Ethics of Care and Urban Aboriginal and Torres Strait Islander Breastfeeding beyond Three Months

Abstract

Background: Although early cessation of breastfeeding is common in Australia, as in other industrialised nations, higher proportions of Indigenous mothers cease breastfeeding in the first three months in comparison with other Australian mothers.Methods: Twenty urban Aboriginal and Torres Strait Islander mothers of infants aged 3 to12 months participated in in-depth, semistructured interviews which explored the mothers' experiences of infant feeding, and the advice and support they received from health professionals. Data were analysed thematically, using an ethics of care lens.Results: Three themes arising from the data are presented here: the impact of care on breastfeeding trajectories, relational support, and mother-centred care. Professional care was found to have a strong influence on breastfeeding initiation and duration. Caring relationships with health professionals which prioritise continuity of care and attention to mothers' and infants' specific needs build mothers' trust in their health carers and their own capacities to breastfeed and in turn facilitate positive breastfeeding outcomes. Mother-centred care in hospital, during clinic follow-up, home visits or phone calls facilitates timely identification of mothers' feeding doubts or problems and initiation of solutions to breastfeeding problems. Empathic mother-centred infant feeding care is especially important for mothers with limited support at home.Conclusion: In this research we saw that when health professionals working with urban Aboriginal and Torres Strait Islander mothers demonstrate an ethic of care, which is characterised by culturally safe, mother-centred, relational support, they can positively influence breastfeeding initiation and duration beyond three months. To support urban Indigenous mothers to breastfeed, policy and services need to embrace relational, mother-centred care.