A meta‐ethnographic synthesis of women's experience of breastfeeding

Burns, Elaine; Schmied, Virginia; Sheehan, Athena; Fenwick, Jennifer

doi:10.1111/j.1740-8709.2009.00209.x

Cited by 110 publications

(160 citation statements)

References 81 publications

(209 reference statements)

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“…Breast-feeding in public is one of the obstacles noted in the present and other studies conducted in Mexico (9,48,49) , in the Hispanic population in the USA (50) , in migrant populations (40) and in other populations (51) . In the present study it was ranked as the third main obstacle to breastfeed (D Bueno-Gutierrez and C Chantry, unpublished results).…”

Section: Breast-feeding In Publicmentioning

confidence: 92%

‘Life does not make it easy to breast-feed’: using the socio-ecological framework to determine social breast-feeding obstacles in a low-income population in Tijuana, Mexico

Bueno-Gutierrez

Chantry

2015

Public Health Nutr.

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Objective: Breast-feeding rates reflect sociodemographic discrepancies. In Mexico, exclusive breast-feeding under 6 months of age has deteriorated among the poor, rural and indigenous populations from 1999 to 2012. Our objective of the present study was to identify the main social obstacles to breast-feeding in a low-income population in Tijuana, Mexico. Design: Qualitative study using a socio-ecological framework for data collection. Setting: Low-income communities in Tijuana, Mexico. Subjects: Mothers (n 66), fathers (n 11), grandparents (n 27) and key informants (n 25). Results: One hundred and twenty-nine individuals participated in the study: six focus groups (n 53) and fifty-one interviews among mothers, fathers and grandparents; and twenty-five interviews among key informants. Seven social themes were identified: (i) embarrassment to breast-feed in public; (ii) migrant experience; (iii) women's role in society; (iv) association of formula with higher social status; (v) marketing by the infant food industry; (vi) perception of a nonbreast-feeding culture; and (vii) lack of breast-feeding social programmes. Conclusions: Socio-structural factors influence infant feeding practices in lowincome communities in Tijuana. We hypothesize that messages emphasizing Mexican traditions along with modern healthy practices could help to re-establish and normalize a breast-feeding culture in this population. The target audience for these messages should not be limited to mothers but also include family, healthcare providers, the work environment and society as a whole. Keywords Breast-feedingObstacles Low income Socio-ecological framework Breast-feeding practices have improved in the last decades in most of Latin America (1)(2)(3) . Exclusive breast-feeding (EBF) under 6 months of age has increased greatly in Brazil, Colombia and Peru. However in other countries, such as Mexico and the Dominican Republic, prevalence of EBF under 6 months of age has decreased (3,4) . Despite improvements, only in five of nineteen Latin American countries with nationally representative data on trends in EBF over a 10-20 year period do >50 % of mothers exclusively breast-fed babies under 6 months of age (1) . Table 1 depicts rates of EBF under 6 months from Latin America including Tijuana.In the last decades, changes in breast-feeding prevalence in Latin America have shown less improvement in population subgroups whose children are most at risk for mortality and increased morbidity from not being breast-fed, such as poorly educated women with little access to health care (5,6) . In Mexico, EBF under 6 months deteriorated among the poor (33·5 % to 16·6 %), rural (32·7 % to 18·5 %) and indigenous (46 % to 27·5 %) populations from 1999 to 2012 (7,8) . Breast-feeding rates in Mexico are one of the lowest of Latin America with 14·4 % of EBF under 6 months of age (1) . Particularly in North Mexico, there is a lower prevalence of EBF under 6 months of age (10·6 %) than the national average in 2012 (4,9) . There are no data with EBF rates in...

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Section: Breast-feeding In Publicmentioning

confidence: 92%

‘Life does not make it easy to breast-feed’: using the socio-ecological framework to determine social breast-feeding obstacles in a low-income population in Tijuana, Mexico

Bueno-Gutierrez

Chantry

2015

Public Health Nutr.

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“…Second, investigations of women's experiences of breastfeeding have often paid limited attention to social context. Two meta-syntheses of qualitative studies (Burns, Schmied, Sheehan, & Fenwick, 2010;Nelson, 2006) usefully included discussion of what was and was not experienced as supportive by breastfeeding women and the difficulties of feeding in public.…”

Section: The Social Context Of Breastfeedingmentioning

confidence: 99%

Socially sensitive lactation: Exploring the social context of breastfeeding

Leeming

Williamson

Lyttle

et al. 2013

Psychology & Health

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Many women report difficulties with breastfeeding and do not maintain the practice for as long as intended. Although psychologists and other researchers have explored some of the difficulties they experience, fuller exploration of the relational contexts in which breastfeeding takes place is warranted to enable more in-depth analysis of the challenges these pose for breastfeeding women. The present paper is based on qualitative data collected from 22 first-time breastfeeding mothers through two phases of interviews and audio-diaries which explored how the participants experienced their relationships with significant others and the wider social context of breastfeeding in the first five weeks postpartum. Using a thematic analysis informed by symbolic interactionism, we develop the overarching theme of 'Practising socially sensitive lactation' which captures how participants felt the need to manage tensions between breastfeeding and their perceptions of the needs, expectations and comfort of others. We argue that breastfeeding remains a problematic social act, despite its agreed importance for child health. Whilst acknowledging the limitations of our sample and analytic approach, we suggest ways in which perinatal and public health interventions can take more effective account of the social challenges of breastfeeding in order to facilitate the health and psychological well-being of mothers and their infants.

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“…Together these form a basis for drawing conclusions that at times confirm existing understandings, and at other points challenge or push back against those in practically and theoretically important ways. The work of Bartlett (2002Bartlett ( , 2005, Schmied (Burns, Schmied, Fenwick, & Sheehan, 2012;Burns et al, 2010;Lupton & Schmied, 2013;Schmied & Lupton, 2001, Shaw (2004aShaw ( , 2004bShaw ( , 2004cShaw ( , 2005, Lupton (2012a) and Van Esterik (1989 has also informed my research through those authors' individual, woman-centred approaches.…”

Section: Approaching Bodiesmentioning

confidence: 99%

“…There is precedent for the use of a phenomenological approach, and the employment of related concepts such as subjectivity and embodiment, in feminist accounts of women's experiences of breastfeeding (Bartlett, 2002;Burns, Schmied, Sheehan, & Fenwick, 2010;Grosz, 1994, p. 209;Murphy, 1999;Schmied & Lupton, 2001Shaw, 2004a;Van Esterik, 1994). Health literature, and particularly that emerging from nursing and midwifery, also shows a trend towards ethnographic and phenomenological investigation of breastfeeding through observation and through individuals' articulation of their experiences (Bottorf, 1990;Cole, 2008;Dykes, 2005a;Dykes & Williams, 1999;Lupton, 2000;Osman, El Zein, & Wick, 2009;Quandt, 1995;Ryan et al, 2009;Schmied & Barclay, 1999;Short, 2005;Spencer, 2008).…”

Section: Approaching Bodiesmentioning

confidence: 99%

“…Further, it provided me with space and time for subsequent detailed analysis and discussion of recordings, transcripts and notes in a way that would have been difficult and unrewarding with a large cohort of women (Burns et al, 2010;Dykes, 2005a;Schmied & Barclay, 1999;Schmied & Lupton, 2010;Sheehan et al, 2003;Stearns, 1999).…”

Section: Engaging With Bodies: Recruitment Collection and Analysismentioning

confidence: 99%

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Becoming-(breastfeeding-)woman: women’s body practices and experiences at the intersection of breastfeeding, milk insufficiency, and milk sharing

Smith¹

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The breastfeeding body is a site of complex, contested, and conspicuously moralised practices that has long been a focus for research in the social sciences through to the arts and humanities. Often too the maternal, lactating body is situated within a biomedical frame that marks the milk-producing body as problematic, failing, and subject to and object of expert knowledges. In this frame, women who identify as producing "not enough milk" to feed their babies have been a significant focus.Despite this extensive attention, however, there is little research that has explored women's experiences of and body practices enacted in relation to continued breastfeeding alongside ongoing milk insufficiency, nor the act of milk sharing as a specific response to this bodily insufficiency.In this thesis, I describe and discuss my research with 13 women who have faced difficulties in breastfeeding based on a shared experience of 'chronic milk insufficiency'. I also focus on the act of milk sharing as one response to this insufficiency. Through analysis and discussion of in-depth interviews and observation, I explore how women enact and experience body practices at the intersection of breastfeeding, milk insufficiency, and milk sharing.My critical exploration of breastfeeding, milk insufficiency, and milk sharing as interrelated body practices and modes of meaning-making is informed by, and also informs, the use of a conceptual frame developed through articulation with corporeal and post-constructionist feminism, and ideas from Deleuze and Guattari's work such as deterritorialisation, complex assemblages, flows, desire, and (inter)corporeality. I employ this rhizomatic, cyborg conceptual frame to analyse women's body practices with reference to a number of Deleuzo-Guattarian thematic strands including expectations and beginnings, incorporation and avoidance, the fragmenting body and complex assemblages, creative corporeality and body extension, and becoming-(breastfeeding-)woman.In situating embodied knowledge relative to creative body practices, and highlighting the spaces between bodies and the tension between normative and resistive body practices, I disarticulate and reterritorialise a range of ideas about maternal, lactating bodies. Taken together, these support the conceptualisation of continued breastfeeding in the context of ongoing insufficient milk as a creative, resistant (inter)corporeal act. I further discuss this creative (inter)corporeality in terms of its pragmatic and conceptual implications for anthropologists and social scientists more broadly, as well as for health professionals and others working with pregnant and breastfeeding women.ii Declaration by authorThis thesis is composed of my original work, and contains no material previously published or written by another person except where due reference has been made in the text. I have clearly stated the contribution by others to jointly-authored works that I have included in my thesis.

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A meta‐ethnographic synthesis of women's experience of breastfeeding

Cited by 110 publications

References 81 publications

‘Life does not make it easy to breast-feed’: using the socio-ecological framework to determine social breast-feeding obstacles in a low-income population in Tijuana, Mexico

‘Life does not make it easy to breast-feed’: using the socio-ecological framework to determine social breast-feeding obstacles in a low-income population in Tijuana, Mexico

Socially sensitive lactation: Exploring the social context of breastfeeding

Becoming-(breastfeeding-)woman: women’s body practices and experiences at the intersection of breastfeeding, milk insufficiency, and milk sharing

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