Abstract

The development of a breastfeeding coalition: activating breastfeeding support systems that acknowledge and disrupt systems of oppression

Bi-sek Hsiao, PhD¹, Bi-sek Hsiao, PhD², Lindiwe Sibeko, PhD² (1)University of Massachusetts Amherst, (2)University of Massachusetts Amherst

APHA 2022 Annual Meeting and Expo

There is growing awareness of the impact of racism and discrimination on breastfeeding practice, yet most breastfeeding promotion activities do not address the roots of oppression. I follow the creation and development of a breastfeeding coalition in northeastern, U.S., to gain understanding of the processes and activities involved in supporting breastfeeding, particularly for African-heritage women and their families. I also explore women’s experiences during the perinatal period to understand the contexts of caring for their babies, and factors influencing infant feeding practices. Using a community-engaged, political activist ethnographic approach, I engage in the collaborative efforts of the coalition and investigate ways that the coalition acknowledges and responds to histories and systems of oppression (e.g., slavery, formula company monopolization, expert-driven and patriarchal healthcare systems) that may influence infant feeding decisions among African-heritage women. Data collected reflect an early stage of an ethnographic study that integrates over 70 hours of participant observations, 5 interviews, and document analysis. Interviews, field notes, and meeting notes were analyzed using thematic analysis with a grounded theory approach, facilitated by NVIVO software. Preliminary analysis shows the coalition’s commitment to disrupting histories and systems of oppression in at least four key ways: 1) building relationships in support of breastfeeding; 2) seeking out voices and experiences of African-heritage women related to breastfeeding; 3) sharing statistics on Black infant mortality and shedding light on challenges to breastfeeding that have not been previously known by community members; and 4) strategizing a culturally-informed system of care that bridges community and hospital services. This study brings new insight on the power dynamics of breastfeeding promotion, and the potential of community activism to support breastfeeding among marginalized groups. Findings can be used to guide structural and policy changes needed in communities and in healthcare systems to better promote breastfeeding.