Published: 5 November 2015

Becoming an Expert: Vicky Fallon on maternal and infant health

Vicky Fallon

Vicky Fallon is a PhD student in the Institute of Psychology, Health and Society:

“I started my psychology degree a little later than most following a few years of trying and failing to find the right career path. During my degree I gave birth to my two children Sophie (aged 5) and Lucy (aged 4). I already had a broad interest in health psychology and experiencing pregnancy and motherhood while studying for my BSc directed my research interests further. I developed a particular focus for my research in maternal mental health, and its significance to maternal and infant health outcomes.

“I graduated in 2012 with a first class BSc (Hons) in Psychology and was extremely fortunate to enrol straight onto a PhD with Dr Jo Harrold, an expert in infant feeding and appetite, as my primary supervisor. Our combined interests led to a research proposal examining the impact of maternal mood on infant feeding.

“The perinatal period is renowned as a time of heightened vulnerability to negative mood changes, with well documented health consequences for both mother and infant. However, the majority of maternal mental health research has traditionally been driven by postnatal depression. The need to widen the focus from postnatal depression to other key dimensions of maternal mood and wellbeing is essential in obtaining a comprehensive view of how maternal mental health impacts on infant outcomes across the transition from pregnancy to parenthood.

“Predominately due to high comorbidity with depression, maternal anxiety has been somewhat overlooked in the literature.  However, limited available evidence suggests that even at subclinical levels and independent of comorbidity of depression, maternal anxiety in pregnancy and the postnatal period leaves infants vulnerable to a variety of adverse outcomes, including infant feeding.

“Feeding is a reciprocal process that depends on the abilities and characteristics of both the mother and the infant. The first six months of life provides a critical window of opportunity for ensuring children’s appropriate growth and development through optimal feeding practices, namely exclusive breastfeeding. Despite this, many mothers have difficulties achieving current breastfeeding guidelines.

“Research has shown that women with depressive symptoms may be at increased risk of negative infant feeding outcomes with heightened susceptibility to decreased breastfeeding initiation, duration, and self-efficacy.  Despite this, little is known about the relative contribution of maternal anxiety. Available research indicates that elevated levels of anxiety may be related to a reduced likelihood of breastfeeding. However, results are inconsistent and not all studies report an effect. A better understanding of potentially modifiable psychological factors such as anxiety could lead to clinical and policy changes which may help to improve breastfeeding rates.

“Methodological inconsistencies have also delayed a clear understanding of the mechanisms behind the relationship. For instance, many of the primary symptoms associated with maternal anxiety have been independently implicated in suboptimal feeding outcomes which suggest that anxiety influences breastfeeding. However, contact with infants is also known to be anxiolytic and some have attributed this reduction in anxiety to the physical act of breastfeeding.

“This leads to further questions about the directional nature of the relationship. Does anxiety influence breastfeeding? Or does breastfeeding influence anxiety? The likely answer is both, but to what degree remains unclear.

“My research aims to provide a more comprehensive understanding of the impact of maternal anxiety on infant feeding across the transition from pregnancy to parenthood.

“I have just published my first piece of work, which is a systematic review of the literature concerning prenatal anxiety and infant feeding outcomes. I also have another baby on the way and it has been particularly insightful researching an area in which I could fit the profile of both researcher and participant. I believe that my personal experiences have provided me with valuable knowledge and worthy insight into my field. It really is a privilege to embark on a professional career researching a topic of such personal significance.”

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