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Background: Although exclusive breastfeeding is recommended for the first six months of life, research suggests that breastfeeding initiation rates and duration among Indigenous communities differ from this recommendation. Qualitative studies point to a variety of factors influencing infant feeding decisions; however, there has been no collective review of this literature published to date. Therefore, the objective of this scoping review was to identify and summarize the qualitative literature regarding Indigenous infant feeding experiences within Canada, the United States, Australia, and Aotearoa. Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses- Scoping Reviews and the Joanna Briggs Institute Guidelines, in October 2020, Medline, Embase, CINAHL, PsycINFO, and Scopus were searched for relevant papers focusing on Indigenous infant feeding experiences. Screening and full-text review was completed by two independent reviewers. A grey literature search was also conducted using country-specific Google searches and targeted website searching. The protocol is registered with the Open Science Framework and published in BMJ Open. Results: Forty-six papers from the five databases and grey literature searches were included in the final review and extraction. There were 18 papers from Canada, 11 papers in the US, 9 studies in Australia and 8 studies conducted in Aotearoa. We identified the following themes describing infant feeding experiences through qualitative analysis: colonization, culture and traditionality, social perceptions, family, professional influences, environment, cultural safety, survivance, establishing breastfeeding, autonomy, infant feeding knowledge, and milk substitutes, with family and culture having the most influence on infant feeding experiences based on frequency of themes. Conclusions: This review highlights key influencers of Indigenous caregivers' infant feeding experiences, which are often situated within complex social and environmental contexts with the role of family and culture as essential in supporting caregivers. There is a need for long-term follow-up studies that partner with communities to support sustainable policy and program changes that support infant and maternal health. [ABSTRACT FROM AUTHOR]

Since the shift to legalizing recreational cannabis use in Canada in 2018, there has been increased attention on the consequences of cannabis use on women's reproductive and maternal health, with particular attention to the impact of cannabis in utero and through breastfeeding. This has resulted in an intense focus on the behaviors of individuals who consume cannabis during the perinatal period, which raises questions about the impact this has on women and mothers who have historically been under the surveillance of the Canadian public health, health and social care, and legal systems. Grounded in an intersectional feminist framework that acknowledges how race, ability, class, and other social positions impact and differentiate women's experience, this paper presents findings emerging from a participatory arts-based research approach called Photovoice with 23 mothers living throughout Canada. All participants consumed cannabis during pregnancy and breastfeeding and illustrated through photographs and individual and group discussion how their experiences of intersectional stigma and surveillance by health and social care providers resulted in barriers to accessing cannabis-related information and support. Implications arising from our inquiry suggest there is a dire need for public health, perinatal care, and social care responses that run counter to the current context where stigma and fear prevent parents from accessing cannabis information and support. [ABSTRACT FROM AUTHOR]

Objectives: Human milk expression has become an increasingly common means for providing milk to an infant, with women expressing to address breastfeeding problems or to allow for flexible feeding options. This study explored the experiences and recommendations of mothers who expressed human milk, with this paper reporting on the advice mothers would offer to other mothers to address common challenges. Methods: Interpretive description was used in this qualitative project. Using purposive sampling, mothers of infants aged 0–24 months who expressed human milk were recruited to participate from two health regions in western Canada. Individual, audio-taped interviews were completed with 35 women. NVIVO™ software was used for data analysis. Results: Mothers reported the desire to offer experiential advice to other mothers navigating milk expression and encouraged other mothers to seek guidance from health care professionals such as lactation consultants, peer support online, and from family and friends. Experiential knowledge shared included: (a) product recommendations, (b) expression tips, (c) support for workplace expression, (d) encouragement to seek help, and (e) moral support. Conclusions: Healthcare professionals should include evidence-based expression information as part of routine lactation support, while recognizing the importance of mother-to-mother knowledge transfer and emotional support. Services that assist mothers to determine and access pumps appropriate to their unique breastfeeding needs and goals should be offered, and the opportunity for peer support through creation of, or referral to, appropriate in-person or online support groups should be made available. [ABSTRACT FROM AUTHOR]

The breastfeeding body is subject to overt and subversive forms of regulation and control in contemporary society, where it is sexualized and naturalized, rendered both visible and invisible, revered and found disruptive. Despite health policy espousing the benefits of breastfeeding for mother and child, duration rates in Canada remain relatively low. In this paper, I explore the spatial practices of the breastfeeding body in public, using feminist work on the body and theorizations of built form, urban space and embodied practice. Drawing on a series of feminist autoethnographic vignettes, I write my breastfeeding body into a diversity of routine urban spaces – a car, grocery store, mall, bookstore, highway, alleyway – and narrate my experiences negotiating social responses and spatial arrangements. I argue that the breastfeeding body challenges normative understandings of gender, motherhood and sexuality through its participation and presence in public space. The breastfeeding body transgresses the meaning of space and the performance of identity as it claims space for private use. [ABSTRACT FROM AUTHOR]

This paper explores the framing of public policy related to infant food insecurity in Canada by examining multiple levels and jurisdictions where infant feeding and food security policy merge. It identifies that both policy areas position breastfeeding as the solution to infant food insecurity, primarily isolating policy within health domains. Overall, this paper provides a critique of policy in relation to what we know about the challenges of maintaining breastfeeding as the sole nutrition strategies for infants and the barriers of access to alternative food for infants within the context of low-income circumstances in high-income countries such as Canada. It argues that infant food insecurity is a matter that requires better conceptualization and broader policy responses beyond health policy aimed at shaping infant feeding practice. An informed merging of infant feeding and food security policy could provide the framework for policy development to address the structural relations that make breastfeeding unsustainable, particularly for low-income women, as well food insecurity outcomes that stem from not breastfeeding in low-income circumstances. [ABSTRACT FROM AUTHOR]