The Good milk: A mixed methods approach to understanding the infant feeding outcomes, influences and experiences of Indian, Pakistani and Bangladeshi mothers living in the United Kingdom

    Student thesis: Doctoral ThesisDoctor of Philosophy

    Abstract

    Background / Aims
    Breastfeeding has significant short and long-term effects on the health and development of the child and the mother’s health. Little contemporary research exists on the infant feeding outcomes, influences and experiences of Indian, Pakistani and Bangladeshi (IPAB) mothers. The thesis aimed to describe the (a) breastfeeding outcomes (b) antenatal/postnatal factors associated with infant feeding amongst IPAB mothers (c) understand the influences on infant feeding choices (d) and the infant feeding experiences and practices of IPAB mothers and grandmothers living in the United Kingdom (e) and to define the next steps for intervention development to support optimal breastfeeding amongst IPAB mothers.

    Method
    A mixed methods approach was adopted. Aims (a) and (b)were addressed via a secondary analysis of the 2010 Infant Feeding Survey. A scoping review of the existing literature addressed aim (c). Qualitative interviews were conducted to address aim(d). Aim (e)was addressed by describing existing interventions available and recommendations were made about the next steps for designing a suitable intervention to meet the needs of the above sub-groups using the REPLACE framework.

    Results
    The secondary analysis highlights that lower proportions of Pakistani and Bangladeshi mothers breastfed at week one and six postpartum compared to Indian mothers. The scoping review shows that discarding colostrum and administering prelacteal feeds are practised amongst IPAB mothers. The qualitative data showed that mothers and grandmothers were unaware of colostrum and its benefits. Mothers’ bottle fed in response to feelings of helplessness and needing to ‘get the baby used to the bottle’. Pardah (Modesty) was a major barrier to breastfeeding. The REPLACE framework shows promise in addressing socially and culturally ingrained messages about infant feeding that may deter mothers from optimally breastfeeding their babies.

    Conclusion
    This novel, mixed method approach has demonstrated that varying outcomes exist amongst IPAB mothers living in the UK. Significant social, cultural and psychological barriers to exclusive breastfeeding exist within a conflicting context that teaches mothers that breast is best but encourages practices such as discarding colostrum and prelacteal feeds which harm breastfeeding. Messages about preserving the mother’s modesty and beliefs that the baby should get used to the bottle hinder mothers’ abilities to breastfeed. Interventions will need to engage with the wider communities to minimise the impact of these practices and beliefs and create supportive environments for mothers to feed their babies.
    Date of Award2018
    Original languageEnglish
    Awarding Institution
    • Coventry University
    SupervisorNaomi Bartle (Supervisor), Marylyn Carrigan (Supervisor), Susan Law (Supervisor) & Elizabeth Grunfeld (Supervisor)

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