Infant feeding experiences and support needs in women with severe mental illness: A qualitative study in England

BACKGROUND: Breastfeeding has significant health benefits for mothers and babies. Severe mental illness (SMI) affects around 3 % of women giving birth but very little is currently known about their infant feeding experiences. Due to a paucity of evidence, support needs are largely unknown. AIM: To explore the infant feeding experiences and supports needs of women with SMI. METHODS: Semi structured interviews were conducted online and in person from 2022 to 2023 with 20 women under care of perinatal mental health teams in England. Interviews were audio-recorded, transcribed and anonymised. Reflective thematic analysis was used to analyse the data. FINDINGS: Four key themes were identified; (1) The intersection between infant feeding and mental health; (2) Infant feeding support from maternity services; (3) Infant feeding preparation; and (4) Specific considerations for women with SMI. The concept of 'collaborative practice to support infant feeding and mental health' draws the themes together and is marked by a disconnect in collaborative care supporting both infant feeding and mental health. DISCUSSION: SMI can manifest itself in beliefs and emotions related to infant feeding. Experiences of support highlighted the need for better anticipatory guidance around infant feeding for women with SMI, including contexts specific to perinatal SMI like psychiatric inpatient settings, psychotropic medication use, and the challenges associated with sleep deprivation. CONCLUSIONS: Negative experiences with infant feeding and poor support have a significant impact on women with SMI. Support should focus on the emotional and practical demands of breastfeeding and how women can manage this alongside their illness.