title: Contradictions and conflict: a meta-ethnographic study of migrant women's experiences of breastfeeding in a new country.
abstract: BACKGROUND
  Studies report mixed findings about rates of both exclusive and partial breastfeeding amongst women who are migrants or refugees in high income countries. It is important to understand the beliefs and experiences that impact on migrant and refugee women's infant feeding decisions in order to appropriately support women to breastfeed in a new country. The aim of this paper is to report the findings of a meta-ethnographic study that explored migrant and refugee women's experiences and practices related to breastfeeding in a new country.
  
  
  METHODS
  CINAHL, MEDLINE, PubMed, SCOPUS and the Cochrane Library with Full Text databases were searched for the period January 2000 to May 2012. Out of 2355 papers retrieved 11 met the inclusion criteria. A meta-ethnographic synthesis was undertaken using the analytic strategies and theme synthesis techniques of reciprocal translation and refutational investigation. Quality appraisal was undertaken using the Critical Appraisal Skills Programme (CASP) tool.
  
  
  RESULTS
  Eight qualitative studies and three studies reporting both qualitative and quantitative data were included and one overarching theme emerged: 'Breastfeeding in a new country: facing contradictions and conflict'. This theme comprised four sub-themes 'Mother's milk is best'; 'Contradictions and conflict in breastfeeding practices'; 'Producing breast milk requires energy and good health'; and 'The dominant role of female relatives'. Migrant women who valued, but did not have access to, traditional postpartum practices, were more likely to cease breastfeeding. Women reported a clash between their individual beliefs and practices and the dominant practices in the new country, and also a tension with family members either in the country of origin or in the new country.
  
  
  CONCLUSIONS
  Migrant women experience tensions in their breastfeeding experience and require support from professionals who can sensitively address their individual needs. Strategies to engage grandmothers in educational opportunities may offer a novel approach to breastfeeding support.
authors.affiliation: School of Nursing and Midwifery, Family and Community Health Research Group, Locked Bag 1797, Penrith South DC, NSW, Australia. v.schmied@uws.edu.au
authors.forename: Virginia
authors.initials: V
authors.lastname: Schmied
authors.forename: Hannah
authors.initials: H
authors.lastname: Olley
authors.forename: Elaine
authors.initials: E
authors.lastname: Burns
authors.forename: Margie
authors.initials: M
authors.lastname: Duff
authors.forename: Cindy-Lee
authors.initials: CL
authors.lastname: Dennis
authors.forename: Hannah G
authors.initials: HG
authors.lastname: Dahlen
mesh_terms: D000884:Anthropology, Cultural; D001942:Breast Feeding / Q000208:ethnology / Q000523:psychology* / Q000706:statistics & numerical data; D003220:Conflict, Psychological; D019049:Developed Countries; D054242:Emigrants and Immigrants / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D012036:Refugees / Q000523:psychology* / Q000706:statistics & numerical data