Breastfeeding practices 2008–2009 among Chinese mothers living in Ireland: a mixed methods study

Abstract

Background: Migration to another country has a potential influence on breastfeeding practices. A significant difference in breastfeeding rates between Irish nationals and non-nationals has been reported. This study was conducted to explore breastfeeding practices of the Chinese in Ireland, one of the largest Irish ethnic groups, and to explore the influence of living in Ireland on breastfeeding practices. This is the first and the only migration study so far on breastfeeding practices among the Chinese in Ireland. Methods: A sequential explanatory mixed methods approach was adopted. The first phase was a cross-sectional self-administered retrospective mailed survey, to explore breastfeeding practices and determinants of breastfeeding among a convenience sample of Chinese mothers living in Ireland (n = 322). Recruitment was conducted in the Dublin metropolitan area, with the application of the snowball technique to increase sample size. The second phase consisted of seven semi-structured focus groups (n = 33) conducted in Dublin, to explore the influence of living in Ireland on breastfeeding among Chinese mothers who had given birth in Ireland. Quantitative data were analyzed by univariate and multivariate logistic regression analyses, and informed the qualitative data collection. Qualitative data were analyzed by thematic content analyses, to explain and enrich the qualitative results. Results: The breastfeeding initiation rate among Chinese immigrants to Ireland who gave birth in Ireland (CMI) (75.6%) was high and close to that of Chinese immigrant mothers who gave birth in China (CMC) (87.2%). However, giving birth in Ireland was independently associated with a shorter duration of breastfeeding (< 4 months) among Chinese immigrants. Qualitative results explained that a shorter breastfeeding duration among CMI than that of CMC was mainly due to cultural conflicts, a lack of family support, language barriers, immigrants' low socioeconomic status, and mothers' preference for infant formula on the Irish market. Both quantitative and qualitative data revealed a strong cultural belief in the efficacy of the traditional Chinese postpartum diet for breast milk production for both CMC and CMI. Antenatal feeding intention was a strong determinant for breastfeeding initiation and duration among CMI. Conclusion: Migration to Ireland was found to be associated with a shorter duration of breastfeeding of the Chinese. Culturally sensitive and language-specific education and support of breastfeeding is needed for the Chinese mothers living in Ireland. The mixed methods design presented here might serve as a template for future migration research on breastfeeding.

How to promote exclusive breastfeeding in Ireland: a qualitative study on views of Chinese immigrant mothers

“…The interviews were conducted by the researcher QZ, the key investigator of this study, and the Ireland Chinese Mothers Survey [18,19]. She was a female doctoral student in public health nutrition at the time of the study.…”

“…Participants met the following criteria were included into the Ireland Chinese Mothers Survey (n=322) [18,19]: 1) Chinese women who were born in China (including Hong Kong and Macau); 2) had given birth to at least one child; 3) had been living in Ireland for more than six months at time of the interview. Participants from the Ireland Chinese Mothers Survey were invited to take part in this study if they had given birth and breastfed successfully for over six months, with exclusive breastfeeding for four to six months in Ireland.…”

“…However, Nolan and Layte reported a 'healthy immigrant' effect that breastfeeding rates of immigrant mothers decreased signi cantly and tended to be similar to that of Irish-born mothers with the increase of immigration time [16]. The Ireland Chinese Mother Survey found that although Chinese immigrants had a high breastfeeding initiation rate (75.6%) and any breastfeeding rate (87.2%), only 5.8% of mothers exclusively breastfed for six months [18,19].…”

How&nbsp;to promote exclusive breastfeeding in Ireland:&nbsp;a qualitative study&nbsp;on&nbsp;views of&nbsp;Chinese&nbsp;immigrant&nbsp;mothers&nbsp;&nbsp;

“…In Ireland, the Chinese population is estimated at 60,000, and is potentially the largest (if not the second largest) minority ethnic community in Ireland [19,20].From 2011 to 2016, Chinese immigrants in Ireland increased by 9.1%, which represented the largest increase among all Asian groups [21].A study using the Growing up in Ireland cohort of 11,092 mother-infant dyads found that although 91.5% Chinese immigrant mothers initiated breastfeeding, only 31.5%of infants werestill breastfed at nine months old [22]. Similarly, the Ireland Chinese Mother Surveyinvolving 322 Chinese immigrant mothers found that although Chinese immigrants had a high breastfeeding initiation rate (75.6%) and any breastfeeding rate (87.2%), only 5.8% exclusively breastfed for six months [23,24]. Given the rapidly growing Chinese immigrant population in Ireland and the low exclusive breastfeeding rates, there is a need to develop effective interventions and formulate a comprehensive strategy to promote exclusive breastfeeding among Chinese immigrants in Ireland.…”

How to promote exclusive breastfeeding in Ireland: a qualitative study on views of Chinese immigrant mothers

“…Although China has a breastfeeding culture, exclusive breastfeeding rate at six months were only 20.8% in China in 2013 [17]. The Ireland Chinese Mother Survey found that although Chinese immigrants had a high breastfeeding initiation rate (75.6%) and any breastfeeding rate (87.2%), only 5.8% of mothers exclusively breastfed for six months [18,19].…”