Barriers and enablers of breast-feeding protection and support after the 2017 earthquakes in Mexico

Abstract

Objective: To study the barriers and enablers of breast-feeding protection and support after the 2017 earthquakes in Mexico. Design: A qualitative study using a phenomenological approach to analyse data collected from in-depth interviews, virtual ethnography and documentary analysis of newspapers. Setting: Data were collected after the September 2017 earthquakes in Mexico (from 8 September 2017 to 15 May 2018). Participants: The participants included key informants (n 13) from different sectors. Postings retrieved from forty-two Facebook and forty-seven Twitter accounts and a WhatsApp group informed the virtual ethnography analysis. Newspaper material covering the 2017 earthquakes in Mexico (seven newspapers) was retrieved for the documentary analysis. Results: Interviews with key informants revealed a lack of knowledge, unclear institutional protocols during emergencies and lack of enforcement of existing international frameworks. The virtual ethnography uncovered a strong call for donations in the immediate aftermath of the earthquakes, and generalized donations of formula revealed a tense relationship between actions taken by breast-feeding experts and the negative reactions from the government and citizens. This analysis highlights the relevance of pre-existing networks of experts in protecting and supporting breast-feeding. From the newspaper documentary analysis, similar themes emerged. Conclusions: This study identified key barriers and enablers in the protection and support of breast-feeding during the 2017 earthquakes in Mexico. Relevant actors should embrace the lessons highlighted in this study because countries such as Mexico are likely to experience other emergencies in the near future.

Breastfeeding media coverage and beliefs during the COVID-19 pandemic in Mexico: implications for breastfeeding equity

“…This finding is consistent with findings from studies in other regions during the same period, which show that BMS companies are capitalizing on fear of breastfeeding during the pandemic to market their products [ 59 ]. Such strategies to promote and distribute BMS during emergencies such as earthquakes [ 60 , 61 ] and tsunamis [ 62 ] have been documented internationally [ 63 ]. Together, this evidence highlights that governments and international organizations need to step in to regulate BMS donations and guard mothers and infants against unnecessary promotion and distribution of BMS, which often reaches the most vulnerable populations.…”

“…For example, while the Mexican Government published clear guidelines that adhered to WHO recommendations, there were no targeted communication efforts to disseminate the key practices through traditional media platforms, hence, limiting the implementation at the clinical level. Finally, as highlighted in prior studies during crises and emergencies [ 60 ], governments need to have clearer protocols on how to enforce and monitor the protection and support of breastfeeding when such events arise.…”

Infants exposed in utero to Hurricane Maria have gut microbiomes with reduced diversity and altered metabolic capacity

“…Our study supports a protective effect of breastfeeding on the infant gut microbiome, specifically during a natural disaster. Since breastfeeding practices are largely impacted by inadequate disaster responses and subsequent barriers and challenges that mothers face during disasters, further studies and interventions are needed to understand, protect, and support breastfeeding during natural disasters ( 80 , 81 ). A previous study reported that gut microbial alterations in infants exposed to prenatal depression were dependent on breastfeeding, although alterations in infant gut immunity, such as impaired secretory IgA levels, were universal and independent of the feeding type ( 28 ).…”

Breastfeeding Media Coverage and Beliefs During the COVID-19 Pandemic in Mexico: Implications for Breastfeeding Equity.

“…Such strategies to promote and distribute BMS during fragile circumstances such as earthquakes (47,48) and tsunamis (49), have been documented internationally (50). Prior evidence highlights that governments and international organizations need to step in to regulate such donations and guard mothers and infants from unnecessary promotion and distribution of BMS that usually reaches the most vulnerable.…”