The National Breastfeeding Helpline Evaluation report

3.1a Access to Helpline breastfeeding information and support

Page last updated: 13 February 2013

Breastfeeding Practice of Callers (N = 96 Respondents)
Breastfeeding practice of callers (n = 96 respondents) - see following text version
Text Versions of Graphical presentation of Breastfeeding Practice of Callers (N = 96 Respondents)

Source: The Allen Consulting Group National Breastfeeding Helpline Caller Survey, 2012.
Also relevant to consideration of service utilisation, is the reason for contacting the Breastfeeding Helpline. 0 shows that the top reasons for contacting the Breastfeeding Helpline recorded by caller survey respondents were to obtain information on feeding patterns, sore breast or nipples, reassurance, and milk supply and storage issues.

Top Reasons for contacting the Helpline as reported by Callers (N = 96 Respondents)
Top reasons for contacting the helpline as reported by callers (n = 96 respondents) - see following text version

Text Versions of Graphical presentation of Top Reasons for contacting the Helpline as reported by Callers (N = 96 Respondents)
Source: The Allen Consulting Group National Breastfeeding Helpline Caller Survey, 2012.
The counsellors understanding of the callers main reasons for contacting the Breastfeeding Helpline varies slightly as shown in 0. The single most often recorded reason is sore breast or nipples, followed by concern with milk supply, wanting reassurance and seeking information on feeding patterns.

Top Reasons for contacting the Breastfeeding Helpline as Reported by Counsellors (N = 174 Respondents)
Top reasons for contacting the Breastfeeding helpline as reported by counsellors (n = 174 respondents) - see following text version
Text Versions of Graphical presentation of Top Reasons for contacting the Breastfeeding Helpline as Reported by Counsellors (N = 174 Respondents) Top of page

Source: The Allen Consulting Group National Breastfeeding Helpline Counsellor Survey, 2012.
Stakeholder feedback suggests that caller wait times are an issue based on comments by mothers to other helplines and to health professionals. As shown in 0, the number of counsellors fell over the period July 2009 to March 2012, the numbers of calls answered fell and the numbers of calls lost rose. This suggests a correlation between Helpline resourcing and service delivery that poses a potential barrier to caller utilisation of services.

Call Wait Times
Graphical presentation of Call Wait Times
Source: The Allen Consulting Group analysis based on ABA data 2012.
The conclusion of a correspondence between Breastfeeding Helpline resourcing and effectiveness is supported by the increase in average waiting time for a caller to be connected to a counsellor from approximately 80 seconds to 120 seconds over the same time period. As the total number of calls received has remained roughly constant, the increase in waiting time appears to correspond to the decreasing number of counsellors over the time period.

Utilisation of the Breastfeeding Helpline should be in part linked to consumer awareness of the service. Stakeholder feedback suggests that awareness is facilitated by a wide base of support for the Helpline among health professionals and services, and the multiple sources of information about the service. In addition, the Breastfeeding Helpline was strongly associated with the ABA and benefited from the organisation’s high profile. Additional impetus was provided by the interest of some jurisdictions in health facility accreditation under the Baby Friendly Health Initiative (BFHI). This had involved provision of training on breastfeeding to health professionals in some public hospitals as part of meeting facility accreditation standards.

Despite this, a small number of caller survey respondents suggested that advertising of the Breastfeeding Helpline could be improved (see below).

Caller satisfaction

Are callers satisfied with the support provided by the Helpline?

Insight into caller satisfaction with the Breastfeeding Helpline service is provided by responses to the caller survey seeking their rating of the experience. The responses are summarised in 0. A high level of satisfaction with the service can be inferred from strong agreement indicated for recommending the service to others, the professionalism of the counsellor and the relevance of the information and support provided. In addition, almost half of the respondents strongly agreed that the information received changed their breastfeeding practice and a further one quarter agreed.

Over three quarters of the callers considered that the wait time before connecting to a counsellor was appropriate.

Callers Experience of the Breastfeeding Helpline
Graphical presentation of Callers experience of the Breastfeeding helpline - see following text version
Text Version of Graphical Image of Callers Experience of the Breastfeeding Helpline

Source: The Allen Consulting Group National Breastfeeding Helpline Caller Survey, 2012. Top of page
Callers were also asked explicitly whether the service they had received from the Breastfeeding Helpline had met their needs. Of the 96 respondents to this question, only one caller indicated they had not had their needs met. Asked to elaborate further, the caller outlined that:
    The counsellor offered to email me further information but did not follow through. Also this was my third attempt at contacting the ABA. The first time I hung up after waiting on hold for nearly 15 minutes. The second time I used the online form but it took 4 or 5 days to get a response (during which time I had called again).
Caller survey respondent

The only aspect of the helpline that has not been fantastic in my experience is that a couple of times there have been long delays and I've been told by the recorded message to call at another time... which is hard when you're in a crisis and have a baby!
Caller survey respondent


All callers were invited to provide suggestions to improve the Breastfeeding Helpline service.

Amongst the responses collected, waiting times were a consistent theme. A number of callers surveyed reported that lengthy wait times had been experienced. Callers generally were prepared to hold on, ‘but I don’t really mind given that I can talk for as long as I need’, and appreciated the advice of where they were in the queue. Some callers found it stressful to wait, and others saw the counsellor caseload as a function of inadequate funding from government and out of the control of the ABA.

Caller survey respondent

I wish it was advertised more as I only just found the ad after three months and it has helped me enormously!

Other suggested improvements from callers included a need for:
  • greater advertising and promotion of the Breastfeeding Helpline to new mothers, as well as the importance of challenging perceptions of the ABA within the community, and broadening their appeal to all mothers;
  • consistency of advice and support received;
  • exploring opportunities for greater continuity of service and care when accessing the Breastfeeding Helpline, including the option of speaking to the same counsellor; and
  • options to better tailor the service, specifically by matching the needs of callers to the specific strengths or experiences of counsellors, including transfer of calls or call backs at agreed times.
This was consistent with suggestions that were made from callers that were collected as part of the StrategyCo research in 2011, specifically, that:
  • the wait times for the Breastfeeding Helpline were too long;
  • there was a need for more counsellors, and a call back service;
Caller survey respondent

I hear often from women that the ABA are breastfeeding nazi's and don't support formula feeding if it's needed and they are scared to call. A boost to their image would be great.Top of page
  • there needed to be back up options if a counsellor could not answer a query; and
  • that counsellors should be regularly updated on new breastfeeding information, research and alternative feeding methods, and that callers should not be judged or pressured about breastfeeding decisions.
Other stakeholder feedback collected through this project (survey respondents and focus group members) suggests that on occasions the experience can be variable depending on the counsellor for those calling on more than one occasion, however, this did not appear to dissuade return calls. There has also been consistent reference to information being provided that is at odds with advice provided from other sources. However, the clear majority of the survey respondents strongly agreed (56 per cent) or agreed (35 per cent) that the information they received was consistent with other information sources.

In assessing the satisfaction with the Breastfeeding Helpline service, consideration has also been given to the systems in place to provide appropriate oversight and development of the service. Governance arrangements for the Breastfeeding Helpline embed the service within the wider capability of the ABA leveraging from the organisation’s infrastructure including:

  • the Lactation Resource Centre and the generation of accurate and appropriate information material;
  • training activities including continuous improvement strategies at all levels (national, branch, local) of the organisation;
  • marketing and promotion of ABA services; and
  • dedicated national Breastfeeding Helpline manager positions to facilitate monitoring including against service agreement indicators and on a day to day basis, such as maintenance of the web portal and staffing of the Breastfeeding Helpline roster.