by Carolyn Neal, Breastfeeding Counsellor, Selby Branch
Mothercare invited me to come into their new store in York to promote World Breastfeeding Week. They were very keen and welcoming, so I agreed to come in for a few hours on the Saturday afternoon to speak to their shoppers and also take the opportunity to promote NCT’s antenatal courses and feeding support. One of my local colleagues and fellow Breastfeeding Counsellor (BFC), Elaine Antcliffe, came too.
I hadn’t done this sort of work before with Mothercare so wasn’t quite sure what to expect. Having a good working relationship with Tessa Kipping, in our Partnerships Team, I contacted her beforehand to check that this was OK to do and fell within our existing contract with Mothercare. I was pleased to find out too that NCT would pay me £87 plus expenses through their Mothercare contract – I am used to doing my BFC work on a voluntary basis so this was an added bonus!
On the day, I was warmly greeted by Mothercare staff and invited to sit at a table and chairs they had set up for me in a good position by their antenatal clothing. Unfortunately though in front of their promotional display for a well-known brand’s formula preparation machine… They had also put out a number of goody bags for us to give away to shoppers.
Several of their staff came to share their breastfeeding hopes, fears and issues so we had the chance to do a little counselling work. We also had some interest from pregnant shoppers who had either already booked their NCT antenatal course or accepted a leaflet about it.
We are all hoping this will lead into a bigger partnership with Mothercare and provide opportunity for our newly-qualified Breastfeeding Counsellors and Postnatal Leaders to get paid work within Mothercare stores. Although I had a great day unfortunately their sale was too good to resist and I ended up spending my earnings on the grandchildren!
Hi, I’m Caroline. I’m part of the One Antenatal co-production team working to develop our new look antenatal course. My practice roles are Antenatal Practitioner (ANT), Baby Massage teacher (not as often as I would like) and Doula (when time permits, so not very often!). I also have Tutor roles at Level 4 and Level 5 specialising in the Antenatal pathway.
I think one of the reasons I was selected for the team is that I have multiple hats in NCT. I can easily see the perspective of current practitioners (particularly those who may have been in practice for some time, as I have) and current and future students. I’m also highly aware of all practitioners needing to be included in this project such as those who deliver our Essential courses.
We had our first meeting back in June – the team has been thoughtfully put together with a range of us from different specialisms. Anyone who has ever attended a cross-specialism study day will know the huge value that that brings. One of the ‘ground rules’ that we established on our first day together is that everybody’s voice needs to be heard.
We’ve had two face-to-face meetings so far and several remote Zoom meetings (see collage of us waving above!). Once we got over the initial technical issues, these worked really well. The meetings are intense. There’s so much to get through but Sarah McMullen (Head of Knowledge) keeps us focused and there is a rigorous (if ambitious!) project deadline, which we are all working towards.
One of the things we are working on at the moment is learning outcomes (LO) – anyone who knows me knows I am a bit of a stickler with these so it was with some trepidation that I approached the first meeting on this.
We are hoping to come up with some over-arching LO’s for the course and leave practitioners to create their own LO’ s for their own individual sessions. In the back of our minds we’re constantly thinking about how this can be a more consistent experience for parents and yet let practitioners retain their autonomy, which we absolutely accept is very important for some practitioners and is perhaps the reason that they were drawn to work with the NCT, rather than any other organisation. We also have to consider the implications this may have on new students we are recruiting and their training.
Shiny new resources
We are also focusing on resources – I am so excited to get the new resource pack which will contain some beautiful laminated images of birth and early parenting. In the face of ever increasing competition in this market it is so important for us to be seen to have a modern image.
New deadlines have been set through July and August, so while some of you may be kicking back and enjoying the summer the One Antenatal team will be beavering away trying to get this right for new recruits, existing practitioners and NCT as a whole.
Your voice matters
We absolutely want your voice to be heard throughout this process so if there are any questions you have or any input which you think would be helpful for us, please do get in touch. If you haven’t already, please do complete our survey to tell us what you’d like the final course framework and toolkit to include!
I qualified as an Antenatal Teacher in 2008 and thought I’d probably be teaching antenatal courses in the evenings in Nottingham perhaps for to five times a year. Little did I know that a change in my other work would lead to my facilitating NCT courses all over Great Britain, from Edinburgh to Exeter, Cambridge to Caerphilly, at weekends and on weekday evenings, a variety of formats, Signature and Essentials, and up to 30 courses a year. When I went to one of the ourNCTservices workshops, I wasn’t remotely surprised to hear how many different formats and price points there were for antenatal courses; I was personally responsible for several of them.
So when the opportunity came up to get involved with the One Antenatal project, I decided to go for it. It wasn’t without some trepidation. I’ve worked in several organisations which have seen major changes, as well as those seen in NCT, and I know it makes for a difficult time. Hand on heart, I sat in the first meeting thinking, OMG is this going to upset everyone? Is there a sub-plot to develop a 300-page manual that will be handed to students who have been through five one-day training sessions and will be sent away to deliver the exact same course to a script? I can’t be associated with anything like that, that’s not very NCT.
As the project has moved along I’ve realised that’s not the plan at all. I have more confidence now that the project will pull together a course which will allow practitioners to maintain our autonomy whilst harmonising the content to ensure parents can be assured of receiving a great quality course, wherever they live and whoever facilitates it. If you’re asked to get involved or have the opportunity to give us some feedback or opinions, please do. We can’t do this without you.
Watch our video about One Antenatal featuring a handful of the co-production team.
You can keep up to date with our progress and opportunities for involvement on babble. We’d love to hear your ideas of what to include in our future course framework – you can share them in this survey.
by Anne Kent-Taylor, Head of Operations and outgoing Safeguarding Lead…
I’m not alone as a Head of Operations in being concerned
about the way in which my role is perceived by an organisation. I have heard
other operational managers, at other organisations, cry:
“I’m sick of being told I’m too negative.” “It’s my job to notice potential problems and fix them.”
So when you’re in a role that requires you to be risk-aware, and to keep the organisation safe, how can you make it fun? Adding the responsibility of safeguarding lead to my remit did not seem like the obvious way of making my working day more cutting edge.
My safeguarding role started three years ago with a review
of policy and procedure, and the drafting of an action plan. So far, so
I worked together with other staff members, particularly in
commissioned services, to ensure that the right procedures were in place to
check, train and support staff, volunteers and practitioners that may come in
to contact with babies, children, young people or vulnerable adults.
In the first three months as safeguarding lead, I was
contacted just three times.
Could this be right? We know that we see nearly 100,000
parents through courses each year; over 10,000 women through commissioned
services each year, and around 15,000 parents through branch events each week.
It’s really hard to find out the “right” level of
safeguarding concerns for a charity. I have seen one charity present a graph
showing an increase in concerns but omitting the numbers from the axis! There
are currently a couple of larger children’s charities working together to
benchmark safeguarding – but their beneficiaries are different to ours.
How would we know when we were at the right level?
We decided that what we wanted to see was an increase in
concerns reported. That we wouldn’t aim for a number, and we would never be
worried that it was “too high”, but we wanted more people to get in touch with
I carried on implementing the action plan but it wasn’t making safeguarding tangible for people. We had to make it more relevant, more real, more relatable.
The breakthrough was to take a more creative approach – away from policy and action plans – and to make safeguarding come alive. We wanted to be able to talk about safeguarding every month, which meant we needed to find stories to tell.
From the contacts we’d had with practitioners and volunteers, we knew the sorts of things that they encountered and were worried about. So we began a series of “Safeguarding scenarios” in Update, our monthly internal newsletter. I’m pretty sure you will have read one, as they were the most clicked through article in Staff, Practitioner and Volunteer Update for three months in a row and people have been in touch with us to say how useful they find them.
Sometimes we use real life examples – an anonymised version
of something that we have been contacted about. Sometimes we invent situations
which we know people have concerns about. Sometimes we base it on examples
given by other charities. We always provide links to additional resources and
make sure that everyone knows to contact the Safeguarding Lead if something
doesn’t feel right.
In the last three months, I was contacted 21 times.
The contacts range from safeguarding concerns, to advice
about mental health, assessing criminal record checks, and supporting people
with sharing information.
The role has allowed a bit of creativity, a lot of variety,
and the chance to see something new at NCT.
Now that I’ve spent nearly three years in this role, it’s time to hand over to another staff member. The responsibility of Safeguarding Lead will move to Helen Simkin, our Head of People. This marks the next stage of NCT’s journey in embedding a culture of safeguarding. Placing this responsibility with Helen allows for learning and development – in safeguarding and safer recruitment – along with the chance to upskill the organisation in mental health awareness.
Safeguarding is everyone’s responsibility and I’m proud of the way NCT has developed over the last three years, and the opportunity that focusing on an area where we need policy and process has still allowed creativity and humanity.
Sample safeguarding scenario:
Scenario 3 | December 2018
A couple in a same sex relationship have been attending an antenatal class that you are teaching, they have been engaging and you have no previous concerns. Tonight as you were loading your equipment into the car after the course, you notice that they are arguing loudly in another part of the carpark, you also notice one partner appear to strike their pregnant partner.
What would you do immediately?
Would you record any of this, and if so where?
What actions would you take in the longer term?
If you felt that you needed to take further advice who would you speak to?
What would you do immediately?
Be aware of your own safety; do not attempt to intervene alone.
The same sex relationship is irrelevant; you are witnessing an assault of a pregnant woman and must act as she is in immediate danger.
Where is the carpark? Can you call out to security?
Is there anyone else in the area who can help?
Call the police 999
There is no set order to the actions above, they can be done concurrently. This is a situation where you must act quickly.
Would you record any of this, and if so where?
Do you have the details of the attendees to hand? The police will need this when they arrive. If possible, make a note of the car registration.
Afterwards when you get home, try to make some notes whilst it is fresh in your memory.
After you have spoken to the safeguarding lead, you will be required to complete an NCT safeguarding form.
As the police have been involved, you may also be required to be available to give further information.
You need to speak to the safeguarding lead and agree a plan, BEFORE you attempt to contact the mum who was assaulted. Due to the nature of domestic violence, this mum may not be ready to leave this relationship and may not welcome contact from you. The police will make a referral to the duty safeguarding team as standard and they will use specialist workers along with the police liaison officer to support the family.
Keep updating the NCT safeguarding lead.
Often after a serious situation such as this, you won’t be given any further updates as it’s considered that your role has ended. Whilst this may feel frustrating, you have to remember that you have done the right thing at the right time and have faith in the statutory services.
If you felt that you needed to take further advice who would you speak to?
Whilst domestic violence may not feel very festive, it has been chosen for the December Update as year on year statistics show a huge spike in incidents over the festive period. You may not ever come into contact with an assault like the scenario, but be mindful, know where to signpost – there are good organisations listed in the further resources section below. The more that you are informed, the more you can help someone – even if it is just showing them a phone number.
It’s National Breastfeeding Celebration Week 17-23 June. Our Breastfeeding Counsellors do an amazing job supporting women to feed their babies. Read Allison’s account of why she loves what she does.
Hello, my name is Allison Thambyrajah and I’m a Breastfeeding Counsellor in Teesside. I’m married to Jeet and we have three children; Grace 21 years, Matthew 17 years and Rose 11 years. As well as being a Breastfeeding Counsellor I’m an Interior Designer and run my own interiors business.
I first joined NCT over 21 years ago when I was five months pregnant with Grace. We had just moved from Leeds to the Midlands and a work colleague had suggested I join as a great way to meet people. She was absolutely right and my local branch in Bromsgrove provided me friendships and a great support network which was invaluable as a first time mum with no family close by. I became a very active member of the branch hosting Bumps and Babies and taking on the role of Antenatal Bookings Clerk as well as helping out at various events.
I was inspired to train as a
Breastfeeding Counsellor after struggling in the early days to breastfeed Grace.
I’d had some great telephone support with a local Breastfeeding Counsellor. When
Grace was just eight months old I commenced my training in Coventry. Jeet still
has fond memories of driving up and down the M42 trying to get Grace to sleep
whilst I was at tutorials. To help the branch fund my training I set up and ran
Music Tots which to my surprise was really popular. I must confess to having
very little music ability but we all had a great time disco dancing with our
Mid-way through my training we moved up to the North East. I changed tutor groups to Hexham but a short time later my tutor retired and so I moved tutor groups once again to Mary Smale’s tutorials in Beverley. I was blessed to have three amazing tutors each with their own personal style and knowledge. I absolutely loved the monthly tutorials of getting together with like-minded women with a shared passion and the shared lunches which were always delicious. I qualified in January 2002 just before Matthew was born and have been supporting families ever since.
Over the years I have developed my role and become a Breastfeeding Peer Support Trainer as well as a Birth and Beyond Community Peer Support Trainer and am exploring applying for Excellent Practitioner status. I have facilitated breastfeeding drop-ins all over the North East and more recently facilitated the Middlesbrough Baby Café and now the Stockton Baby Café after successfully securing Public Health funding for the Teesside Branch. I still really enjoy facilitating the breastfeeding session in the antenatal classes and am actively involved with my local branch. It’s lovely to see other women forging new friendships and getting support through the branch groups and Baby Café.
The way in which I support families has changed as technology has progressed – fewer people telephone but prefer to make initial contact either by text, email or via social media. I am very active on the Teesside Breastfeeding Facebook group and reach far more families than I ever would have imagined possible. Facilitating the Baby Café every Tuesday then enables me to direct families there to get some good old-fashioned face-to-face support.
The birth of a baby is such a monumental time in a person’s life. It can at times feel like a rollercoaster ride both physically and emotionally and to be able to offer support to families and to make a difference to their experience is a privilege and incredibly special. I absolutely love my work as a Breastfeeding Counsellor and I cannot imagine never doing it. Every family is unique and I know I will never get to the point where I have seen it all or know it all and that’s what keeps it interesting. I’m very grateful to my own family for their support and understanding in the work that I do and the odd times that I do it. Jeet often says if he wants to get my attention he just starts the sentence with breast or baby!
We had a fantastic response to our call for practitioners to be involved in ourNCTeducation and the next stage of ourNCTservices. Five practitioners on the project teams tell us more about why they applied and what they’re hoping to get out of it.
The education of our practitioners is the foundation of the excellent courses and support we provide for parents. As an antenatal practitioner of four years, I have had the experience of studying with Bedford and Worcester models of education at levels 4 , 5 and 6. I am really pleased to be a part of the ourNCTeducation team as we explore the best of what our education provides and develop it further.
Having studied at Worcester University since 2016, achieving my FdA degree in Birth and Beyond and now continuing with my BA hons, I bring to the table the most recent training experience. I have thoroughly enjoyed my training, and I am now working in the field too as an antenatal teacher (ANT) and postnatal leader (PNL). When the opportunity came up to be involved with shaping the future of ourNCTeducation I knew I would love to be involved. I’m really looking forward to bringing about change in order to maintain the high quality training our practitioners receive, whilst making it accessible and appealing. I feel truly honoured to be involved in this project and look forward to what the future brings.
This is a photo of me (centre), just before I went into the cathedral for my graduation last November. I love this photo, nervous, but delighted!
I am passionate about supporting parents, particularly their emotional needs in the transition to parenthood. Good quality practitioners are key to supporting parents and I am keen to help develop a robust education system that supports the needs of NCT whilst ensuring good parent support.
If you have any questions about ourNCTeducation, please get in touch.
Lucy Pedder – developing one antenatal course, bringing together the best of Signature and Essentials
I’m really excited and fired up to get started on this project. I really believe in the value of co-production and involving as many stakeholders as possible when designing services. As practitioners we can sometimes feel a little side-lined and it’s really nice to be invited to contribute to this project.
I believe that good antenatal education makes a real and lasting difference to parents in the transition to parenthood. It can be the difference between a new parent starting out feeling confident, empowered and with full self-efficacy, versus fearful, traumatised and insecure. Practitioners know we make a difference but often feel stifled by the constraints imposed by course formats and administrative complexities.
Most parents on my courses have no idea of the difference between Signature and Essentials and book based on dates and location alone (I do ask at the start of each course). This means that there is no real purpose to having two courses apart from distinguishing between practitioners, which feels divisive and unfair. We are aware that the Preparation for Birth and Beyond (PBB) qualification was devised when it was thought that we would be delivering courses under contract to the NHS. Now that this has fallen through it feels like the right time to move on and revert to one, nationally recognised, core antenatal course for the NCT brand. As a practitioner from that “tricky” cohort who are level 5 qualified postnatal practitioner (PNP) but cannot deliver Signature courses, I recognise the frustrations that delivering Essentials brings, when we know we could be doing so much more.
Those of us who are passionate about perinatal support in general and NCT in particular want to help strengthen the charity so it can fulfil its potential. We know that the antenatal courses are key to this and the charity could be doing so much more once the antenatal offering is “fixed” and growing again.
Heather Kale – developing a paid 1:1 breastfeeding service
I’m very excited to be part of this small team looking into one-to-one paid for breastfeeding counselling. Although I’ve been a breastfeeding counsellor for 12 years I’ve always kept my head down and just got on with it. When this opportunity came up to consider the future direction of NCT breastfeeding counselling it really resonated with me as an idea and I applied straight away.
I have some experience of being ‘on the other side’ as I have been an International Board Certified Lactation Consultant (IBCLC) for the past seven years and run a small private practice but my NCT breastfeeding counsellor role is always what I come back to as the foundation of everything I do. There are many things to consider here and I look forward to meeting the rest of the team and us getting our teeth into the nitty-gritty of how such a scheme might work.
If you have any questions about ourNCTservices, please get in touch.
Yet, the post-natal struggles new fathers can encounter continue often to be overlooked in conversations about the wellbeing of new parents and how to support them. Building on our existing interests in mothers and wellbeingand caregiving fathers, we interviewed 15 fathers who had experienced mental health difficulties after having a baby.
Here we outline findings and recommendations we hope will be useful for antenatal and post-natal practitioners, who are in a unique position to help alleviate some of the issues we highlight.
The fathers typically reported symptoms resembling anxiety and/or depression, with a minority outlining more specific conditions. A range of contributing circumstances were described, some of which comparable to issues faced by mothers and others more distinct. The most prevalent included:
the negotiation and aftermath of difficult pregnancies and/or traumatic births
everyday post-natal challenges relating to sleep, constant crying, juggling of responsibilities and isolation
struggles to come to terms with dramatic changes of identity and responsibilities
baby’s mother suffering depression, anxiety or physical difficulties recovering from birth
the weight of masculine expectations – to support, carry on, be strong
The last of these, we found, often connected to all the others, with fathers often experiencing spirals of guilt at what felt like a failure to live up to their ideals of what a new father should be.
Difficulties recognising and reaching out
Difficulties understanding and talking about their struggles often made fathers’ struggles worse. Typically, it had taken several months, and sometimes a crisis or breakdown, before professional help was sought. Reaching out to partners and/or friends and family often remained a struggle for longer. Key factors here included the following:
Lack of prior knowledge about new fathers and mental health made it difficult to recognise the seriousness of the problem. Many were not aware that fathers could suffer from post-natal mental health difficulties.
Fathers often interpreted their struggles as a personal failure as a man and father, and refused to regard their problems as legitimate as compared to their partners’ situation.
A sense of failure to live up to masculine expectations – to support, rather than being supported – often prevented men from talking about their difficulties with friends, family and, sometimes, partners.
Fathers often had minimal contact with communities of other new parents, limiting opportunities to speak to others in similar circumstances.
Relief via social media?
At one point or another, many fathers had turned to social media, though uses were diverse and such platforms should not be viewed as a magic solution. Going online did often help with finding information and connecting to other sufferers, as well as offering potentially useful channels through which to talk about their own struggles.
In particular we found that:
Engaging with others’ struggles often helps. Encountering the accounts of other sufferers on blogs, online communities or individual social media accounts helped provide understanding and a sense that their own difficulties were legitimate, easing self-blame.
It can be easier to talk about problems online. Several fathers had found it easier opening up to strangers or distant acquaintances online, free from the burdens of existing relationships and the awkwardness of face-to-face encounters.
Social media can enable people to send out ‘coded’ cries for help. Those most reluctant to talk directly about their struggles sometimes felt able to subtly hint at them in the hope someone might notice and respond.
Examples included ‘liking’ or sharing general articles about depression, responding supportively to others, or even going silent for a time.
While this sometimes triggered support and enduring relationships, such coded gestures sometimes remained unnoticed or unanswered.
Moving Forward: Helping fathers to understand, cope and communicate
We would particularly highlight the following lessons from our research as areas for consideration for antenatal and post-natal practitioners.
We need to better inform and prepare fathers for the difficulties they could face.
Greater awareness of the possibility of male post-natal mental health struggles could help alleviate spirals of self-blame and damaging delays with seeking support.
The problems dads can encounter could be covered, alongside maternal mental health questions, as part of antenatal classes, and dealt with more prominently in online and other resources oriented to parents-to-be.
Fathers need more networks of support during the post-natal period to help their general wellbeing and enable them to recognise symptoms and seek help if necessary.
We need to make it easier for fathers to access supportive groups of new dads, or mixed-gender parent groups that welcome then.
As well as setting up or facilitating new fathers groups, it would be invaluable to provide more information about existing groups.
Since fathers sometimes find it easier to engage with mental health issues online, we should help them find and become involved in online as well as face-to-face groups.
We need to recognise and revise some of the expectations placed on new fathers and establish that it is OK for them to need support.
Our research highlights the potential negative impact of intense pressures on fathers to provide ‘rock-like’ support and be strong at all costs.
The nature of such pressures and how to deal with them could be explicitly discussed as part of antenatal and post-natal courses and/or online materials
It would be useful also to review existing content and its delivery to ensure such pressures are not inadvertently being reinforced.
I think sometimes we don’t realise the impact of what we are doing.
I met a stranger on a train last Friday holding her seven month old. We chatted and I shared some toys from my NCT bag on the journey as I dashed between venues as usual. She was so pleased with her NCT experience and then said she had some help with feeding from a wonderful woman – her eyes lit up as she told how incredible the support had been. She asked me lots of questions and tips about parenting. She told me her parenting journey and all about her birth and so on. By the time she got off the train, despite feeling exhausted I wanted to smile as she had mentioned several NCT connections and I thought that’s because of my PSAs and the breastfeeding counsellor, and her antenatal teacher, and the friends she has made, and the conversation with me, and so it goes on.
She is a one-mum publicity department for NCT telling anyone who will listen to do our courses and it made me so proud to be associated with such a great team of women.
The following morning as I arrived for a course at the library, a dad greeted me with his toddler, glad to see me as he and his partner had done an Essentials course with me 18 months ago. Another mum popped her head round the door as I set up for my final Essentials session with her three year old from a previous course – we had a catch up. Another new parent also spotted me that morning.
During that Essentials session I had invited a same sex couple to come along to talk about life with a new baby as they had recently attended an Essentials course and had their baby by surrogate in the US. The reason I invited them specifically to come along was that on the current course there is another same sex couple having a baby by surrogate in the US. It meant so much to all of the clients to meet this new family but it was worth so much more to the expectant two dads in the room. All four dads asked to stay in touch with each other and that is what has happened. I left that session and had tears in my eyes at what wonderful opportunities we are able to create for future support for all families.
I have a journal of comments which I ask clients to write in at the reunions…. tips for those finishing their Essentials courses. It is such a wonderful book which I pass round to clients in session five of their Essentials course. Some are written in English, others in the parent’s first language. It’s such a powerful way of capturing the transition that people are making. They often mention how their NCT group is a lifeline, how the WhatsApp group has been so helpful and how they want to say how much better the course was than they thought it would be!
So many people at NCT are part of this incredible journey, making a huge difference to parents, including PSAs. The true unsung heroes!
This blog has come from an NCT practitioner. While it is the experience of one individual, it echoes what many share about their experience of supporting parents within NCT.
We said at the start of the ourNCTservices project we were going to do this properly. And my goodness we’ve stayed true to that. After hearing from 130 parents during interviews and focus groups and holding 70 workshops with volunteers, practitioners and staff there have been times over the last few weeks where I’ve suffered serious evidence overload. So I am incredibly excited to finally be on the road sharing findings and discussing the next steps at the #ourNCTstory events.
ourNCTservices is a systematic review to understand how, over the decade ahead, we ensure our NCT services are as relevant, accessible and impactful for parents as possible. We are going to focus first on strengthening our existing core services across breastfeeding, postnatal support and antenatal education. And, we are going to start to lay the foundations for increasing our reach and expanding postnatal support. It will consider what we need to stop, start, continue and adapt to ensure that more parents benefit from our existing core services and enable the space and resources to invest in increasing reach and expanding scope in future.
Since the beginning of the year we’ve been gathering evidence from parents, from practitioners, volunteers and staff and from NCT data. My challenge over the last few weeks has been to distil months of work and hundreds of pages of fascinating research into no more than ten key pieces of evidence for antenatal, breastfeeding and postnatal.
One of the things we’ve heard loud and clear from all of you is that we can make things very complicated at NCT. This is a problem because it gets in the way of meeting parents’ needs and costs us a lot of time and money. You’ve told us that we just need to make it simpler to use our skills and expertise to do better for parents.
On antenatal we heard that parents don’t understand the difference between our antenatal courses and people who don’t do NCT simply don’t understand the value of the knowledge and networks above NHS classes and family/friends. Those who do our antenatal courses like it at the time and see the peer groups as a complete lifesaver. But in hindsight they feel unprepared for the realities and are in need of continued support after birth.
We heard that breastfeeding support is a big area of need for all parents but many aren’t getting the right support at the right time – for a whole complicated web of reasons and emotions. Many parents feel judged, pressured and totally unprepared for the challenges. Some report that we’re contributing to these issues.
Postnatal support is vitally important to all parents, in the early weeks but also as they are finding their feet and establishing their new life as a parent. Peer networks aren’t enough and they still need our support. Yet the uncertainties of postnatal life make it harder to get people through the door. We’re not giving up but we’ll need to do things differently to thrive and make the most of our unique skills and expertise in this space.
We were worried it might all sound a bit obvious. But in the first nine events you’ve told us that it’s incredibly useful to see challenges acknowledged and also to see all the different pieces of the jigsaw brought together for the first time. We’ve learnt a lot that is new about why parents do and don’t engage with services. We’ve revealed new insights on the impact, reach and cost of our services. We’ve learnt from you about what’s getting in the way. And we’ve also knocked some long-held assumptions off the list of things to worry about. For example:
people do still bond and form networks on intensive courses
parents thinking about antenatal classes don’t hold a perception that we’re all a bunch of natural birth and breastfeeding zealots
the slightly lower income group we spoke to didn’t see any need for antenatal classes whatever the price
Now what do we do with our services as a result of what we’ve heard? That’s the hard bit. It is clear from the #ourNCTstory events so far that there are some areas which many people feel are pretty obvious next steps. Such as moving to one antenatal course and testing out paid-for breastfeeding support alongside the free services we already offer. However, many weeks and months of work lie ahead to figure out how we would actually do this in reality and make a success of it. There are other areas causing more debate – like exactly how to describe and shape our postnatal services and whether they should be pay-as-you-go or booked in a block.
We’ll be collating every single post-it note and feedback comment made at these events during June. We will use these alongside the evidence to identify the service changes with the highest potential to serve parents better and make things easier. In the second half of the year we’ll be exploring what it would take to make a success of these service developments. Proposals will then be discussed with our Board in December. This will ensure that when decisions are made they are based on a good understanding of the time, the people and the resources it would take to put them into action.
I’m about halfway through and I can’t wait to jump on the next train and get on with the second half of the #ourNCTstory events. The conversations I’m having make me really excited about how we can do better for parents and make better use of the amazing skills, expertise and empathy in the NCT movement.
If you’d like to discuss ourNCTservices further please do contact Caroline any time at firstname.lastname@example.org or on 020 8752 9190.
How we feed our babies is a very personal decision, dependent on our circumstances, the information and support we receive, the challenges we face, and the social and cultural context in which we live.
To support these decisions, the NCT services we provide for expectant and new parents, including our infant feeding support, are built around a parent-centred approach. This means understanding and respecting each parent’s unique circumstances, and supporting them to make the decisions that are right for them.
Yet very often, right across society, mothers don’t feel prepared or supported to feed their babies the way they want to. They face judgement or feel guilty about their feeding experiences and the decisions they make. This can affect any mother, however she feeds her baby, and has a very real impact on emotional wellbeing at a challenging and vulnerable time.
We want this to change.
Our mission is to help parents have the best possible experience of pregnancy, birth and early parenthood. This means we are committed to informing and supporting mothers’ decisions, whatever that decision is.
We want all parents to feel prepared and confident as they welcome their baby into the world.
We want parents to know where to go for trusted support, and to be able to access that support, whoever they are and wherever they live.
We want them to feel respected in the decisions that they make, and supported to feed their babies the way they want to.
By providing trusted and personalised support, alongside evidence-based information on a range of feeding topics, we have a unique opportunity to help make these ambitions a reality.
What challenges do parents face?
We are particularly concerned about three ongoing challenges to positive feeding experiences:
A high proportion of women find that they have to stop breastfeeding before they want to, often in the first few weeks. These mothers report feeling pressurised but not supported to breastfeed, and this can have a significant impact on their emotional wellbeing. This level of unwanted drop-off and related emotional impact has persisted in the UK for decades, but is not inevitable.
Parents who introduce formula milk often report feeling unprepared or not able to access information on formula feeding. It is important that parents can prepare to formula feed their baby safely and responsively. They need to be able to ask questions about formula feeding without fear of judgement. They also need reliable and non-judgemental information, free from commercial interests, on the use of formula, and to know that they can get that information, plus help and support, from us. Many topics, such as feeding cues, responsive feeding, and an assortment of feeding difficulties, are relevant to all parents – regardless of how they intend to feed their baby.
Women experience unacceptable levels of pressure however they feed their babies… from family and friends, as well as from people they hardly know. Mothers who breastfeed their babies often feel pressurised and constrained about whether, where, how often, and how long, they breastfeed. Similarly, mothers who use formula milk often feel judged or guilty too, particularly – but not only – if they planned to breastfeed.
What are we doing at NCT to address these challenges?
As part of the ourNCTservices project, we are conducting a major piece of new research with parents across the UK, helping to strengthen and shape our future services so that they are as accessible and impactful for parents as possible. One thing we’ve heard very strongly from parents is just how much need there is to be prepared for the reality of feeding their babies, to be able to access good quality breastfeeding support soon after birth, and to be able to access information and support with formula feeding too.
Our breastfeeding counsellors and peer supporters already provide highly valued practical and emotional support to thousands of women and families every year – on our infant feeding helpline, in people’s homes, in community drop-ins and Baby Cafés, and on postnatal wards. With cuts to services being felt across the UK, it is more important than ever that we work to protect and promote good quality support for all.
In addition to this major piece of strategic work, we have a number of other activities already underway.
We have updated our infant feeding message framework for our staff, volunteers and practitioners. This framework sets out how the services and support we provide, and the language that we use, can best support all parents with infant feeding and demonstrate inclusivity.
We have worked with a team of breastfeeding counsellors, building on parent feedback, to develop a new framework for the antenatal breastfeeding session and to outline how parents who are planning to feed formula milk (whether exclusively or in combination with breastmilk) can be supported antenatally.
Our quality team have produced a guide to best practice for antenatal practitioners and breastfeeding counsellors to work together effectively to deliver antenatal education in a way that best meets parents’ needs.
We have updated our study day programme for practitioners to build on new evidence and parent feedback, to support our practitioners with their knowledge, skills and confidence as part of their continuing professional development.
The quality team have been working one-to-one with a small group of practitioners who find it harder to get positive feedback from parents after their antenatal courses. This has led to significant improvement in parent satisfaction, and we’re continuing to focus on improving experiences for parents through our feedback and quality assurance processes.
We are reviewing and updating all of our web content to strengthen our evidence-based information across a range of feeding topics including breastfeeding, formula feeding and combination feeding.
Throughout all of our work, parents are at the very heart of our organisation. Our mission is to help parents have the best possible experience of pregnancy, birth and early parenthood. We are deeply committed to this and to continual improvement. So we always welcome feedback or suggestions for how we can improve what we do.