The growing gap in support and confidence with infant feeding: what you have told us

By Denise Gray, on behalf of the Infant and Toddler Forum


Coming soon: The Infant and Toddler Forum announces a new focus on infant feeding and nutrition with the upcoming launch of new educational resources for healthcare professionals

As a consultant midwife working in East London, I see how frontline healthcare professionals are increasingly being asked to do more with less. There’s never enough money or resources in post-natal and breastfeeding services, and the government openly acknowledges a shortfall in frontline staffing.

At the Infant and Toddler Forum, we wanted to better understand the magnitude of these reductions and their consequences. Are new parents getting the information they need to make informed choices about how to feed their newborn infants? Are frontline health care professionals (HCPs) such as midwives, health visitors and GPs able to access the training they need to confidently support new parents and be their reliable source of support on matters of feeding and nutrition?

To find out, we commissioned a survey of 506 UK parents with a child under one year of age and 151 frontline HCPs. The results, which I explore in greater detail below, reveal that both HCPs and parents are looking for more information in a variety of key areas in breastfeeding and bottle feeding.

To fill the gap, we have been developing a series of resources that inject evidence into the infant feeding conversation. We hope these resources will help HCPs refresh their knowledge and answer the question ‘why?’ in their day-to-day exchanges with parents of infants.


The gap in confidence and support

The survey of HCPs (which included 50 GPs, 51 midwives and 51 health visitors practicing currently within the UK) revealed that these frontline professionals too often lacked confidence in supporting mothers: 22%​ of HCPs indicated they were not very confident or not confident at all in providing support and information to parents on key areas of infant nutrition. The areas they wanted more training in included:

  • Breast feeding maintenance: 31%
  • Responsive feeding: 28%
  • Food allergies: 26%
  • Combination feeding 26%
  • Weaning: 26%
  • Differences between available formulas: 25%
  • Colic, regurgitation, constipation: 25%

Parents also said they wanted more information. 1 in 4 of the parents surveyed indicated they did not receive adequate support from their HCPs in any of the 11 key areas of infant feeding listed in the survey. Only 15% of parents said they received adequate support in initiating breastfeeding, and only 19% said they received adequate support for breastfeeding maintenance.

The survey also reinforced our perception that the availability of training has been reduced significantly in recent years. While one’s own Trust used to be the main source of ongoing training, the survey revealed that 40% of HCPs couldn’t access the training they were looking for on infant nutrition through their own organisation. HCPs said that the second most common way they stay informed (after vocational training) was by finding information through infant feeding websites. Sharing information with colleagues was the third most popular way to stay informed.

While most professionals had received recent training on a variety of areas in infant feeding, a significant minority (16%) had not received any training on key areas of infant feeding and nutrition in the past year, if ever. The lack of both confidence in HCPs and the support experienced by parents is perhaps unsurprising given these gaps in training.


A new focus for the ITF

In order to bridge the confidence and knowledge gap, the ITF will be launching an educational programme for frontline HCPs to enhance or refresh their knowledge of the topic. All the resources will be free to access on the ITF website, including an educational refresher course and fact sheets to support frontline professionals and parents to make informed choices.

With these new training resources, we hope to provide a back-to-basics approach that gives frontline professionals the latest evidence available in the field and the confidence they need to best support parents and infants.



 Next Steps

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Further Reading

  • Judy More, Paediatric Dietitian and Registered Nutritionist Lucy Upton, Specialist Paediatric Dietitian and Nutritionist   Have a healthy Easter with The Infant & Toddler Forum’s suggested menu for toddlers!
  • Lucy Upton, Specialist Paediatric Dietitian and Nutritionist   Why is salt important for my toddler’s diet? Sodium, which is in salt, is important for healthy muscle, stomach and nerve function as well as being an essential component in the blood. Children need some sodium to grow.
  • Lucy Upton, Specialist Paediatric Dietitian and Nutritionist   Although the number of people in the UK forced to turn to food banks has been on the rise for a number of years now, the COVID-19 pandemic has exacerbated the already worrying situation even further. Data gathered by the Trussell Trust shows that there was a 47% increase in the number of people relying on foodbanks during the first six months of the pandemic compared to the same period last year. It seems families with children have been hardest hit with 2,600 food parcels being provided for children every day.