in Family Hubs.
4. Generate buy-in and support from leadership and the wider network: Sharing rationale and plans across the wider family service network fostered support from politicians, commissioners, managers and staff members and created a unified approach.
5. Recruit staff to deliver services: Recruitment focused on training existing staff and volunteers in peer support and employing staff members to engage with ethnic minority communities specifically. This approach aimed at building a diverse team capable of connecting with and supporting a wide range of families.
6. Take action to make Family Hubs more welcoming and contribute to wider destigmatisation: The team invested in upscaling the Hubs, decorating them and making them more inviting for families to attend.
7. Invest in quality and standards: The team pursued the prestigious UNICEF Gold Sustainability Accreditation, demonstrating their commitment to high-quality, sustainable services.
8. Implement a marketing campaign to increase awareness amongst target groups: Raising awareness through the Go CV+ platform and data-driven social media advertising helps to promote Coventry’s Start for Life offer and highlight the value of infant feeding services. This new content is now shared through GP surgeries, Family Hubs and antenatal units.
9. Build successful relationships with families by ensuring continuity of care. In Coventry, the same staff member is allocated to a family throughout their breastfeeding journey which begins at pregnancy and ends post-delivery.

“Families coming into Coventry and coming into the UK have that perception that the UK is a bottle-feeding culture, but we’re absolutely breaking the mould in terms of Coventry”.

Coventry suggests their ambitious multilayered and integrated plans have led to increased breastfeeding rates. In Q3 (2023-2024), local health visitor data collection showed that breastfeeding rates (6 to 8 weeks) increased from 51% (Q1 2022-2023) to 57%. As a result of efforts to improve the diversity of in-person breastfeeding groups, the team reported that the footfall of their Saturday breastfeeding group is increasing, particularly amongst parents from ethnic minority communities. There are plans to develop local data collection processes to better understand the impact of interventions amongst different demographic groups.

With hindsight, the infant feeding team acknowledged that translation services would improve the effectiveness of services when interacting with women where English is not their first language. Language barriers during health visits can be difficult, as they prevent meaningful discussion of the baby’s health and development. Coventry are looking to introduce translation services to ensure that all services are accessible to every family.

This case study has been produced by the Start for Life Unit within the Department of Health and Social Care, in partnership with RSM and Coventry City Council. By sharing promising examples of delivery, we hope to facilitate connections between LAs across the country and support LAs in their delivery of Start for Life services. For further information please contact familyhubs.startforlife@dhsc.gov.uk

The data included in these case studies is self-reported by Local Authorities and has not been quality assured by the Department of Health and Social Care. The views expressed are those of the authors and not necessarily those of the Department.