12 Jul 2021

Breastfeeding initiation in England is around 74% but very few prior studies investigate breastfeeding outcomes among women with SMI,  or the factors associated with women’s infant feeding choices and experiences.

Project aims

The overarching aim of the project is to broaden understanding of infant feeding in the context of SMI and to provide data which will inform resources for both staff and women to help individualise infant feeding support for women with SMI.

Breastfeeding baby

How this research is meeting the needs of local people

Infant feeding choices have long-term maternal and infant health implications, impacting both physical and emotional wellbeing. This study utilises data from the early-LIfe data cross-LInkage in Reseach (eLIXIR) database to investigate infant feeding in women with SMI. The database includes routinely collected maternal and mental health outcome data from general and psychiatric services across south London and is therefore very representative of the local population, addressing the health inequalities of women living with SMI in south London.

How the research will be carried out

This is a mixed methods study with three key workstreams:

Work package one - is a qualitative study to explore the infant feeding experiences and support needs of women with SMI. Women who received care from a secondary mental health service in England during their pregnancy, or the first year following childbirth  will be interviewed about their experience of infant feeding.

Work package two - is a cohort study using prospectively collected data from the eLIXIR database to find out how many women with SMI start breastfeeding, compared to women without SMI attending the same maternity service. The data will also be used to look at what medical and social factors might influence breastfeeding initiation in women with SMI.

Work package three – researchers will develop infant feeding resources for staff and service users tailored for women with SMI. A stakeholder engagement event will be in the final phase of this research to present key findings from the research and to facilitate a workshop in which resources will be evaluated by key stakeholders, including research participants from work package one, service users with lived experience of perinatal SMI, members of patient and public advisory groups, clinical and academic staff, and policymakers.

How the public are involved in the study

Patients and the public have engaged in discussions about the study at the initial proposal stage of the research and will continue to be an active part of the research by developing and reviewing key study documents, offering advice on recruitment and questions for the interviews, and helping to interpret and disseminate results. Patient and public advisory groups include:

  • The King’s College London, Section of Women’s Mental Health, patient advisory group (PAG) includes women with lived experience of perinatal severe mental illness and their carers.
  • Camden baby feeding peer support group specialise in the relationship between mental health and infant feeding.

Potential benefits of the project

The findings of the study will be used to design resources for women and staff to improve infant feeding support in the context of SMI. This will help women to make informed choices about feeding, increasing their sense of control and improving self-efficacy which could have a positive impact on their emotional and physical wellbeing, their ability to bond with their baby and their transition to motherhood.

The study was adopted by ARC South London Executive in July 2021. It is funded by Natasha Baker’s NIHR clinical doctoral fellowship and will be completed by May 2024.

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