Reframing the Context of the Breastfeeding Narrative: A Critical Opportunity for Health Equity Through Evidence-Based Advocacy

The individual focus of nursing research in breastfeeding: Perpetuating a neoliberal perspective

“…In the context of breastfeeding, research which focuses on addressing individual factors, such as personal goals or breastfeeding knowledge, places the responsibility for success in breastfeeding outcomes squarely on the individual's shoulders, all the while ignoring the structural factors that contribute to breastfeeding inequities in the first place (Hamilton, ) . This individual focus is compounded by the context of the free market economy supported in the United States, which gives way to formula industry interests having influence over policymakers and further aggravates the lack of political support for breastfeeding (Griswold, ) . Focusing on the individual is, as Ayo () states, a “facade as it is understood that a number of oppressive social and structural forces mediate the choices…which one is able to make” (p. 104) and undermines health equity work which, as will be discussed, nurses are called to do.…”

“…Thus, these interdisciplinary teams might include public health scholars, various health professions, those working in health policy research, and scholars in disciplines such as sociology and anthropology. Such teams, in being composed of a variety of disciplines, bring a diversity of perspectives, theories, and methodologies to the study of breastfeeding, thus yielding a powerful body of evidence in this field (Griswold, ).…”

Considering Inequities in Breastfeeding

“…Michele Griswold (2017), in our Advocacy column in this issue, summarizes this need well, stating that it "requires us to develop knowledge surrounding conditions that restrict breastfeeding across social strata and to move in the direction of a more equitable distribution of opportunities for human beings to thrive" (p. 417).…”

The CRIAA Program complex intervention in primary care to support women and their families in breastfeeding: Study protocol for a pilot trial

“…Breastfeeding is multidimensional given its biological, social, and cultural components, which are determined by the context of the lived breastfeeding experience (Asiodu, Waters, Dailey, & Lyndon, 2017; Srebro, 2017). As breastfeeding comprises a complex social system, a systemic approach is required to understand its various dimensions and how they interact (Griswold, 2017; Srebro, 2017). Therefore, although robust evidence exists about the experiences and circumstances affecting women's decision to breastfeed, a more comprehensive understanding of the complex dimensions of the process is required.…”

“…A partial view of breastfeeding and breastfeeding care misses the opportunity to address the complexities of the phenomenon (Torres, 2014). To have more impact, future interventions must address all the relevant aspects, including components that address related biological and socio‐emotional complexities, acknowledging that breastfeeding is not simply an infant‐feeding practice (Asiodu et al., 2017; Griswold, 2017; Primo & Brandão, 2017; Srebro, 2017). Additionally, such interventions must use a systematic approach to breastfeeding care, analysing current practices in the health system into which they will incorporate changes.…”