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Breastfeeding rates of Aboriginal and Torres Strait Islander women in Australia: a systematic review and narrative analysis

  • Tanisha L. Springall
    Correspondence
    Correspondence to: Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Plenty Road, Bundoora 3086, Victoria, Australia.
    Affiliations
    Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia

    School of Nursing and Midwifery, Griffith University, Meadowbrook, Queensland, Australia
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  • Helen L. McLachlan
    Affiliations
    Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia

    School of Nursing and Midwifery, La Trobe University, Bundoora, 3086, Australia
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  • Della A. Forster
    Affiliations
    Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia

    Maternity Services, Royal Women’s Hospital, Parkville, Victoria, Australia
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  • Jennifer Browne
    Affiliations
    Global Obesity Centre (GLOBE), Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
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  • Catherine Chamberlain
    Affiliations
    Judith Lumley Centre, School of Nursing and Midwifery, La Trobe University, Melbourne, Victoria, Australia

    Centre for Health Equity, The University of Melbourne, Melbourne, Victoria, Australia

    Ngangk Yira: Murdoch University Research Centre for Aboriginal Health and Social Equity, Perth, Western Australia

    The Lowitja Institute, Melbourne, Victoria, Australia
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      Abstract

      Background

      Australian Aboriginal and Torres Strait Islander (referred to hereafter as Aboriginal) women breastfeed at lower rates than non-Aboriginal women, and rates vary across and within Aboriginal populations.

      Aim

      To determine rates of breastfeeding initiation and maintenance and compare individually collected survey data with existing routinely collected state and national breastfeeding data for Aboriginal women.

      Methods

      CINAHL, Medline, EMBASE, SCOPUS, PsycINFO, and the Cochrane library were searched for peer-reviewed literature published between 1995 and 2021. Quantitative studies written in English and reporting breastfeeding for Aboriginal women or women having an Aboriginal infant were included. Screening and quality assessment included co-screening 10% of papers. Two reviewers completed data extraction. A proportional meta-analysis was undertaken for breastfeeding initiation and narrative data synthesis used to summarise breastfeeding maintenance.

      Findings

      The initial search identified 12,091 records, with 31 full text studies retrieved, and 27 reports from 22 studies met inclusion criteria. Breastfeeding initiation was 78% (95% CI 0.71, 0.84), however, rates were lower than non-Aboriginal women. Maintenance ranged between one week and five years. Rates and definitions varied significantly between studies, with inconsistencies in government collection and reporting of breastfeeding.

      Conclusion

      Significant variation in definitions and reporting make comparisons difficult. Breastfeeding rates were below recommended targets. Future pattern and trend analyses require standardised measures and definitions. Current collection and reporting of breastfeeding data, particularly routinely collected state-based data, is inadequate to present an accurate picture of current breastfeeding in Australia for Aboriginal women and infants, and to effectively inform interventions and policies.

      Keywords

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