Using qualitative research findings to analyse how breastfeeding public health recommendations can be tailored to meet the needs of women of Bangladeshi origin living in England

Breastfeeding, by improving health outcomes and life chances for women and children, is a key strategy for addressing health inequalities. National evidence-based public health recommendations for breastfeeding exist in the UK (NICE (2008)Improving the nutrition of pregnant and breastfeeding mothers and children in low-income households. NICE public health guidance 11. London: National Institute for Health and Clinical Excellence). The need to tailor interventions to the needs of diverse disadvantaged population groups is an overarching principle informing these recommendations. However, there is little evidence on how to achieve such tailored services. This qualitative paper examines the breastfeeding experiences of 14 grandmothers, 23 women of Bangladeshi origin and 28 health practitioners to illuminate how public health recommendations can be modified for diverse populations. The findings suggested that while many of the women's needs were similar to the majority population, much current breastfeeding support is not culturally sensitive. These findings were used to interrogate barriers to implementation of national public health recommendations to promote and support breastfeeding for women and babies from ethnically diverse communities. These included services that do not consider women's individual needs and expectations, and practitioner stereotypes and assumptions. In addition to informing recommendations for service provision and the education of health practitioners, this analysis offers an example of using qualitative research to scrutinise how national public health recommendations might work for different population groups.