The lactation and chestfeeding/breastfeeding information, care and support needs of trans and non-binary parents: An integrative literature review

Abstract

Background: The National Breastfeeding Strategy launched by the Ministry of Health in 2020, commits to the protection, promotion and support for breastfeeding with the aim of increasing exclusive breastfeeding rates in Aotearoa New Zealand. This strategy includes a recommendation that the breastfeeding/chestfeeding information and support needs of trans and non-binary parents and their whānau are identified so that those involved in their care are knowledgeable about these specific needs. Midwives are the primary providers of lactation and breastfeeding/chestfeeding information, care and support for most pregnant people in Aotearoa New Zealand. Aims: An integrative literature review was undertaken: to ascertain the specific lactation and chestfeeding/breastfeeding information and care needs for trans, non-binary, takatāpui and other gender diverse whānau; to consider the implications of this knowledge for contemporary midwifery in Aotearoa New Zealand; and to identify continuing research needs. Method: Literature for this integrative review was primarily sourced through the Ovid Online Database using search terms pertinent to the topic and limited to articles published in peer reviewed journals in English, excluding editorials, commentaries and opinion pieces. Findings: Literature about trans and non-binary parents and chestfeeding/breastfeeding, although increasing since 2010, is limited internationally and absent nationally. From extant literature, connections between healthcare barriers and the negative experiences of trans and non-binary parents are identified and explored in three overarching themes: the foundations of Western perinatal healthcare systems; the invisibility of trans and non-binary people within perinatal healthcare systems; and the lack of perinatal healthcare provider knowledge. Conclusion: Cis-normative, gender binary foundations are omnipresent in perinatal healthcare, rendering trans and non-binary people invisible, and excluded from this space. These factors contribute to the limiting of perinatal healthcare provider knowledge, an overwhelming finding in the literature. The absence of locally produced literature presents scope for research production here in Aotearoa New Zealand, exploring this topic from our unique cultural contexts. Such contributions may help inform whether adaptations and additions to current midwifery education are necessary to support midwives in the provision of equitable, safe, culturally appropriate, gender-inclusive care.