The unique challenges of working in infant feeding
Burnout, Moral Injury or Vicarious Trauma?Understanding What You're Really Feeling in Infant Feeding Work
If you work in infant feeding, you already know the feeling. The tenth time this week that you are seeing a woman at breaking point, and if only she had the right advice a week ago, so much could have been prevented. The Sunday night dread. The frustration at the maternity system not working for the women you are seeing.
We tend to reach for one word for it all: burnout. Maybe we just see it as the cost of working in the NHS, or hope that working independently may solve it. But three distinct things may be going on, and we need to understand and respond to each differently.
1. Burnout
A chronic mismatch between demands, resources and values, leading to depletion.
In infant feeding, this is fuelled by a very particular set of pressures: unrealistic expectations, feeling personally responsible for outcomes, a lack of time set against the genuine complexity of families' needs, and constant exposure to distress.
What it looks like:
Emotional exhaustion
Detachment
A reduced sense of accomplishment
2. Moral injury
Feeling forced to act in ways that conflict with deeply held values, or witnessing harm and being unable to prevent it.
If you've ever known exactly what care a family should have received and been unable to provide it, you've felt this. It's there when you support families through distress caused by systemic gaps beyond your control. It's there when a policy conflicts with your professional ethics, or when you feel pressured to "sell" a choice instead of genuinely supporting a family's autonomy.
The tell with moral injury is that rest doesn't fix it. A holiday helps burnout. It does very little for the feeling that you were made to betray your own values.
What it looks like:
Anger at systems or leadership rather than at the work itself
Feeling complicit in harm you didn't cause and couldn't prevent
A sense of betrayal by an employer, a policy or a profession
Guilt and shame: "I failed them"
3. Vicarious trauma
The cumulative impact of witnessing or holding other people's trauma, grief and distress.
When we empathise, we imagine, and to some degree we relive. Your nervous system doesn't fully distinguish between the threat you face and the threat you're imagining on someone else's behalf.
As an infant feeding professional, you are exposed to repeated stories of trauma, supporting parents who feel they failed or were failed (or both), bearing witness to preventable harm, and holding the distress of families retraumatised by the wider maternity system.
What it looks like:
Heightened emotional reactivity
Feeling heavy or affected by stories after the session has ended
Changes in your worldview
Intrusive thoughts and images
Burnout, moral injury and vicarious trauma are not personal failings. They are expected outcomes of caring work under pressure.
They tell you something about the conditions you're working in, not something shameful about your capacity.
And the responsibility can't be on you to fix understaffing, unrealistic caseloads or policy conflicts by becoming more and more resilient. At the same time, you do need to protect yourself. Both things are true.
What can you do with this?
Take a moment to notice:
Which of these three concepts resonates the most with you right now?
Where do you feel it in your body?
What does it make you want to do?
If what surfaced was moral injury, the work is likely about values and boundaries. If it was vicarious trauma, it's about processing and support. If it was burnout, it's about demands and resources.
Training for infant feeding professionals
We offer a half-day accredited training workshop, A Compassion-Focused Approach to Wellbeing and Burnout in Infant Feeding Professionals, which you can book individually or arrange for whole staff teams to attend together. Please don't hesitate to get in touch to arrange this.
Dr Kelsey O'Reilly is a Consultant Clinical Psychologist and founder of Breastfeeding Psychology, supporting women's mental health during and after breastfeeding challenges, and offering training, supervision and consultation to infant feeding professionals.
