Abstract
BackgroundThe United Kingdom has one of the lowest breastfeeding rates in Europe, with the initiation and continuation of breastfeeding shown to be closely related to the mothers’ age, ethnicity and social class. Whilst the barriers that influence a woman’s decision to breastfeed are well documented, less is known how these barriers vary by the UK’s diverse population. As such, this study aimed to explore mothers’ experiences of breastfeeding and accessing breastfeeding services offered locally amongst a deprived and culturally diverse community.MethodsA qualitative interpretive study comprising of 63 mothers (white British n = 8, Pakistani n = 13, Bangladeshi n = 10, black African n = 15 and Polish n = 17) who took part in single-sex focus groups, conducted in local community centres across the most deprived and ethnically diverse wards in Luton, UK. The focus groups were audio-recorded, transcribed and analysed thematically using Framework Analysis.ResultsThe most common barriers to breastfeeding irrespective of ethnicity were perceptions surrounding pain and lack of milk. Confidence and motivation were found to be crucial facilitators of breastfeeding; whereby mothers felt that interventions should seek to reassure and support mothers not only during the early stages but throughout the breastfeeding journey. Mothers particularly valued the practical support provided by health care professions particularly surrounding positioning and attachment techniques. However, many mothers felt that the support from health care professionals was not always followed through.ConclusionsThe findings presented inform important recommendations for the design and implementation of future programs and interventions targeted at reducing breastfeeding inequalities. Interventions should focus on providing mothers practical support and reassurance not only during the early stages but throughout their breastfeeding journey. The findings also highlight the need for tailoring services to support diverse communities which acknowledge different traditional and familial practices.
Highlights
The United Kingdom has one of the lowest breastfeeding rates in Europe, with the initiation and continuation of breastfeeding shown to be closely related to the mothers’ age, ethnicity and social class
The majority of mothers irrespective of age and ethnicity had made the decision to breastfeed prior to birth. It was common among all focus groups that decisions regarding the uptake and continuation of bottle or breastfeeding were made by the almost entirely by mothers and that this decision was not influenced by the father
Confidence and motivation were shown to be key facilitators of breastfeeding; whereby mothers felt that interventions should seek to reassure and support parents during the early stages but throughout the whole breastfeeding journey
Summary
The United Kingdom has one of the lowest breastfeeding rates in Europe, with the initiation and continuation of breastfeeding shown to be closely related to the mothers’ age, ethnicity and social class. Breastfeeding has many advantages for infants and their mothers [1,2,3] with the health, nutritional, and psychological benefits widely documented [1, 4, 5] Despite these considerable benefits, the United Kingdom (UK) remains to have one of the lowest breastfeeding rates in Europe [6]. The initiation and continuation of breastfeeding have been shown to be closely related to the mothers’ age, ethnicity and social class [6, 8, 9], with highest rates found among older mothers (30+), mothers from Black and Minority Ethnic (BAME) groups alongside mothers who are more affluent and have a higher education status [8, 10]. Whilst there are a range of well-established psychological and sociocultural factors shown to influence breastfeeding[13,14,15] there is less understanding of how these vary among the UK’s increasingly ethnically diverse population
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