Breastfeeding and weaning practices of African mothers living in North East England

PhD ThesisAbstract Breastfeeding provides optimal nutrition for the healthy growth of infants and is the highest preventive measure in reducing under-five mortality. It is also beneficial to the health of the mother and reduces maternal deaths from breast cancer. Evidence shows that mothers migrating from regions of higher breastfeeding rates, to high-income countries of lower breastfeeding rates, tend to breastfeed less the more acculturated they get to the new environment. With the United Kingdom (UK) having one of the lowest rates of breastfeeding globally, the impact of acculturation on the breastfeeding practices of Africans living in the UK has been understudied. This study aimed to investigate the breastfeeding and weaning practices of African mothers living in North East England. The first phase of this study was a systematic review of existing international literature on the breastfeeding knowledge and practices among African immigrant mothers living in high-income countries. Thirty-five studies were included in this review. The second and third phases of this study used qualitative interviews and thematic analysis to explore the breastfeeding experiences of 19 African mothers and the perception of 18 health professionals providing breastfeeding support to Africans in the UK. Pierre Bourdieu’s theory of practice was applied to interpret the findings. Three key themes were identified: breastfeeding as a culture, gathering and navigating information sources, and the essentiality of support. Key differences between the views of mothers and health professionals were observed and highlighted. Social norms and practices within the UK influence the beliefs and practices of African mothers as they are faced with conflicting opinions and suggestions regarding choices of infant-feeding. An awareness of the cultural practices of African mothers, recognising their challenges to breastfeeding in the UK and offering more intentional support including education on exclusive breastfeeding and strategies to overcome barriers is required to improve breastfeeding outcomes