Facilitators and barriers to successful breastfeeding among Chuukese mothers who have migrated to Guam

Abstract

Background/Significance Breastfeeding has long been known to positively influence infant health. Chuukese mothers traditionally breastfeed their babies, but little is known about breastfeeding among migrant Chuukese mothers. This study investigated the factors influencing breastfeeding behavior among Chuukese migrants living on Guam. As the first study of this type among Chuukese migrants, information was gained to allow policy development or revision to best support breastfeeding among this group. Method This was a qualitative study, based on the theory of reasoned action, utilizing key informant and focus group interviews. Key informants (n=9) included three each from health care professionals, migrant Chuukese breastfeeding mothers, and migrant Chuukese formula/mix-feeding mothers. Focus groups (n=7) included migrant Chuukese breastfeeding mothers (n=8 mothers) and migrant Chuukese formula/mix-feeding mothers (n=10). A total of 27 individuals participated in the interviews. Findings Facilitators for breastfeeding included attitude shaping, confidence, family support, knowledge acquisition, and traditional values. Barriers to breastfeeding included cultural conflict/social change, lack of commitment, lack of community support, lack of family support, lack of health care staff support, lack of knowledge about managing common problems, and mixed messages. The findings supported the theory of reasoned action in that where facilitators were present, breastfeeding was practiced. Where barriers existed, formula/mix-feeding occured. Conclusion Findings should be shared with members of the health care community of Guam, as well as other states and jurisdictions where Chuukese mothers migrate. Efforts should be made to address the barriers, including policy development/revision, staff education, peer-to-peer breastfeeding support, and provision of support services from non-traditional means such as through churches, non-traditional leaders, and Chuukese women's groups. Future research should address breastfeeding among other cultural groups on Guam, and how health care staff perceive their role in breastfeeding.