Midwives have always been public health practitioners, as defined by the activities in which they are involved (Edwards, 2008). The Public Health Work Stream for midwifery 2020 made recommendations for midwives to strengthen their role in public health agenda, as the first professional point of contact for childbearing women (Lewis, 2015). The midwife is expected to provide a service and information that help parents to access health promotion messages and use them effectively to nurture their health as well as that of their family (Bowden, 2016).
Midwives make up a significant proportion of the professional support available to women. World health organization recommends exclusive breastfeeding for the first six months of baby’s life (Pollard, 2011). Midwives use evidence based approach to promote the health of women and their babies. Evidence based practice is compatible with philosophy of midwifery as it seeks to provide the highest and safest level of care (Rees, 2011). It is recommended by BFI that all breastfeeding mothers should be offered written and verbal information about the benefits of breastfeeding (Dalzell, 2010). Midwives use a wide range of resources including leaflets, websites, apps and support groups in order to support women in their important decision such as how they want to feed their baby.
I have chosen two leaflets based on breastfeeding to critically compare and contrast them. These two leaflets are widely shared with women in clinical settings during antenatal and postnatal period and they both have easily accessed online versions. In order to critically analyse two leaflets I used The Critical Appraisal Skills programme, as it states by Aveyard that CASP is the most widely used critically appraisal tool. The Critical Appraisal Skills programme (CASP) provide a checklist tool that “enables you to assess the trustworthiness, relevance and results of published papers so that you can decide if they are believable and useful” (CASP, 2016). I found this tool useful to critique these leaflets although it does not specific guide to critique leaflets.
The first is called ”off to the best start” contains 24 pages produced by Public Health England (Start 4 life) published in 2015. Start 4 life is a campaign that provides accessible and concise information about to support a better life for infants from birth (Start for life, 2017). The second leaflet is called ”Essential guide to feeding and caring for your baby in Wiltshire”. This leaflet is produced by real baby milk printed in 2015 and contains 30 pages. Real baby milk is a company that begun its voluntary project in 2006 to protect, promote and support breastfeeding by empowering families with fantastic, evidence based information and support.
First leaflet is colourful and attractive for audience. Its bright colours are persuading for the audience to read it than the second leaflet which is made of light colours. Off to the best start leaflet has a mum and baby picture on its front cover which means that the target audience is only mum and baby. However, the second leaflet has mum, baby and dad picture which is giving a positive element of involving fathers in the maternity care as well. Active fathering, particularly in the early years, has shown to have a positive impact on the child’s development (Lewis 2015). The RCM have also published guidelines about the involvement of fathers in maternity care (Lewis 2015). The title of both leaflets does not specify that they are aiming for breastfeeding. Off to best start stated on the front page ” important information about feeding your baby” and second leaflet states that essential guide to feeding” however both leaflets providing information only about breastfeeding, which can mislead bottle feeding mums. This does not support CASP guide that the resource has a clearly focused title/ question (CASP 2017).
The front cover of off to best start leaflet shows the logos of NHS, UNICEF and BFI making it more reliable source by having all these accredited trusted bodies. The second leaflet has only got logo of NHS compared to leaflet one, but there is no reference list provided in both leaflets that leads to question the validity of research. Leaflet two is not using all the trusted bodies used by leaflet one but on page two, the authors and reviewers names are mentioned which is suggesting that information provided is accurate. This is also supporting CASP critique as CASP suggest that quality of included studies should be reviewed (CASP, 2017).Both leaflets providing the information based on BFI standard. It is stated by National Institute of care and Excellence states that BFI should be used as a minimum standard for educating breastfeeding mothers (NICE, 2014) Both leaflets are published within last three years as NMC Code states that midwives should always be practicing using the evidence based and most up to date information (NMC, 2015). Midwives have a professional responsibility to keep themselves up to date with the best available evidence (Steen, 2011). Therefore, it is important that leaflets accessed by mums or families are accurate and up to date.
Both leaflets are easy to read, each section is titled properly and pictures are also provided for more clarity. As (Dalzell, 2010) states that written information should be easy to read and the language should be user-friendly. In comparison to leaflet 2, leaflet 1 suggesting that it is more reliable as it can be easily accessed on BFI website which representing the accreditation. Both leaflets suggesting women about support groups including La Leache League (UK) and The breastfeeding network (BfN). BFI also recommend women to join support groups as NICE (2011a) recommends implementation of peer support programmes as part of a multi-faceted approach to increase breastfeeding prevalence (BFI, 2013).
NICE (2014) Maternal and Child Nutrition. Available from: https://www.nice.org.uk/guidance/ph11/chapter/4-recommendations Accessed 5 December 2017.
Start4life (2015) Off to The Best Start. Available from:
Accessed 5 December 2017.
UNICEF (2013)The evidence and rationale for the UNICEF UK Baby Friendly Initiative standards. Available from: https://www.unicef.org.uk/wp-content/uploads/sites/2/2013/09/baby_friendly_evidence_rationale.pdf Accessed 5 December 2017.
Rees, C. (2011) Introduction to Research for Midwives: 3rd ed. London: Churchill Livingstone
Steen, M. and Roberts, T. (2011) Handbook of midwifery research. West Sussex: Wiley-Blackwell.
Critical Appraisal Skills Programme (2016) Making Sense of Evidence. Available from: http://www.casp-uk.net Accessed 5 December 2017.
Lewis, L. (2015) Fundamentals of Midwifery A textbook for students. West Sussex: John Wiley and Sons Ltd.
Essential guide to feeding and caring for your baby in Wiltshire (2015) https://www.gwh.nhs.uk/media/192046/esssentialguidetofeeding-wiltshire.pdf Accessed 5 December 2017.
Bowden, J. (2016) Health Promotion in Midwifery: Principles and Practice. 3rd edition. Boca Raton: CRC Press.
Edwards, G. (2008) Essential Midwifery Practice: Public Health. Oxford: Blackwell Publishing Ltd.
Pollard, M. (2012) Evidence-based care for breast feeding mothers. Oxon: Routledge.
Dlazell, J. (2010) Breastfeeding: Contemporary Issues in Practice and Policy. Oxon: Radcliffe Publishing Ltd.
NMC (2015) The code Professional standards of practice and behaviour of Nurses and Midwives. Available from: https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf
Accessed 5 December 2017.