Kia mau, kia ū : supporting the breastfeeding journey of Māori women and their whānau in Taranaki : a thesis presented in fulfilment of the requirements for the degree of Masters in Public Health at Massey University, Wellington, New Zealand

Abstract

The benefits of breastfeeding for maternal and infant health are well known to Maori. Yet inequities in breastfeeding rates between Maori and non-Maori exist. To understand some of the causes of these inequities, this qualitative study was designed to investigate some of the barriers to breastfeeding for wahine Maori. It is grounded in Kaupapa Maori and Mana Wahine research methodologies as a way of ensuring that the experiences of Maori women were prioritised and to provide transformative outcomes for whanau, hapu and iwi. The aims were to: (1) Identify the barriers to full and exclusive breastfeeding for the recommended six months for wahine Maori in Taranaki; (2) Identify ways to reduce these barriers; and (3) Understand how a breastfeeding culture can be enhanced within whanau Maori. Semi-structured interviews were conducted with 11 Maori women and two whanau Maori living in Taranaki. Thematic analysis identified several intervention points to support breastfeeding: (1) access to high quality breastfeeding information (Filling the kete); (2) a compassionate and culturally-safe maternity healthcare workforce (Health service support); (3) active whanau involvement (Whanau support); (4) greater acceptance of breastfeeding by the wider community (Hapori – supportive communities); and (5) access to breastfeeding role models (Role-modelling breastfeeding). Partners and whanau provide important emotional and practical support to breastfeeding women (The breastfeeding support role) however the significance of this role needs to be acknowledged and encouraged (Supporting the supporters). Building whanau capacity and capabilities related to breastfeeding support must begin in the antenatal period (Access to information). This thesis presents a Kaupapa Maori breastfeeding support framework that highlights two areas of action. Tiakina Te Ukaipo describes the relationship between whanau and maternity providers and the ways in which they can protect the mother/infant dyad. It also offers a pathway for supporting Maori women in their breastfeeding aspirations. Hapai Te Tikanga Ukaipo describes the responsibilities of Government, the healthcare sector and the wider community to protect tikanga ukaipo. Maori women aspire to breastfeed our babies, just as our tupuna did. As this thesis clearly shows, achieving these aspirations will require a commitment and reorientation of the maternity healthcare system towards whanau ora.