Shannon McGill-Randall: Infant Feeding Lead

Shannon McGill-Randall is a Band 7 Infant Feeding Coordinator and part-time community midwife. At the time of writing, she is 3 years into being qualified. I love Shannon’s ability to use midwifery to live the way she wants to, it’s impressive and heartening.

Was it always your plan to work in lactation support?

Initially, I was into mental health support and wanted to go down that route, and I always thought I wanted to go into management at some point. In terms of breastfeeding support, there’s actually a lot to consider in terms of mental health. For instance, my brother was born prematurely, he was a NICU baby, and though my Mum breastfed me for 6 months, she couldn't feed him, which must have been really tough. I have a soft spot for going up to neonatal and supporting families there.

You’ve done really well in a short space of time, any advice on career progression?

Just take every opportunity that's given to you. I qualified in Oxford, and then I moved down to South West to do my preceptorship. So I moved trust, did a rotational year and worked with lots of different people. Really get yourself out there and I think just be open and honest with it. And if things are hard and you’re struggling and you need more staff, or whatever's going on, just say it, tell management.

Did you come from South West originally?

No, it was just somewhere I wanted to live! The trust advertises about once a year. They tend to employ those that are trained here, it’s the catchment area for the newly qualified staff. So it can be a bit competitive to get in. But I always think with interviews, if you go in thinking I'm not going to get it, you're not going to perform well, and you won't get it because you don't feel you deserve it. Make sure you go into the interview with a positive mindset.

Any other tips for interviews?

I played loads of really good music beforehand, that puts me in a really good mood. Also, wear good underwear. And just believe that you can do it. There’s absolutely no reason why you can’t do whatever job you want. Have self-confidence.

What kind of preparation did you do before the interview for your current role?

I’d had an initial discussion with the current feeding team coordinator at the time and said, Oh, I'd be really interested in doing this. A lot of people feel really underconfident with supporting infant feeding, I’d love to help develop some training. We'd recently taken on loads of new support workers who I knew felt underconfident with supporting families, and we were coming out with big weight losses and finding re-feeding to be a challenge. I kept thinking this is not okay, I want to do something to change it.

And so the infant feeding lead from that time said to me, brilliant, we're looking for someone in the team. I thought I’d keep an eye out for a job to come up and I hoped to go in as a Band 6 specialist and see what I could do.  And then she contacted me and said I've got a job coming up soon.

I was a little concerned because I still wanted to do a bit of community, I didn’t want to completely deskill. But I was also very interested. Then I realised that the job role was for Band 7 and I thought yeah, I can’t do that, but I went for it just in case.

I asked a friend of mine who was applying for a delivery suite coordinator role, What’s the difference between Band 6 and Band 7 interviews? What do I need to know? And then I spoke to one of the matrons and asked, Is there anything you can do to give me a heads up in terms of governance? But she never got back to me before the interview, so I just did loads of research. I looked into Baby Friendly, what was going on nationally, and then I looked at the statistics here in South West, you know, what are our rates? What’s going on at 6 weeks postnatally? Where is it that we need to make improvements? That all helped.

Breastfeeding and chestfeeding can be quite political subjects, and staff and clients feel strongly about them. How do you go about making changes in a trust, bringing in your passion for the subject but also being supportive?

It’s about being aware that especially if your team has been very short staffed, you need to respect the team and what they’ve already achieved. I think that it helps that I still work part-time in the community, which means I notice things. I can ask, could you help me understand why this is happening? And you can get your information by trying to expand your knowledge, rather than saying, why are you doing it this way? It’s wrong.

There is a framework as well. Each year your trust will get assessed on the UNICEF Baby Friendly standards. If you get your UNICEF standard, then you can go for the Gold Award. There are different things that standard means but part of it is about doing all your training in house and making sure culture and leadership are working well.

One of the problems in this area is that clients can feel quite pressured about feeding choices, do you have any advice?

I think be really open-minded. Because you might meet someone that's really passionate about breastfeeding and really wants to do it, but when their baby arrives actually, they don't want to do it at all and it's awful. It's just being mindful that that's okay, that's absolutely okay. Or the other way is that you meet someone and they really don't want to do it, no inclination at all and then baby arrives and they say I’ll give it a go and oh my gosh, it turns out to be amazing. They might feel now I don’t know what I’m doing because I didn’t want the information before. And it’s about being really kind and understanding that it’s not just feeding, there’s so much more that will be going on under the surface, maybe a friend or family member will have said something to them, or it could be their partner...be really passionate but also open-minded, don’t overload people with information, just drip-feed. You can ask what about skin to skin? and then mention the benefits. Small doses. And I think the same with midwifery colleagues as well, it's doing it in a kind way and saying, oh, do you know about this? There's some new research, would you like to read it? And that way, you can pass the knowledge on without saying to someone, you're doing it wrong.

Going back to when you were a student, how were you at both the practical and academic parts of training?

I started my career as a Maternity Care Assistant. I found being with people and supporting feeding to be really great, I could manage that side of it. But I struggled with some of the essays. I never failed them but I came close on a few. I think that was because sometimes if I can’t link it to practice, then I don’t get what I’m trying to write about. I’m also very last minute, I have to have the pressure of a deadline being like, right now.

So just because you're not terribly into the academic side, doesn't mean you can't take a management role? Or otherwise usefully get the research out there.

Yeah, completely. I'm the first person in my family to go to uni, my Mum never went, and she was our single parent. My family were asking How do we support you? Because they never did it. They didn't know. Which is maybe a big thing. There’s no one to ask, I really need to get this essay done, and I don't know what I'm doing with it, any advice?

They call it the ‘hidden curriculum’ that some students get from home, don’t they. How did your dissertation go?

Ah, yeah. I did it on mindfulness. There was an embedded mindfulness programme that they had in Oxford, which was targeted at vulnerable families. They had a  drop-in session once a month, and they would do 30 minutes of mindfulness with these families, teach them about mindfulness walking, and the three-minute body scan. For my dissertation, I audited it, and went to the families, and asked how they felt about it. It was really cool.

I also can link that experience to my current role. Mindfulness definitely works in terms of infant feeding because if you've got someone with a baby that's reluctant to feed and the parents are thinking oh my goodness, this is just not happening, they’re feeling loads of emotions and you can just get them to calm a little bit. Have a moment, it calms them down, and calms baby down. It works really well.

You seem like a really confident person, do you have any advice for students or newly qualified midwives who are feeling less confident?

Definitely. I am the first to admit I hated working on Labour Ward to begin with, I just didn't want to be there. I don’t know if it was because when I was a support worker, I just felt invisible. And so I thought as a student I’d have the same experience. But then I said to myself this could be horrendous, but I’ve just got to open my mind and get rid of all my preconceived ideas. Then I had a really amazing mentor and it flipped it around.

Can you tell me about supporting informed decision making and client autonomy in terms of infant feeding, especially coming from a management point of view?

It's really interesting, isn't it.? I think the biggest informed choice issue in terms of feeding is when you've got a baby that's lost loads of weight. Looking at it from a clinical point of view, you think, your baby's dehydrated, they're not going to thrive. Therefore, we need to do something about that... sometimes it can help to say, I’m not suggesting supplementation to follow the guidance, I’m saying it because I truly want the best for you and your baby.

It’s also about listening. I’ve looked after clients who have been admitted for the baby and they ended up not being listened to, despite having pain while feeding and feeling uncomfortable. And one time a client ended up having a breast abscess due to mastitis because no one was listening. We have to address cultures where clients are not listened to.

Do you have any advice on advocating for LGBTQ+ families in terms of lactation support?

In my interview to get this position, the question from the Maternity Voices Partnership representative was about supporting LGBTQ+ families, particularly how a non-birthing parent would initiate lactation to feed a baby. I’m really big into supporting this. I cared for a same-sex couple when I was case loading and I look after quite a few families down here in South West. You just ask about feeding choices, what they want to do and how best we can offer support, as well as the language they’re most comfortable with. At the moment we’re revamping all the leaflets and our staff training, particularly changing all the language so everything says feeding partner and feeding parent, adding words like partners and carers and chestfeeding. We’ve gone through everything to make it very inclusive, which is fantastic.

Do you have any suggestions of resources students and newly qualified midwives could use to improve their chestfeeding and breastfeeding support?

Looking at all the UNICEF stuff is really good. Have a look at their PSR, the Practical Skills Review forms. This is what trusts should be trying to do, giving everyone time to look at the checklists, which will help you assess your competence. And also, Amy Brown’s The Positive Breastfeeding Book is amazing. Have a read of that and also the Pinter and Martin books, Why Breastfeeding Matters and Why Tongue-tie Matters. And you can get involved with local feeding groups. For instance, where I’m based, we have a community centre that is linked with the Navy families, and they meet every Monday, it’s a two-hour feeding support group. I’d message a group like that and say can I come along for an hour or so because if you sit down and drink a cup of tea, you’ll be watching and listening. It’s about getting that exposure and experience, and you might have to do that off your own back though you might also be able to include it in placement hours. It’s actually the kind of thing that looks great on a personal statement for a job.