Infant feeding experiences and support needs of mothers with mental illness
Guest blog from Natasha Baker
Ahead of the 2024 Baby Friendly Annual Conference (Virtual), guest speaker Natasha Baker discusses her work on supporting the infant feeding experiences and needs of women with mental illness.
Natasha Baker is a midwife and National Institute for Health and Care Research clinical doctoral research fellow. She is based in the Institute of Psychiatry, Psychology and Neuroscience at King’s College London, working within the Women’s Mental Health Group. She is currently undertaking her doctorate and her research focuses on the infant feeding experiences and support needs of women with mental illness.
The health benefits of breastfeeding to mothers and babies are well researched and there is also evidence to suggest that breastfeeding is beneficial to maternal and infant emotional wellbeing. I have been a midwife since 2012 and have supported many women through their infant feeding challenges. Breastfeeding is often portrayed as the optimal method of feeding to successfully bond with our children. However this ideology can lead to feelings of guilt and failure for those experiencing breastfeeding challenges, those unable to breastfeed, and those who do not want to breastfeed.
There is a growing body of evidence examining the mental health of women who, despite intending to breastfeed, have been unable to. There appears to be a distinct association between unmet breastfeeding intentions and symptoms of postpartum depression and anxiety. However, what remains unclear is how infant feeding experiences can affect the mental wellbeing of women who have pre-existing mental illness and those susceptible to severe mental illness.
During my pre-doctoral fellowship, I started working with the King’s College London Women’s Mental Health Group. It was during this time that I first recognised a significant evidence gap around the infant feeding outcomes of women with severe mental illness and the subsequent impact that this has on infant feeding support. The research I carried out during this time demonstrated that women requiring intensive secondary mental health input during the perinatal period (crisis resolution services or admission to psychiatric mother and baby units or general psychiatric wards) are less likely to breastfeed compared to women in the general population. Most women in the study felt unsupported with infant feeding due to inconsistent information provided about taking psychotropic medication while breastfeeding and that their breastfeeding intentions were de-prioritized for mental health care and treatment.
I developed my research proposal with the overarching aim of broadening our understanding of infant feeding in the context of maternal mental illness to inform future support and resources in this area. I was awarded a prestigious Doctoral Clinical and Practitioner Academic Fellowship from the National Institute for Health and Care Research in 2021 and commenced my PhD with the Institute of Psychiatry, Psychology and Neuroscience where I am currently based.
My research combines the findings from qualitative interviews with women requiring care from specialist perinatal mental health services, with linked data from routinely collected maternity and mental health outcome records. The study is the first, to my knowledge, to compare breastfeeding initiation in women with and without mental illness, whilst also exploring the lived infant feeding experiences of women with severe mental illness.
What is clear from my research is the significant intersection between breastfeeding and mental health. Whilst breastfeeding can be hugely protective of mental health, many women also share experiences of very poor support and trauma related to adverse experiences of breastfeeding. As a midwife I have witnessed the barriers women with mental illness face around infant feeding, whether that’s concerns about taking psychotropic medications whilst breastfeeding, how to manage sleep deprivation and stress alongside their mental illness, or anxieties about not wanting to breastfeed and the stigma they feel they might face because of this.
When I had my own son last year and developed postnatal depression, I experienced firsthand the monumental significance breastfeeding plays in perinatal mental health and the distinct relationship between the two. My clinical and personal experience with perinatal mental health has led me to appreciate the significance infant feeding experiences have on the parenting journey and the importance of developing appropriate infant feeding support resources for women with mental illness.
