A new mother who took part in research at University Hospitals Plymouth NHS Trust (UHP) said that increased infant feeding support for first-time mums stopped her giving up breastfeeding when she encountered challenges.
The ABA-feed study is investigating whether providing support to women helps them to feed their baby successfully and confidently, and whether it is good value for money.
Marina Marmolejo, an entrepreneur and business owner from Plymouth, volunteered for ABA-feed at UHP after seeing a poster for the study in the antenatal clinic. She explains what was involved: “I was contacted by someone from the study team, and they explained I had been assigned to the group that would be receiving the support. I filled out some forms, and then a wonderful lady called Elizabeth came over to my house, and we had a chat and she told me how the study would work.
“She told me the support would be on offer for a specific length of time, and we went through a kind of flow chart of the help that would be available after the birth. Since then I’ve had to fill out two or three online surveys, with questions about the feeding, and about things like mental health, hospital and GP visits. It was easy to complete the surveys, you didn’t have to log in or anything, just click the link, and there were reminders.
“I had to contact Elizabeth when Theo was born, and she was then available for support. We basically messaged on WhatsApp, and I think I might have spoken to her once over the phone. But it was really, really worthwhile.”
Soon after he was born, staff at UHP noticed Theo had tongue-tie, where the strip of skin connecting a baby's tongue to the bottom of their mouth is shorter than usual. The condition can make it harder to breastfeed, although not all babies with tongue-tie are affected in this way. Marina continued: “If I hadn’t had Elizabeth around, I don't think I would have carried on breastfeeding. It was quite difficult with his tongue-tie, it really impacted the way he was latching on.
“He was still gaining weight but it did make it difficult, like when I went out I could only feed in one position, which was really hard when I was sitting on just a normal chair. Elizabeth arranged a referral, and we had the procedure to fix it when Theo was about eight weeks. She was just so supportive.
Aimee Miller, Principal Investigator for the study at UHP, and the Trust’s Infant Feeding Lead for Maternity Services, said: “Across Plymouth we know that working together to support families with their feeding journey results in the best outcomes; so it has been incredibly exciting for University Hospitals Plymouth and Livewell Southwest to work together on this research project.
“Peer support is such a valuable resource and is one of the best ways of ensuring wraparound care for each of our families. We are very lucky to have these wonderful infant feeding helpers taking part in the study.
“The relationship and support given is tailored to each individual and is particularly important in those early weeks, which we know is when many parents end their feeding journeys earlier than they would like, this is why this study is so important. We look forward to being able to support as many families as possible in this way.”
Participants in the study, which is open to first-time mothers regardless of how they plan to feed their baby, are randomly allocated into one of two groups – usual care, or ABA-feed. The ABA-feed group receives woman-centred support for all types of feeding (breastfeeding, formula feeding and mixed feeding) from specially trained infant feeding helpers.
Breastfeeding can improve the health of mothers and babies, but fewer UK women breastfeed compared to other countries. Many women stop breastfeeding within the first two weeks, and previous research has shown most would have liked more support to help them continue. Younger mothers and those from lower income homes are less likely to breastfeed.
Reflecting on the study, Marina said: “I definitely think if everyone had someone like Elizabeth, they would be less likely to stop so soon. Even if people made it to three months, that would be much better than not doing it at all.
“But if you persevere it is actually easier in many ways. I always wanted to make it to six months, but now I’m thinking, I'd have to get up in the middle of the night and make formula, which is potentially more of an effort. And there’s also the cost if I had to pay to feed Theo solely on formula milk. I think especially for lower income families, with the current cost of living, you could save a lot over a whole year.
“I also really want to mention how important I think it is to normalise breastfeeding in public. If you’ve got that fear it’s another massive barrier, and maybe more women might breastfeed if it was more normalised.”
The National Institute for Health and Care Research (NIHR)-funded study is running at a number of sites in England, Scotland and Wales, including Derriford Hospital, part of University Hospitals Plymouth NHS Trust. The Trust is working in partnership with Livewell Southwest to deliver the study, with Livewell providing training for the infant feeding helpers.
It is being supported locally by the NIHR Clinical Research Network South West Peninsula.
ABA-feed is led by Professor Kate Jolly at the University of Birmingham with a team of researchers from across the UK. For more information, including how to take part, visit the study website: https://aba-feed.org/