Abstract
BackgroundStudies report mixed findings about rates of both exclusive and partial breastfeeding amongst women who are migrants or refugees in high income countries. It is important to understand the beliefs and experiences that impact on migrant and refugee women’s infant feeding decisions in order to appropriately support women to breastfeed in a new country. The aim of this paper is to report the findings of a meta-ethnographic study that explored migrant and refugee women’s experiences and practices related to breastfeeding in a new country.MethodsCINAHL, MEDLINE, PubMed, SCOPUS and the Cochrane Library with Full Text databases were searched for the period January 2000 to May 2012. Out of 2355 papers retrieved 11 met the inclusion criteria. A meta-ethnographic synthesis was undertaken using the analytic strategies and theme synthesis techniques of reciprocal translation and refutational investigation. Quality appraisal was undertaken using the Critical Appraisal Skills Programme (CASP) tool.ResultsEight qualitative studies and three studies reporting both qualitative and quantitative data were included and one overarching theme emerged: ‘Breastfeeding in a new country: facing contradictions and conflict’. This theme comprised four sub-themes ‘Mother’s milk is best’; ‘Contradictions and conflict in breastfeeding practices’; ‘Producing breast milk requires energy and good health’; and ‘The dominant role of female relatives’. Migrant women who valued, but did not have access to, traditional postpartum practices, were more likely to cease breastfeeding. Women reported a clash between their individual beliefs and practices and the dominant practices in the new country, and also a tension with family members either in the country of origin or in the new country.ConclusionMigrant women experience tensions in their breastfeeding experience and require support from professionals who can sensitively address their individual needs. Strategies to engage grandmothers in educational opportunities may offer a novel approach to breastfeeding support.
Highlights
Studies report mixed findings about rates of both exclusive and partial breastfeeding amongst women who are migrants or refugees in high income countries
One mother in Choudhry and Wallace’s study in the UK explained, ‘When I lived in Pakistan my mum always encouraged me to breastfeed my baby but after I got married and came here I was told something different by my mother in law’ [14, p.80]. Another woman stated, ‘my parents advised that I should breastfeed but I found it really hard to fit into my life and the things I have to do around the house, like housework and looking after my mother in law’ [14, p.80]. In this meta-ethnographic study we have synthesised the findings of 11 studies reporting qualitative data on the breastfeeding experiences and practices of migrant and refugee women living in a high income, English speaking host country
Conclusion the WHO recommends exclusive breastfeeding to six months [1], studies report mixed findings regarding the rates of both exclusive and partial breastfeeding amongst women who are migrants and refugees in high income countries
Summary
Studies report mixed findings about rates of both exclusive and partial breastfeeding amongst women who are migrants or refugees in high income countries. The aim of this paper is to report the findings of a meta-ethnographic study that explored migrant and refugee women’s experiences and practices related to breastfeeding in a new country. Cross sectional surveys [15,20,21] and prospective cohort studies [5,22] have identified factors associated with breastfeeding initiation and duration amongst recent migrant and refugee women. Traditional postpartum beliefs and practices are commonly reported as influencing continued breastfeeding to six months after birth [13,30,31]
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