Social and economic influences on infant and child feeding practices in a Marshallese community

Abstract

ObjectiveThe present study aimed to examine the key influences on infant and child feeding practices among a Marshallese community at each social ecological level. It is the first study to examine the key influences on infant and child feeding practices with Marshallese immigrant women in the USA and helps fill a gap in the previous literature that has included other immigrant women.DesignCommunity-based participatory research design with twenty-seven participants taking part in four qualitative focus groups.SettingThe study took place within the Marshallese community in Arkansas, USA.ParticipantsParticipants included Marshallese women with children aged 1–3 years and/or caregivers. Caregivers were defined as someone other than the parent who cares for children. Caregivers were often older women in the Marshallese community.ResultsThere were five primary themes within multiple levels of the Social Ecological Model. At the intrapersonal level, mothers’ and caregivers’ autonomy emerged. At the interpersonal level, child-led and familial influences emerged. At the organizational level, health-care provider influences emerged; and at the policy level, the Special Supplemental Nutrition Program for Women, Infants, and Children emerged as the most salient influence.ConclusionsMarshallese immigrant women’s infant and child feeding practices are influenced at intrapersonal, interpersonal, organizational and policy levels. Understanding these multidimensional influences is necessary to inform the creation of culturally tailored interventions to reduce health disparities within the Marshallese community.

Best of Intentions: Influential Factors in Infant Feeding Intent among Marshallese Pregnant Women

“…Second, participants described gender breastfeeding preference deriving from a desire to not see their female infants become upset when weaning from the breast, whereas with male infants, this was not viewed the same. Previous research with Marshallese mothers identified infant-and/or child-led feeding [34,37]. However, this is the first study to identify a gender preference in infant feeding decision making among Marshallese or other Pacific Islander women.…”

“…Arkansas has the largest population of Marshallese living in the continental US (~14,000 people) [26][27][28][29][30]. Marshallese culture is matriarchal and collectivist, with immense value placed on motherhood [31][32][33][34][35][36]. Now that the Marshallese community has migrated to the US, their maternal culture has been disrupted, affecting reproductive life planning, pregnancy, birth, and especially their infant feeding behavior and experiences [31][32][33][34][35][36][37].…”

“…Marshallese culture is matriarchal and collectivist, with immense value placed on motherhood [31][32][33][34][35][36]. Now that the Marshallese community has migrated to the US, their maternal culture has been disrupted, affecting reproductive life planning, pregnancy, birth, and especially their infant feeding behavior and experiences [31][32][33][34][35][36][37]. However, due to the aggregation of Pacific Islanders with other Asian groups, there are little-to-no statistics on health behaviors such as exclusive breastfeeding for Pacific Islander subgroups such as the Marshallese [38][39][40][41].…”

Dietary Practices during Pregnancy in a Marshallese Community: A Mixed Methods Analysis

“…This level of food insecurity among pregnant women is much higher than it has been documented in other populations [ 30 , 31 , 32 ]. The previous qualitative literature with the Marshallese in Arkansas has identified a strong desire for both healthy and traditional foods and financial barriers to obtaining them [ 19 , 33 ]. This is the first article to document this qualitative concern among pregnant Marshallese and the first study among pregnant Marshallese to document the high level of food insecurity risk using Hager et al’s 2-item screening measure [ 34 ].…”

“…This type of research is uniquely suited for engaging indigenous and/or immigrant populations. As part of the CBPR collaborative, the research team has spent the past six years meeting with Marshallese community members to determine and prioritize the community’s primary health concerns [ 17 , 18 , 19 , 20 , 21 ]. Maternal health was identified as a top priority.…”