A biographical narrative exploration of infant feeding in an area with low breastfeeding rates

Gallagher, Justine (2022) A biographical narrative exploration of infant feeding in an area with low breastfeeding rates. Doctoral thesis, Northumbria University.

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Abstract

Rates of breastfeeding in areas of the UK described as deprived are lower than in more affluent areas. Research so far has highlighted the individual determinants of breastfeeding, driving a dominant narrative that problematises alternative feeding practices as a behavioural issue. There is a paucity of qualitative research focussing in deprived areas and including both infant formula and breastfeeding stories. A biographical narrative methodology was chosen in this project to explore the stories women tell about their infant feeding practice; how these stories are passed through generations and across friendship groups; and how they influence the initiation and experience of breastfeeding. Nine women were interviewed in a socio-economically disadvantaged area of Newcastle upon Tyne where infant formula feeding was the norm. The analysis is presented in the shape of a narrative and considered using an ecological systems framework, in order to shed light on the contextual conditions that shape feeding practices in this area. The findings highlight how family narratives, including those of grandparents and fathers, help shape feeding practices in ways that are both very pragmatic, and informed by historical practices. Wider narratives, such as the multiple and sometimes inconsistent stories provided by health professionals and infant formula marketing campaigns were also important. Participating mothers highlighted how place shaped their feeding behaviour, in determining others’ gaze and judgement over their mothering. Mothers demonstrated acute awareness of local cultural acceptance of different feeding approaches and developed strategies to ‘fit in’. Overall, narratives of extraordinary maternal identity were developed regardless of feeding method, and placed within a novel infant feeding ecological framework. Key recommendations include the provision of nuanced support and advice, that includes mothers’ wider network, is available online, and framed within policies that shape marketing regulations and mothers’ freedom to breastfeed in public.

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