iFeed: User-centred development of an online and mobile phone intervention to support infant feeding choice and confidence to sustain breastfeeding and/or safe formula feeding

Funder

Medical Research Council

Project objectives

In order to improve public health we aim to improve the available information and behavioural support for infant feeding, and improve access to it via the web and smart phones since their use is becoming prolific. The main objective of this project is to develop a low cost, high reach intervention that can aid healthcare professionals in proactively delivering consistent, evidence based support to all mothers, in a format which is acceptable to all mothers, their partners and their clinicians, but particularly to those mothers least served by current services, without adding considerably to staff workload. Within this project we will:

1. Conduct a needs assessment incorporating a review of existing smartphone and web-based interventions, and in-depth focus groups with clinicians, breastfeeding supporters and parents.
2. Develop a prototype intervention specified in terms of behaviour change and technological components.
3. Test the acceptability of the prototype intervention offered to parents alongside their usual care.

• Impact statement

  Eighty percent of mothers who stop breastfeeding in the first two weeks want to continue BF for longer, but stop due to difficulties such as pain or concerns about milk supply. These difficulties can be overcome or prevented with skilled support. However, a shortage of midwives, scarcity of lactation specialists and funded peer support services, and a high birth rate mean services to support mothers to establish BF are increasingly stretched, both in hospital and the community. Ultimately we aim for this intervention to increase the initiation and the maintenance of breastfeeding, with associated improvements in infant and maternal health, and reduced NHS costs.

  For mothers who choose not to breastfeed, or who stop early, the alternative is to provide formula milk. Many mothers choose to combine breast- and formula milk feeding, so the majority of infants are given at least some formula feeds. The aim is for this intervention to reduce the risks associated with formula / bottle feeding by encouraging skin-to-skin contact and responsive feeding whatever feeding method chosen. This will support parent-infant bonding and may support the infants’ ability to regulate their food intake and reduce risk of obesity. Encouraging parents to follow key recommendations when preparing formula feeds will reduce the risks of infection associated with bottle feeding.

  The prototype intervention will be offered to parents in Coventry as part of an acceptability study, therefore there is a potential for local impact to be achieved within the scope of this study. The outcomes of this research will inform the design and feasibility testing of a future clustered randomised trial of the intervention for clinical and cost effectiveness.

  Dissemination of the outcomes of the research will be via social media alongside academic-focused outputs of conference presentations and peer-reviewed publications. Conferences will include both those targeting academic audiences (e.g. UKSBM annual conference) and those targeting professionals such as the UNICEF UK Baby Friendly Annual Conference. Open access publications will include one outlining the needs assessment and user-centred development of the intervention (targeting other intervention developers), and a second describing the implementation of the intervention and the outcomes (targeting the clinical academic community in infant feeding).

• Outputs

  Bartle,N. Brown, K. Gokal, K. Law, S. Moody, L. Dale J. (2017) Systematic development of an online intervention to support infant feeding (iFeed)  Oral Presentation the Conference - 3rd UCL Centre for Behaviour Change Digital Health Conference 2017: Harnessing digital technology for Behaviour change. http://www.frontiersin.org/10.3389/conf.FPUBH.2017.03.00017/event_abstract