Infant feeding peer support specification

Purpose

General overview

North Tyneside Council is seeking to award a grant for a programme of work across the borough to a single provider, focusing on the recruitment and co-ordination of infant feeding peer supporters in a group setting to protect, promote, normalise, and support breastfeeding. Giving Every Child the Best Start in Life policy paper aligns with the UNICEF Baby Friendly Initiative standards, recognising the importance of supporting parents to build close and loving relationships with their infant to ensure the best start in life (BSIL). What happens during the early years of a child’s life has long-lasting impacts, setting the foundations for growth, learning and emotional and physical development.

The Children’s Public Health Service is proud to be a UNICEF Gold Award holder. UNICEF recognise the importance of collaborative working with community partners to innovate and support ongoing service improvement. The Public Health team is looking to commission a project through its grant process that aims to:

Normalise breastfeeding and promote a positive breastfeeding friendly culture
Support more parents to initiate and sustain breastfeeding, particularly in deprived localities
In collaboration with the Children’s Public Health Service (CPHS) infant feeding team, identify locality areas with low breastfeeding uptake and target services accordingly
Support parents to develop close and loving relationships with their baby
Support parents to develop their parenting skills and social networks

The North Tyneside Joint Health and Wellbeing Strategy ‘Equally Well’ highlights the very clear evidence that the period from conception to age 2 is globally recognised as critical for building strong societies.

The experiences of parents, babies and children during this time lay the foundations for their future and shape their development, educational attainment, and life chances. For families facing multiple challenges and disadvantage, the importance of appropriate support during this time can have lifelong impact. The focus of this work will be centered around supporting parents with children in the first 1,001 critical days to reduce health inequalities and promote BSIL.

Background

North Tyneside’s Health and Wellbeing Board’s Equally Well Strategy and national evidence highlights the following key issues:

The period from conception to age two is recognised as being critical for building strong societies. The first 1,001 critical days are when the building blocks for lifelong good emotional and physical health are laid down through the love, care and nurture babies and young children receive
During the first 2 years of life the brain displays a remarkable capacity to absorb information and adapt to its surroundings. Positive early experience is therefore vital to ensure children are ready to learn, ready for school and have good life chances
Parents have the biggest influence on their child’s early development. Supporting parents to build close and loving relationships with their infant to ensure the best start in life is essential
Many parents struggle during the first few years of their child’s life or have difficulty forming a close bond, for example if they are experiencing mental health issues, misusing substances, living in abusive relationships, experiencing financial hardship, or not having an effective support network around them and being socially isolated
Struggling new parents need non-judgemental support, but often find it difficult to navigate the system or are reluctant to engage with statutory services

There is a strong evidence base around infant feeding peer support and the benefits this brings to parents. When deciding whether to breastfeed, or considering whether to stop, mothers tend to talk the issues over with close friends and family. Unfortunately, in the UK, many mothers’ social networks have been substantially drained of positive breastfeeding experiences by a history of healthcare practices that have tended to work against decisions to breastfeed and by a wider social context in which breastfeeding is not seen as part of everyday life.

Infant feeding peer support aims to fill a gap by linking mothers who want to breastfeed to others who have personal experience and some training. Peer support is recommended by the World Health Organisation (WHO) and forms part of UK NICE guidance on maternal and child nutrition: nutrition and weight management in pregnancy, and nutrition in children up to 5 years on postnatal care. The UNICEF UK Baby Friendly Initiative standards require that additional support such as peer support is provided and that services work together to ensure that parents can get additional help as needed.

Parents value friendly, competent and proactive peers. These qualities seem to outweigh social similarity, although evidence suggests that it helps if peers have personal experience of very specific cultural barriers to feeding. These qualities also seem to outweigh extensive training, though it may be that the impact of training was masked by upstream factors related to difficulty in accessing support. Peers who feel well integrated and valued by professional healthcare workers are more likely to feel confident in their roles and to exhibit the qualities that mothers value.

Parents who experience a warm and affirming relationship with their peer supporter often feel helped to overcome challenges and to meet their feeding goals. Relationships that deepen over time are particularly valued, though short-term support can also feel enabling. Just knowing that the peer supporter will be in touch can help some parents overcome challenges.

Aim of the project

The infant feeding peer support programme will provide evidence-based interventions. This will include supporting parents, carers to enhance their experience of infant feeding.

The provider will work with parents, carers, and infants to support them on their feeding journey. The provider will recruit peer support volunteers to promote infant feeding and give them the skills, knowledge, and confidence.

The provider will work with the CPHS to access training delivered by the infant feeding team to ensure volunteers are skilled in supporting new parents. This will also include refresher training as and when required. The CPHS will also offer supervision to peer support volunteers to support their development.

The provider will develop a programme of recruitment and support with a process in place to recruit and assess volunteers’ motivation and commitment to becoming a peer support volunteer and will work alongside the CPHS to develop this process.

It is envisaged that the provider will offer support to parents through this programme through group work offered across the borough and using evidenced based interventions that volunteers will be trained in via CPHS.

The number of groups to be delivered across the borough will be agreed with the provider on appointment. Groups will be expected to be delivered across North Tyneside to promote access across the borough however, there will be an expectation that the provider will deliver as a minimum four groups across the four geographical areas in North Tyneside. Best Start Peer Support Groups will need to be delivered at community venues which are accessible across the borough, once weekly, in each locality: North West; South West, Central and Coast, ensuring International Code of Marketing Breast Milk Substitutes (ICMBS) compliance, in line with CPHS UNICEF Baby Friendly Gold Award.

Group activities / discussions will be dependent on need but must be designed to support parents/carers, to develop resilience, skills, and knowledge around infant feeding. This would support parents/carers on their feeding journey and provide the opportunity for support through experiences of participants in the group as well as the experiences of the peer support volunteers.

The provider will work with the CPHS to support those volunteering to be able to signpost or refer to key infant feeding resources and information as well as staff within the CPHS where appropriate for additional support. This will also increase the knowledge of volunteers around referral pathways and wider community support around infant feeding.

Expected outcomes

The aim of the project will be to recruit and coordinate peer supporters to work with new and expectant parents and babies to address key health and wellbeing needs primarily in relation to infant feeding. Key public health messages closely linked with infant feeding will also be reinforced e.g. safe sleep and ICON.

The council is looking for innovative approaches to recruit, work with and engage with peer supporters to build trust and confidence with new parents via Best Start Groups across the borough. The ethos of the Best Start Group will be to empower parents through enabling informed choice and decision-making.

The key outcomes from the programme include but are not limited to the following. These may be developed further as the programme develops. A performance workbook will be used to evidence outcomes around this programme. The key outcomes the Public Health small grants scheme is looking for include the following:

Improved breastfeeding rates
Improved infant feeding experience, regardless of feeding method
Improved perinatal and infant mental health
Increased participation in wider networks

In terms of evidence of delivery and achieving outcomes, the council would like to receive the following monitoring and reporting information:

Annual evaluation of successes and challenges, including action plan for on-going improvement
Anonymised case studies
An annual report to be produced
Regular meetings (bi-monthly) with the CPHS infant feeding team to update on progress and outcomes achieved
Engagement in wider public health / local authority / partner initiatives where appropriate e.g. World Breastfeeding Week
Co-ordinate action learning sets, in partnership with the CPHS infant feeding team
The provider will be expected to present and give updates at the CPHS professional forum, as and when expected to help keep staff informed of the work so they can disseminate to parents they are working with

Scope

Service description

The council would expect the successful provider to facilitate Best Start Peer Support Groups, at community venues across the borough, once weekly, in each locality: North West; South West, Central and Coast, ensuring ICMBS compliance, in line with the CPHS UNICEF Baby Friendly Gold Award.

The provider will need to show evidence of working with and supporting peer supporters in their volunteer roles. Evidence to demonstrate support for parents will also be required in the form of regular, anonymised feedback.

Accessibility/acceptability

The programme will be offered to parents and carers across North Tyneside.

Whole system relationships

The programme will demonstrate a strong whole system approach to infant feeding. The provider will develop key links with services and partners linked to infant feeding through the support of the CPHS for example maternity services, GP’s etc.

Service delivery

Service model

The programme will be expected to have staff supporting volunteers who will be required to have key communication skills which includes listening, negotiating, encouraging participation, facilitating action, decision making, mediating and advocacy.

The approach will support infant feeding peer support volunteers and parents / carers to:

Support parents, carers to have a support network during their feeding journey
Support volunteers to participate effectively and responsibly in supporting parents and carers
Aim to ensure volunteers are listened to and work with them to see what support they need
Support volunteers to become more confident and resilient in their role and enabling them to empower parents/carers to be responsible for their own health needs
Support volunteers to have opportunities to develop further skills and knowledge that might support them into paid employment
The provider will support and encourage volunteers to attend on a regular basis supervision with the CPHS infant feeding team
Support volunteers to understand the wider offer of family support and services in North Tyneside e.g. CPHS, Family Hubs and Community Hubs offer in North Tyneside.

Data confidentiality and access issues

The provider is expected to collect and store volunteers’ data in line with GDPR and data protection guidance.

Applicable standards (national/local)

The CPHS is CQC registered and complies with all regulatory requirements. The provider must deliver interventions that will be evidenced based in line with recommendations from CPHS professional bodies and OHID.

The program must be delivered in line with UNICEF’s Baby Friendly Standards (the CPHS currently holds UNICEF Baby Friendly Gold Accreditation) and in line with the international code of marketing of breast milk substitutes (The Code) which is an international health policy framework to regulate the marketing of breast milk substitutes to order to protect breast feeding. This was first published by the WHO in 1981 and is an internationally agreed voluntary code of practice. The provider will be expected to deliver in line with these frameworks working alongside the CPHS to maintain compliance with the framework. Please see more detail below on the UNICEF Baby Friendly Achieving Sustainability (Gold) Award.

UNICEF Achieving Sustainability (Gold) Award

The CPHS holds the UNICEF Baby Friendly Achieving Sustainability (Gold) Award, ensuring that Baby Friendly standards are upheld. These standards not only relate to policy, guidelines and education, but also ensure a mutually supportive culture, where issues can be openly and safely addressed. For such a culture to exist, well-informed and consistent leadership is needed, backed up by vigilant monitoring and a desire to continue to improve.

The provider will ensure an understanding of the Baby Friendly standards and specifically, the International Code of Marketing Breastmilk Substitutes (The Code)
The provider will demonstrate an awareness of the cultural context within the UK, including why breastfeeding is a contentious issue and how it needs to be protected
The North Tyneside Breastfeeding Strategy details improvement of services which make a difference to parents, carers, and infants within North Tyneside to support and normalise breastfeeding. This strategy is for health professionals, public health, education, voluntary sector, and public and private sector partners. The provider will be expected to be aware of this strategy and how the project will support the wider ambitions of the strategy.

Governance

Governance of the programme will be managed through regular meetings with CPHS and relevant service managers from the service. Progress will also be fed into the CPHS clinical governance committee.

The annual report will be presented to the Director of Public Health via the clinical governance committee.

The CPHS will review progress and monitor outcomes for the program through an agreed performance workbook.

Staffing

The provider will ensure a person in post is responsible for:

Co-ordination and organisation of the volunteers to deliver group-based sessions across the borough as stipulated
Delivering in line with UNICEF’s Baby Friendly initiative and the international code of marketing of breast milk substitutes (The Code)
Liaison with the CPHS on a regular basis to keep the service informed of any operational issues
Regular training and updates from the CPHS to ensure standards are maintained in line with the UNICEF Baby Friendly Initiative and The Code
The working relationship with the CPHS to agree communication / press releases and any associated communication about the programme and agree these before being published
Using skills, competencies and experience in supporting and recruiting volunteers to the programme
Embracing and developing a volunteer recruitment process that actively recruits peer supporters who are genuinely committed advocates of the approach and uphold the UNICEF Baby Friendly Initiative and the International Marketing Code

The person in post will ensure:

All volunteers have suitable support and links to relevant resources to support them in their peer support role
Processes are in place to ensure training and the continued development of volunteers
There is a record of volunteer training and relevant checks to enable volunteers to undertake peer support roles e.g. DBS Checks, health and safety training, safeguarding adults and children’s training, information governance (confidentiality), GDPR, etc
Training requirements and competencies are monitored through regular assessment and volunteer appraisal and that volunteers are enabled to progress through supported learning

Policies and procedures

The provider will have written policies and procedures which are available on request, as stipulated in the call-out.

Health and safety

The provider will ensure appropriate risk assessments are in place for the duration of the programme for volunteers and participants.

Insurance

The provider will hold relevant and up to date Public and Employers’ Liability.

Safeguarding adults and children and young people

The provider will follow the local safeguarding partnership arrangements.

Staff and volunteers will undertake CPHS training re safeguarding.

Referral, access and acceptance criteria

Location(s) of service delivery

This will be agreed with the provider on appointment. There will be an expectation that the provider will deliver as a minimum four groups across the four geographical areas in North Tyneside.

Days/hours of operation

As agreed with CPHS, there is flexibility around delivery.

Exclusion criteria

Behaviour demonstrated by physical or verbal abuse. The provider will highlight any cases to the CPHS service where they feel a member of the public needs to be excluded from accessing the programme. If there is an immediate threat to staff, volunteers or participants the provider can act in excluding individuals immediately (then update the CPHS accordingly).

Monitoring

Monitoring will be undertaken via quarterly meetings with the CPHS.

Invoicing arrangements

The provider will invoice North Tyneside Councill for the sum of £25,000 by 1 January 2026
Funding for year two will be agreed between October and December 2026 if the CPHS is satisfied with the performance and outcomes being delivered by the provider
The invoice for year two, if agreed, will be for the sum of £25,000 by 1 January 2027
Funding for year three will be agreed between October and December 2027 if the CPHS is satisfied with the performance and outcomes being delivered by the provider
The invoice for year three, if agreed, will be for the sum of £25,000 by 1 January 2028

Public Health small grants

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