'Feeding was such a huge element of how my illness manifested itself, it can't just be me.': A qualitative study of infant feeding experiences and support in women with severe mental illness

Background: There are many benefits of breastfeeding to the physical and emotional wellbeing of mothers and babies but very little is currently known about the infant feeding experiences of women with severe mental illness (SMI). Due to a paucity of evidence in this area, womens individual support needs are largely unknown. Aim: To explore how women with SMI experience infant feeding and their support needs with this. Methods: Semi structured interviews were conducted online and in person with 20 women. 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 joined up thinking to support infant feeding and mental health draws the themes together and is marked by lack of support specific to the individual needs of women with SMI. Discussion: Findings revealed how 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.