Author(s): Powell R.; Reynolds S.; Thomas V.; Raja J.; Colleran G.

Source: Breastfeeding Medicine; Oct 2019; vol. 14

Publication Date: Oct 2019

Publication Type(s): Conference Abstract

Abstract:Background: Despite the well recognised risks of not breastfeeding, it has long been understood that doctors face almost overwhelming barriers in trying to meet their own breastfeeding goals. Doctors are a unique group of professionals who are expected to know everything about breastfeeding but who receive very little education around it. Clinical practice varies wildly with much advice from doctors given to breastfeeding mothers being based on myth and opinion rather than hard evidence. In 2017 I recognised that the internet, and particularly Facebook was somewhere mothers turn to for advice (this is likely due to convenience while feeding a baby multiple times overnight) and I saw that there was no specific, safe place for doctors to turn to for personal breastfeeding advice. When doctors did reach out for breastfeeding support online, they were most often given advice to just feed formula and weren’t supported to continue breastfeeding. I decided to set up an evidence based Facebook group for doctors who are breastfeeding. Objective(s): To set up a Facebook group aiming to provide support and advice to its members who are doctors and who are/were breastfeeding mothers, and to try to change the culture around breastfeeding in medical circles. The focus of the group is breastfeeding solutions to breastfeeding problems with the aim of continuing the breastfeeding relationship. The membership is extended to breastfeeding mothers, pregnant women who plan to breastfeed or would like to find out more about it, mothers who are feeding expressed milk or mixed feeding, or any other way of feeding a child some breastmilk, and doctors who wish to support others to find breastfeeding solutions to breastfeeding problems. The group supports the WHO recommendation of exclusive breastfeeding until 6 months with the introduction of complementary foods thereafter and that ideally breastfeeding should continue until age 2 and beyond. The group has a page associated with it, on which we aimed to post evidence based information for educational purposes. Materials/Methods: In September 2017 I put a team together as I realised I didn’t have the time or expertise to run such a group on my own. I had previously identified a number of doctors from other Facebook doctor groups who seemed to have breastfeeding expertise and passion, so I approached them to ask if they would like to be involved. Out of 8 initially approached, 7 agreed to become involved and so I set up a Facebook messenger group that we would use as virtual meetings (as we were spread throughout the UK and Ireland). Over time, two members realised they didn’t have time to be involved as much as they would like to, and so have left the admin group, although they remain active group members. The current admin group is made up of myself Dr Robyn Powell (an Emergency Medicine registrar and breastfeeding mother of 3), Dr Jane Raja (a GP trainee and breastfeeding mother of 2), Dr Gabrielle Colleran (a Paediatric Radiology Consultant and breastfeeding mother of 2), Dr Victoria Thomas (a Consultant Paediatrician and breastfeeding mother of 2), Dr Sofia Reynolds (an Emergency Medicine Staff Grade doctor, breastfeeding peer supporter, and exclusively pumping mother of 2), and Dr Natalie Shenker (who runs the Hearts HumanMilk Bank and previously breastfeeding mother of 2). We set up the group with objectives as listed above, and three screening questions when someone requests membership. The questions included providing GMC number and place of work, so that we could try to ensure a safe space formembers, and amention of theWHOrecommendations so peoplewere aware of the ethos of the group. We set up the page simultaneously and began posting informative, evidence based articles/links/videos on it.Within the group, we responded quickly to people’smembership requests and between all of us admins, almost immediately to posts for help.We were aware we didn’t want to keep desperate mothers with newborns waiting, and as a number of uswere breastfeeding ourselves, it was easy to provide 24/7 cover of the group. The support we offered was emotional (reassurance in early weeks/around breastfeeding in public/breastfeeding beyond 12 mths) and practical (signposting, specific advice re latch, thrush, mastitis). Result(s): The group was set up in September 2017, and at the end of March 2019 it has 2,150 members. Initially much of the advice and evidence was provided by the administrators of the group only, but in the last 6 months we have noticed the members are now giving out the same advice to newer members, and it is rare that misinformation about breastfeeding is given by a member. It has become a valued safe space for members to seek support during their own breastfeeding journeys, and for members to provide advice for others. There is an ongoing survey currently to try to assess the impact of the group, and initial results are favourable. ‘I’m not sure I would have carried on so long without this group”Knowing other women.have had shared experiences.helps reduce anxiety”Knowing other women feed beyond 12m and the evidence they have a huge support”Invaluable support, helped guide realistic expectations, troubleshooting and emotional support”Very difficult start and relied heavily on this group”I thought there was something wrong with and my initial reaction was that I would have to start formula top ups.asked group for help.kind reassurance, advice.links to good quality videos meant things got remarkably better very quickly. I’m now breastfeeding at 11 months and have no intention to stop”This group.has totally normalised ‘extended’ BF for me”Feeling part of a supportive online community is invaluable”It has not only helped me continue breastfeeding but also educated me so much. I can’t believe I didn’t really know anything about breastfeeding as a doctor I was so ignorant”I.feel better informed about bfing patients and drug effects on lactation as well as not being a brutish medic about it anymore ie the mantra about no evidence after 6 mo and fed is best”So nice to be in a group that isn’t full of the doctor-bashing so prevalent on other BFing support groups”I am ashamed to say that I had previously thought that you need to pump and dump post GA’Conclusion(s): To date, the feedback from the survey has been entirely positive, with mothers finding the group a useful source of information and support. As admins of the group, we have observed what we consider to be a culture change amongst our members, and it seems that some of our members use education from the group to support their clinical practice. The group has met our initial objectives and is very successful in continuing to meet these. We have plans to take the group forward and improve it, particularly as an educational resource, and initial survey responses have given us food for thought.

Database: EMBASE