Socio-Cultural Barriers and Facilitators for Breastfeeding: A Qualitative Study of Parents and Healthcare Providers in a Small Canadian City.

Background: Despite efforts to protect, promote and support breastfeeding, breastfeeding duration and exclusivity rates remain inadequate within Canada and worldwide. A New Brunswick (Canada) hospital observed declining rates of exclusive breastfeeding 2014/2015 to 2020/2021 that were both the lowest in NB and below national averages. Thus, within the catchment area of this NB hospital, a targeted constructivist qualitative approach was used to shed light on these low levels of breastfeeding by examining both parents' and healthcare providers' (HCPs) perceptions of breastfeeding barriers and facilitators during the pre- and post-natal periods.

Methods: Semi-structured interviews were conducted with parents (N = 16) and HCPs working in family medicine or within maternal health (N = 13) in 2022 during the COVID-19 pandemic. Iterative reflexive thematic analysis was performed.

Results: Many themes discussing barriers and facilitators to breastfeeding were documented, with a particular focus on social and cultural influences. Both parent and HCP groups predominantly discussed the need for further education on breastfeeding; the parents focused on the education that they wanted for themselves, and HCPs felt that education was needed for both parents and HCPs.

Conclusions: Education on infant feeding is strongly needed for parents, HCPs, as well as the entire population in general. Education should be appropriately tailored to individuals' respective educational and cultural needs to move the needle forward on social and cultural acceptance and normalization of breastfeeding. Increased support throughout the breastfeeding journey, whereby a patient-centred approach is used, and available resources are made known, is also essential.