"Fitting-in Australia" as nurturers: Meta-synthesis on infant feeding experiences among immigrant women.

PROBLEM: Migration or resettlement to western nations frequently alters breastfeeding and complementary feeding practices.

BACKGROUND: Infant feeding practices in traditional societies (originally from non-white countries) are ingrained within customary beliefs and practices.

AIM: To understand maternal infant feeding experiences pre- and post-resettlement for the benefit of policy and healthcare practice.

METHODS: This meta-synthesis of qualitative studies on infant feeding experiences of migrant and refugee women in Australia adopted the Noblit and Hare aproach. CINAHL, ScienceDirect, MEDLINE, Social Sciences, SCOPUS and PubMed databases from 1980 to 2018 were searched. Fourteen papers of the 218 retrieved met the inclusion criteria. The Critical Appraisal Skills Programme (CASP) tool was used to assess the quality of papers and data were synthesised through reciprocal translation.

RESULTS: One overarching theme emerged: "Fitting-in" to nurture a healthy child in a new homeland. This theme composed of two major themes: beliefs about breast milk and breastfeeding; and beliefs about complementary feeding. In Australia, manufactured foods such as infant formula were often associated with modernism. Western hospital policies were seen as a deterrent to lactation, while familial disconnections and unfamiliarity with healthcare and societal norms undermined maternal infant feeding confidence. New to the scope of migratory infant feeding literature, this synthesis uncovers how migrants and refugees negotiated the western hierarchical structures differently due to issues of power differences.

CONCLUSION: The 'Fitting-in' notion is best described through the socio-ecological model and maternal capital possessions. This paper calls for a proper 'balancing' between traditional beliefs and the safeguarding of infant health.