Smita Hanciles works for Central & North West London NHS Foundation Trust and leads the Camden Baby Feeding Service. Here’s a taster of her presentation at our conference this Saturday (6th October), on the power of peer support. If you’ve been unable to get a ticket, follow #BfNConf18 on social media to catch our updates throughout the day.
There is evidence that establishing breastfeeding can be protective of maternal mental health and aids with bonding. When establishing breastfeeding is challenging or even unsuccessful, particularly when a mother really wants to breastfeed, the mother can be left vulnerable and at increased risk of post-natal depression. At points of such vulnerability, does having access to a trained breastfeeding peer supporter in addition to her own network of relationships provide a source of emotional co-regulation and co-learning? Does this help increase resilience and possibly decrease the risk of anxiety and depression and any negative impact on bonding? These are the questions we have been asking in Camden as we introduced a group of new volunteer breastfeeding peer supporters into the Baby Feeding service.
We often think of support for breastfeeding and support for perinatal mental health separately and services generally focus on one or the other. There are peer support projects for mothers who need help with feeding their baby and there are now separate peer support projects for mothers experiencing mild to moderate postnatal depression and anxiety. However, this way of delivering care doesn’t factor in that one impacts on the other and can’t easily be addressed separately. What would happen if we supported new mothers in a much more holistic way? Or maybe we already do this as peer supporters but just don’t describe it as such.
Having reflected on what we actually spend our time doing in the Baby Feeding drop-ins in Camden and on the stories of mothers we support, we recently decided that instead of describing ourselves as solely providing peer support for women experiencing difficulties with feeding or establishing breastfeeding, we would emphasize that we also provide listening support to those who had intended to exclusively breastfeed but were experiencing challenges or were not able to for various reasons. We added the Baby Feeding service to the Camden Perinatal Mental Health services register under services for the ‘mild /moderate’ end of mental health concerns. We hoped this would help with the recognition of our role in providing emotional as well as practical feeding support and as a place from which referrals to more specialist help could be made if necessary.
I recently saw a poster with the words ‘I sat with my anger long enough, until she told me her real name was grief’. Mothers struggling to breastfeed can feel angry with services that failed to provide the right support or even at themselves or their baby. However, the anger could be borne from a sense of grief over the loss of the breastfeeding relationship they had wanted or looked forward to. They are unlikely to seek help from other mental health services in this situation but still need to be listened to and for their feelings of loss to be acknowledged as a normal response and justified. They don’t want to be told their feelings are unreasonable because they can always just give a bottle and as long as the baby is fed, it’s all ok. They also need support to accept and embrace a different feeding relationship from the one they had anticipated whether it is mixed feeding or bottle feeding with EBM and /or formula.
We approached the Maternal Mental Health Alliance and began a discussion about how to join up different elements of support for new mothers and how we could best train and develop our volunteer peer supporters to work in a more holistic way. This resulted in a diverse and knowledgeable working group coming together including all the main voluntary sector organisation that train peer supporters to develop competencies for the Infant feeding workforce in relation to perinatal mental health.
We know from countless stories of mothers we have supported that breastfeeding peer support has the power to change a mother’s story and experience of care. Those of us who provide peer support have the privilege to hear a mother’s story, to become part of her story as we come alongside to help empower her to find the way forward that is right for her. Can receiving peer support help a mum change the way she views her own story? Providing peer support can often help reframe our own stories and see them differently. If our story was one of painful experiences or even trauma, we can often realise the pain wasn’t in vain but has provided the backdrop to another mother feeling supported and empowered.
We are now looking for ways to collect evidence of the impact breastfeeding peer support has and how it contributes to perinatal mental health. We are still very much on a learning curve with this piece of work and I hope to share more during my presentation.