Professor Fiona Dykes

Reconfiguration of the UK UNICEF Baby Friendly Initiative reflecting the importance of relationship

In 2013 UNICEF UK Baby Friendly Initiative launched a reconfiguration of the UK version of the Global WHO/UNICEF Baby Friendly Initiative (BFI) (UNICEF UK 2013).  This represented recognition of the importance of facilitating mothers in becoming attuned to their baby's behavioural cues and needs and building a close and loving relationship with their baby.  In this presentation, Fiona Dykes highlights a programme of research conducted by the Maternal and Infant Nutrition and Nurture Unit (MAINN) at University of Central Lancashire, England, and the ways in which it has influenced a paradigm shift with emphasis on the centrality of relationships at an organisational, staff to parent and parent to infant level.   This work commenced with a critique of the ways in which institutionalisation of maternal and child health influenced staff practices and women's experiences of breastfeeding in postnatal ward settings with the 'production line' ethos being central to the experiences of staff and mothers (Dykes 2005a,b, 2006). The critique extended to incorporate a neonatal intensive care perspective illuminated by the work of Flacking et al (2006, 2007) in which a similar emphasis on the production influenced both staff and breastfeeding mothers in some neonatal units. This body of work resulted in recommendations that we need to encourage a paradigm shift away from institutionalised, production-line approaches to a more relational perspective (Dykes and Flacking 2010).  A programme of research led by Thomson et al (2012a,b) offered key insights into implementation of the UNICEF UK Baby Friendly Initiative and ways in which implementers could change the hearts and minds of the health care staff.  Key aspects of their approach included seeing policy change as dynamic, engaging grass-root staff in decision making, endeavouring to understand the local culture, recognising complexity and ensuring that change is implemented in a creative, systemic and culturally sensitive way.  Understanding the ways in which women develop a sense of coherence related to their infant feeding experience is central to relationally based implementation of the  BFI. The insights from a recent meta-ethnographic study of health care staff perceptions of the WHO/UNICEF BFI by Schmied et al (in press) in collaboration with MAINN staff illustrate some of the global challenges in implementing a relational ethos within institutionalised settings.  The reconfigured discourses and standards of UNICEF UK BFI are outlined and challenges ahead discussed. 

Biography

Fiona Dykes (opens in a new window) is Professor of Maternal and Infant Health and leads the Maternal and Infant Nutrition and Nurture Unit (MAINN), School of Health, University of Central Lancashire.  She is an Adjunct Professor at University of Western Sydney and holds Visiting Professorships at Högskolan, Dalarna, Sweden and Chinese University of Hong Kong.  Fiona has a particular interest in the global, socio-cultural and political influences upon infant and young child feeding practices; her methodological expertise is in ethnography and other qualitative research methods. She is a member of the editorial board for Maternal and Child Nutrition, the Wiley-Blackwell published international journal (editorial office in MAINN) and a Fellow of the Higher Education Academy. Fiona has worked on WHO, UNICEF, European Union (EU Framework 6), Government (DH), NHS, National Institute for Health and Clinical Excellence (NICE), TrusTECH^® Service Innovation (UK), National Institute for Health Research (NIHR HTA), Wellcome Trust, British Council and Australian Research Council (ARC) funded projects. Fiona is author of over sixty peer reviewed papers and editor of several books including her monograph, Breastfeeding in Hospital:  Mothers, Midwives and the Production Line (Routledge) and Infant and Young Child Feeding: Challenges to implementing a Global Strategy (Wiley-Blackwell).