Outcome 1 - Putanga 1

Develop and maintain an up-to-date database of national and regional breastfeeding support services (both public and private).

Identify service gaps and report these to the IYCFC.

Health and social services need national coordination to efficiently and effectively protect, promote and support breastfeeding, and to identify and address gaps and duplication in services (Women's Health Action and Point Research 2017; National Breastfeeding Advisory Committee of New Zealand 2009).

Increase the bicultural competence and confidence of the maternal and child health workforce, with particular attention to understanding and responding to the breastfeeding information and support needs of Māori and Pacific people.

Accessing breastfeeding support that is culturally safe, responsive and reflects cultural diversity can help address inequities in breastfeeding rates (Reinfelds 2015; Foaese 2019; Castro et al 2017).

DHBs work together with iwi, hapū and whānau, and existing breastfeeding support services, to address national and regional breastfeeding support service gaps.

Report actions and progress to address gaps to the IYCFC.

A key aspect of effective breastfeeding support services is that they are tailored to the setting and the needs of population groups experiencing inequity (Public Health Unit, Taranaki DHB 2017).

Increase the capacity of health providers (including Well Child Tamariki Ora providers and Whānau Ora navigators) to engage with partners and wider whānau to support and encourage breastfeeding parents.

Support from partners and wider whānau is consistently identified as key to establishing breastfeeding and increasing exclusivity and duration (Foaese 2019).

Identify current effective wānanga hapūtanga or kaupapa Māori breastfeeding and antenatal initiatives. Prioritise resources to support increased capacity and capability where need is identified.

Report actions and progress to address gaps to the IYCFC.

Breastfeeding education is a central aspect of increasing breastfeeding initiation and duration. Ensuring that all whānau Māori have access to breastfeeding education is crucial, particularly education that honours Māori worldviews (Foaese 2019).

Embed effectively resourced kaiāwhina and peer supporters into wider community lactation services.

Use of tuakana-teina models and peer support interventions can result in improvements in the number of parents initiating breastfeeding (Balogun et al 2016). Those accessing peer support services were more likely to be breastfeeding at six months (Forster et al 2019). Peer support is particularly important for assisting younger parents to breastfeed (Public Health Unit, Taranaki DHB 2017).

Identify and action the breast/chestfeeding information and support needs of trans, non-binary, takatāpui and other gender-diverse parents and whānau.

Report actions and progress to address gaps to the IYCFC.

Health workers and other support services involved in the care of breast/chestfeeding parents need to be knowledgeable about the specific lactation support required by trans, non-binary, takatāpui and other gender-diverse parents. Breast/chestfeeding support and information should be informed by the principles of gender-inclusive care (MacDonald et al 2016).

Identify and action the breastfeeding information and support needs of parents and/or infants with disabilities and their whānau.

Report actions and progress to address gaps to the IYCFC.

Health workers and other support services involved in the care of breastfeeding parents need to be knowledgeable about the specific lactation support required by parents and/or infants with disabilities and their whānau (Powell et al. 2018).

Increase the competence and confidence of the maternal and child health workforce to understand and respond to parents and caregivers who cannot, or choose not to, exclusively breastfeed.

Many health workers report having limited understanding on how to support appropriate use, preparation and storage of infant formula (Allen and Clarke 2018). Evidence indicates that interventions to increase breastfeeding that fail to address caregivers’ needs in relation to formula feeding, particularly in a culture where mixed feeding is common, risk alienating potential beneficiaries, limit intervention reach and retention, and decrease the likelihood of achieving breastfeeding related outcomes (Jolly et al 2018).