'Life does not make it easy to breast-feed': using the socio-ecological framework to determine social breast-feeding obstacles in a low-income population in Tijuana, Mexico.
OBJECTIVE
Breast-feeding rates reflect sociodemographic discrepancies. In Mexico, exclusive breast-feeding under 6 months of age has deteriorated among the poor, rural and indigenous populations from 1999 to 2012. Our objective of the present study was to identify the main social obstacles to breast-feeding in a low-income population in Tijuana, Mexico.


METHODS
Qualitative study using a socio-ecological framework for data collection.


METHODS
Low-income communities in Tijuana, Mexico.


METHODS
Mothers (n 66), fathers (n 11), grandparents (n 27) and key informants (n 25).


RESULTS
One hundred and twenty-nine individuals participated in the study: six focus groups (n 53) and fifty-one interviews among mothers, fathers and grandparents; and twenty-five interviews among key informants. Seven social themes were identified: (i) embarrassment to breast-feed in public; (ii) migrant experience; (iii) women's role in society; (iv) association of formula with higher social status; (v) marketing by the infant food industry; (vi) perception of a non-breast-feeding culture; and (vii) lack of breast-feeding social programmes.


CONCLUSIONS
Socio-structural factors influence infant feeding practices in low-income communities in Tijuana. We hypothesize that messages emphasizing Mexican traditions along with modern healthy practices could help to re-establish and normalize a breast-feeding culture in this population. The target audience for these messages should not be limited to mothers but also include family, health-care providers, the work environment and society as a whole.
1Nutrition Department,University of California Davis,3135 Meyer Hall,One Shields Avenue,Davis,CA 95616,USA.
Diana
D
Bueno-Gutierrez
2Center for Healthcare Policy and Research,UC Davis Children's Hospital,Sacramento,CA,USA.
Caroline
C
Chantry
D001942:Breast Feeding / Q000208:ethnology / Q000523:psychology* / Q000639:trends; D005260:Female; D017144:Focus Groups; D005783:Gender Identity; D006801:Humans; D007225:Infant Food / Q000191:economics; D041943:Infant Formula / Q000191:economics; D007231:Infant, Newborn; D008297:Male; D008800:Mexico; D008960:Models, Psychological; D011203:Poverty / Q000208:ethnology; D011247:Pregnancy; D036301:Qualitative Research; D012922:Social Change; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000208:ethnology / Q000209:etiology*; D014171:Transients and Migrants / Q000523:psychology; D014505:Urban Population
Breast-feeding; Low income; Obstacles; Socio-ecological framework