South Asian grandmothers' influence on breast feeding in Bristol.
OBJECTIVE
To assess South Asian grandmothers' health beliefs and cultural practices around baby feeding, knowledge of breast feeding and their ability to support successful breast feeding. To design a suitable antenatal intervention for grandmothers to support their breast-feeding daughters/in-law in an area of low exclusive breast feeding and to assess the acceptability and feasibility of the initiative by means of structured interviews.


METHODS
Qualitative focus groups and interviews. Evaluation of an intervention.


METHODS
Community health centre and family homes in Easton, Bristol, where 32% of women having babies are South Asian.


METHODS
14 Pakistani, Bangladeshi or Indian grandmothers in focus groups or interviews. 16 South Asian families in the intervention.


METHODS
An intervention for grandmothers to support exclusive breast feeding was based around a leaflet, which covered the health benefits of breast feeding, good positioning and attachment, feed management, and how families can support breast feeding. The intervention was delivered to mother and grandmother pairs at around 36 weeks gestation, and was translated into three languages.


CONCLUSIONS
South Asian women are not a homogeneous group and differences were seen in cultural and religious practices and in breast-feeding rates between the Pakistani, Bangladeshi and Indian communities. To ensure that the health education message of exclusive breast feeding, how to overcome problems and the importance of family support reaches all women, linkworkers with appropriate training should be available to speak the languages relevant to the ethnic groups in the area. An antenatal educational intervention for extended family members to promote good breast-feeding practice was appreciated by the South Asian families involved and seemed to be influencing behaviour, particularly in giving colostrum, water or artificial milk and the use of dummies/pacifiers.


CONCLUSIONS
Recording details of baby-feeding method at eight weeks systematically by ethnic group will enable local rates to be monitored, particular groups targeted with information and positive reinforcement provided. Linkworkers with appropriate training should be available to speak the languages relevant to the ethnic groups in the area. Involving influential local interpreters in an educational intervention will help to educate the wider population in practices to support exclusive breast feeding.
Ingram
Jenny
J
Centre for Child and Adolescent Health, Institute of Child Health, University of Bristol, Hampton House, Cotham Hill, BS6 6JS Bristol, UK. jenny.ingram@bristol.ac.uk
Johnson
Debbie
D
Hamid
Nishat
N
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001459:Bangladesh; D001942:Breast Feeding / Q000523:psychology*; D003466:Cultural Characteristics; D005260:Female; D017144:Focus Groups; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007194:India; D007223:Infant; D007231:Infant, Newborn; D016901:Intergenerational Relations; D008297:Male; D009035:Mothers / Q000193:education / Q000523:psychology*; D010154:Pakistan; D011247:Pregnancy; D011795:Surveys and Questionnaires; D013997:Time Factors