What influences infant feeding decisions for Māori mothers aged 15-24 years?

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Gosman, Helen
Author ORCID Profiles (clickable)
Master of Nursing
Eastern Institute of Technology
Manhire, Kathy
Pool, Leanne
Wepa, Dianne
Masters Thesis
Ngā Upoko Tukutuku (Māori subject headings)
New Zealand
Māori mothers
Māori infants
decision making
Gosman, H. G. (2015). What influences infant feeding decisions for Māori mothers aged 15-24 years? (Unpublished document submitted in partial fulfilment of the requirements for the degree of Master of Nursing). Eastern Institute of Technology (EIT), New Zealand.
The vast evidence that supports the profound benefits of breastfeeding for infant and maternal health are reportedly well known by mothers and health professionals alike. Yet in New Zealand [NZ] nationally collected statistics show breastfeeding rates continue to fall well short of Ministry of Health [MOH] national targets. These targets are guided by The World Health Organization [WHO] recommendations (National Breastfeeding Advisory Committee of New Zealand, 2009). It is of concern that lower breastfeeding rates for Māori are consistently reported compared with non-Māori. Despite considerable investment into resourcing nationally for breastfeeding promotion and support, there has been no improvement in breastfeeding outcomes for Māori over time (Royal New Zealand Plunket Society, 2010). This is particularly concerning as poor breastfeeding rates are contributing to health inequity for Māori (Hawke's Bay District Health Board, 2010). This research project seeks to develop an understanding of the factors that influence the infant feeding decisions of Māori mothers aged 15-24 years. A qualitative, descriptive, research design using thematic analysis was chosen to best capture the women’s experiences. A purposive sample of 11 women who met the inclusion criteria, which was defined as mothers aged between 15-24 years with a child/children aged from birth to 24 months who had experienced nutritive breastfeeding (at least one experience). Qualitative data was derived from nine interviews using a template of semi-structured questions over a three-day period in November and December 2014. All participants were offered the option of focus group or individual interviews and their choice of location. Thematic analysis using Bryman’s (2008) four-stage method was applied and four key themes were identified. The four themes identified were: breastfeeding as natural, easy, normal and healthy; breastfeeding support is crucial especially in the early stages; knowing it’s best and being determined despite adversity; and making the decision to introduce infant formula or stop breastfeeding. The overarching finding revealed that the expectations of breastfeeding were often very different to the reality of the breastfeeding experience. Though the women’s intention to breastfeed and the breastfeeding initiation rate was high, for many, early breastfeeding experiences were marred with unexpected difficulties that impacted on the initial feeding choice and future infant feeding practices. Breastfeeding support received in the first six weeks was critical to breastfeeding outcomes. Whānau and partners were a significant influence on the women’s initial and subsequent infant feeding decisions and were often sought when experiencing breastfeeding difficulties. Recommendations include: the involvement of whānau and partners in all aspects of breastfeeding education and support; mandatory breastfeeding education for health professionals working with pregnant woman and mothers; consultation at a community level with strong Māori representation to identify breastfeeding realities, bright spots, issues, and potential solutions that are realistic, meaningful, and achievable; increased availability and access to skilled health professionals to provide quality breastfeeding support, particularly when establishing breastfeeding and throughout the first six months; and the development of a complete breastfeeding database which includes a range of information on all breastfeeding women in NZ, including maternal age.
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