Dr Ben Newton, Senior Research Evaluator at Health Innovation West of England, reflects on recent work he’s been involved with to understand the perceptions of maternity staff around the use of smartphone technology to support women with breastfeeding and how this is now shaping our real-world evaluation of the Anya parenting app in Gloucestershire.
How do we improve breastfeeding rates?
What will help women start breastfeeding?
How do we ensure babies receive breastmilk for as long as possible?
These questions reflect the longstanding challenge of low breastfeeding rates in the UK and beyond. Such rates have long been an evasive puzzle for policy makers and healthcare commissioners alike. To improve breastfeeding rates, healthcare systems have designed and delivered educational interventions to women. However, deploying interventions in this way often comes from a starting point that assumes what women need to breastfeed is to be ‘educated’; surely if we just show women the benefits of breastfeeding, we will solve the problem. The underlying assumption that low breastfeeding rates is caused by a lack of education can be problematic.
The reality is that breastfeeding can be tricky and parents need a wide support circle of family, friends and professionals to help. I’ve seen such challenges in the early days of my own children’s lives. Where is that magical professional at 2am when your baby is struggling to latch? I know what helped our first one to successfully feed: the patient support of a breastfeeding volunteer on a late Saturday night. We didn’t need to be told that breastfeeding was best, what we needed was practical support.
It is encouraging to see how the Anya smartphone app arose from a personal experience of breastfeeding difficulties; see the Anya website for a glimpse of the innovator’s story. The Anya app is designed to be that constant source of practical support, day or night, when it’s next to impossible to see a professional.
So how are we supporting Anya?
Health Innovation West of England has been supporting Anya for some time. You can read more about this in our case study. The next stage of our support is running a real-world evaluation of the app in Gloucestershire, working with the Local Maternity and Neonatal System. The app was recently made available to users of maternity services in the areas of Gloucester City and the Forest of Dean and maternity staff have been actively promoting the app with the women they work with. However, with our knowledge and experience of healthcare systems, we know that such systems are too complex to expect results by simply parachuting in an intervention.
Care and planning are required to implement change in complex systems. We therefore carried out a survey of the local maternity workforce to understand the views, beliefs and practices related to smartphone use and breastfeeding.
What did we find?
- The maternity workforce is an experienced group of staff who are confident in using smartphone apps. However, this confidence did not necessarily translate into being confident to introduce Anya to the women they work with.
- Staff consider one of Anya’s key benefits is its 24/7 availability to women, alongside the user-friendly and empowering nature of the app.
- Staff were concerned about the infrastructure required to support the smartphone app (such as a functioning work phone and good internet signal) as well as the commercial nature of the app.
- Despite concerns, the majority of staff identified with positive feelings regarding introducing Anya.
We drew on these findings to put together some potential recommendations that could facilitate a successful delivery of the app’s implementation. Some of these insights have already been drawn upon in the launch of Anya.
So what’s next?
We are undertaking a full-scale of evaluation of Anya. We will be working closely with new mums and maternity staff to understand how they have experienced Anya and the impact it is has had for them. We look forward to bringing you the results later on this year.
Dr Ben Newton, Senior Research Evaluator at Health Innovation West of England
P.S. If you’re a parent looking for Anya in Gloucestershire, talk to your midwife about it.
 The areas of Gloucester City and Forest of Dean were specifically chosen because of their relatively lower rates of breastfeeding compared to other areas in the county. By focussing on areas with lower breastfeeding rates, the system is playing an active role in reducing health inequalities alongside targeting resources where they are most needed.
Posted on January 22, 2024 by Dr Ben Newton, Senior Research Evaluator