The health visiting service is commissioned to deliver information to parents about weaning their baby onto solid food. This forms part of the wider health visiting team's core offer of universal services and is also a requirement of the Unicef UK Baby Friendly Initiative, for which Doncaster is accredited level 3 Baby Friendly status.
In the past, the health visiting team invited parents into a group setting to learn all about the process of weaning their babies onto solid foods. This was an opportunity for them to ask questions and seek parent-to-parent support. However, it was recognised that these sessions were often poorly attended. Therefore, parents were not receiving the information they needed and this was an ineffective use of clinicians' time. We needed to re-think our approach in order to deliver weaning sessions to local parents more effectively.
Weaning can be a confusing time for parents; with such a wealth of information available on the internet, social media, from family and friends, it can be hard for them to know which information to trust. It is therefore important that evidence-based information is readily accessible from a source such as the health visiting team. Health visitors also support by signposting and discussion with parents, which offers an opportunity for them to ask any questions they may have.
Service provision
At the time that changes to the delivery of the weaning sessions were being considered, Doncaster Health Visitors was already running a successful Facebook page with around 3000 followers. This was growing week on week and we were reaching far more people than this with the posts we shared. Facebook reach works by posts appearing on the news feeds of followers and as they engage with the post (through likes, shares and comments), this in turn appears on their friends' news feeds and so on. By creating posts that are engaging to our followers, we are able to increase our reach and therefore deliver a health message on a larger scale than delivering this in a group session. Another benefit is that the information is accessible to parents whenever they need it and with an increasing number of people looking for access to information online, we were already in a position to meet this demand.
We initially consulted with a parent volunteer who was working with the social media team and we discussed our plan informally at health professional-led parent groups. This helped us to identify whether this approach would be welcomed by parents. We recognised that not only would an e-health weaning offer enable us to reach a large number of parents, it was also a good method of sharing visual content such as videos and photographs that we didn't have the means to share in our home visits. Other than the staff cost of running the social media pages, there was no additional cost involved in sharing content via Facebook. It was recognised that content needed to be simple, relatable and cost-effective for parents to ensure topics such as meal ideas were achievable for all parents regardless of their ability or financial situation.
Considerations
It was important to consider the potential implications of offering this information predominantly on Facebook to ensure we were offering an equitable service. Although not all parents have a Facebook account, anecdotal evidence suggested that it was the most popular and growing social media site in our target age group. It is possible for anyone to access our Facebook page even without a Facebook account, so all parents can still view the content. Staff time was also an important consideration to ensure we were able to meet increasing demand and create fresh ideas and new content. As a team we have also worked hard to educate the health visiting service, management team and wider children's care group to understand the benefits of social media and have received good support as a result.
E-health offer
The social media team consists of me, as a part-time health visitor working 7.5 hours, and a full time e-health and social media project support worker who manages social media across the children's care group. The latter is a relatively new role created in part as a result of the success of the Doncaster Health Visitor's Facebook page and to support the development of social media across the children's care group. This team is under guidance from the transformation and integration lead.
Doncaster Health Visitors has since expanded its social media accounts onto Instagram and Twitter as well as supporting the development of social media in other services within the trust including community and mental health services, the Project 3 Young People's Health and Wellbeing Service and school nursing. Alongside the delivery of information via the social media pages, parents can also seek advice via our Facebook Messaging service, the health visitor single point of contact, health-led groups and home visits.
The e-health offer became a key area of focus in the commissioned health visiting service. It was identified by the social media team that the weaning offer would fit well within this e-health framework and that social media would be an effective means of delivering weaning information. The initial idea was to video and photograph a baby's weaning journey from 6 months with the view of sharing this with parents on Facebook and Instagram.
It just so happened at the time of this discussion, I was pregnant, and I agreed to undertake this piece of work while on maternity leave. In the process, I became aware of a Facebook post by NHS Start4Life that asked for parents' experiences of weaning their babies onto solid foods. After a number of discussions over the phone, I was invited, along with my daughter Anna, to London to take part in filming for the national Start4Life weaning campaign. This was launched online in February 2019. As part of the launch, we were both invited to BBC Breakfast News to be interviewed alongside a Public Health England nutritionist about the experience of weaning Anna onto solid food and being part of the Start4life weaning campaign.
Launch of the new service
Doncaster Health Visitors decided to launch the weaning resources to coincide with the launch of the Start4Life campaign. By this time the social media team had created a bank of evidence-based resources focusing on tips and ideas about how to introduce solid foods including recipe and meal inspiration for parents. These ideas have since developed into scripted videos, which show the normality of weaning baby onto solid foods with the aim of increasing parent confidence with weaning. Since then, we have also been able to share toddler meal ideas and tips on fussy eating as Anna has moved through toddlerhood.
As a service we are working together to signpost all parents at core universal contacts from the antenatal contact to the 2-year review to raise awareness of these resources and our social media pages. Health visitors also discuss weaning onto solid foods at the 6-8 week core contact. The aim of having this discussion early on is to share information about safe weaning and recognising developmental readiness for introducing solid foods.. The 6-8 week contact also provides a good opportunity to share resources such as the Start4Life weaning leaflet and signpost parents to evidence-based online resources, which gives parents time to feel prepared for weaning their baby at around 6 months.
What now?
Since the launch of the local weaning offer, we have shared a number of videos and photographs on both platforms with weaning tips and advice for parents with babies from 6 months and beyond. The aim for the content is to give practical and realistic tips for successful weaning that is evidence-based and simple. Recipes and meal suggestions have been recognised as a particular favourite with parents.
Verbal feedback from parents at home visits suggests that the weaning information shared on social media has been positively received and helpful. Comments received on social media from parents, clinicians and other services both locally and nationally have also been positive overall—such as, ‘this is really helpful’, ‘great ideas for introducing solid foods’, ‘fantastic advice’.
One of our weaning posts with the highest reach was themed around Christmas dinner. The post contained examples of three different plates of food suitable for different ages and stages of weaning: at 6 months old, 8-12 months old and 12-18 months old. This post reached more than 256 500 people with 727 shares on the post and a combined total of 1375 comments including comments on post shares. This was something of an anomaly in terms of the huge amount of people it reached, but it just shows the power of social media to reach and engage a large audience.
Our aim is to continue enhancing the resources we have developed to ensure they are current and remain interesting and supportive for the families that need it. We are always looking for ways to develop our digital resources to enhance service delivery.