Perceived facilitating and hindering factors to exclusive breastfeeding among Latin American immigrant women living in Colmenar Viejo (Community of Madrid, Spain)

Abstract

The way in which an infant is breastfed by a migrant woman reflects her bio‐psycho‐social circumstances and her process of cultural transformation and adaptation to the host country. Exploring facilitating and hindering factors to exclusive breastfeeding (EBF) of immigrant mothers in Spain is essential for the development of guidelines that protect EBF. The aim of this qualitative study is to explore the factors perceived as facilitating or hindering EBF during the first six months of the baby's life by Latin American women living in Colmenar Viejo, a city in the Community of Madrid (Spain). We carried out in‐depth semi‐structured face‐to‐face interviews between December 2018 and February 2019 with 11 Latin American mothers who were recruited through key informants and snowball sampling. We audio‐recorded the interviews, transcribed them, and performed content analysis to examine the data. EBF was facilitated by the mother and her family having information about its benefits, lower economic expenses, family and healthcare system support, certain popular and spiritual beliefs, and the mother's acculturation process in Spanish society. The hindering factors identified were the perception of EBF as a sacrifice, incompatible with working life, with unsightly and painful consequences for the mother, insufficient to nourish the baby and ineffective after some months, poorly supported by the broader social environment and the healthcare system. EBF was restricted by certain popular beliefs, associated with a stigma if abandoned, and linked to less economically favored social classes. Some of these hindering or facilitating factors are similar to those present in the original Latin American society or the receiving Spanish society. EBF is a complex process, with satisfactory and suffering stages, regulated by beliefs and experiences. EBF must be promoted intersectorally by governmental, health and societal actors considering the biological, psychological, social, and cultural characteristics of the mother and her community.

A systematic review of migrant women's experiences of successful exclusive breastfeeding in high‐income countries

“…It is as everything has always been, as we have been created. (Blanco & Otero García, 2022) Some migrant mothers expressed that they would extend their breastfeeding duration after noting a positive association between breastfeeding and the infant's growth (Kuswara et al, 2016;Wambach et al, 2016). Others also recognised their emotional stability and attachment with their infant was improved by breastfeeding (Kuswara et al, 2016).…”

“…They remind me that it is important, that it is the best for me and for the baby. (Blanco & Otero García, 2022) Navigating breastfeeding challenges Some mothers mentioned it was important to know how to deal with breastfeeding problems after they returned to their home country (Chen et al, 2021). They also recognised what was considered normal breastfeeding and whether formula was required.…”

“…They felt pressure to complement breastfeeding with formula, despite not feeling a necessity to do so (Blanco & Otero García, 2022).…”

“…(Zhou et al, 2020) Support from healthcare workers Migrant mothers pointed out both positive and negative influences from their HCWs in the host country (Zhou et al, 2020). Their encouragement, practical support and advice assisted their breastfeeding continuation significantly (Blanco & Otero García, 2022;Scott et al, 2016;Zhou et al, 2020). Women mentioned the necessity of their support, especially in the early postnatal period (Blanco & Otero García, 2022).…”

“…We were always with her. (Blanco & Otero García, 2022) 3.3.5 | Theme 5: Autonomy Some migrant mothers experienced conflict with their family members and HCWs. Despite this, they exerted self-determination in their decision-making with resilience and strong willpower.…”