Hermandeep Deo

Breastfeeding has a direct impact on the health of individuals and communities. Despite the implementation of diverse health promotion and education strategies, global breastfeeding rates remain relatively low. Predominantly, these strategies are implemented during the prenatal period and focus on individual-level education and behavior change, with less attention paid to the structural and contextual resources necessary for breastfeeding support and education. Breastfeeding experiences are contextually shaped by social, cultural, economic, and political factors. In addition, breastfeeding education, support, and rates are influenced by complex structures such as policy. Thus, a health equity approach to guide the planning and implementation of prenatal breastfeeding education can contribute to improving breastfeeding rates for diverse individuals and populations. Drawing from critical theoretical and health equity concepts, we present an equity approach with the potential for direct application to educating parents about breastfeeding. We discuss how a health equity approach could guide policymakers and perinatal healthcare providers to ensure culturally, emotionally, and psychologically safe learning spaces to reduce access barriers to breastfeeding education. Also, the approach could tailor the learning of parents to accommodate the unique contexts of their lives, thereby optimizing their breastfeeding experiences and outcomes.

The World Health Organization has identified the importance of improving the rates of breast/chest feeding for population health. Canadian health organizations have put public health resources toward breast/chest feeding support. Despite statements of purpose describing health promotional interventions to be focused on improving overall population health, many times these methods are based only upon biomedical knowledge and fail to adequately address the needs of diverse populations. Thus, in this paper we critique a Canadian policy providing clinical guidance to care providers through the application of a relational inquiry framework. We draw on the first author’s experience as a Public Health Nurse delivering breast/chest feeding support within the scope of these guidelines to further illustrate the point. The results from published evidence are integrated within this critique to provide an evidence base for policy improvement recommendations to improve the social, cultural, and political components of breast/chest feeding typically overlooked in current standards.