(P37-20-26) Improving Breastfeeding Outcomes for Refugee and Immigrant Women: Insights From a Community-Based Study in Clarkston, Georgia

Objectives: Refugee and immigrant women (RIW) who practice exclusive breastfeeding (EBF) in their home country often experience declines in EBF after resettlement. Non-Hispanic RIW are an increasing yet understudied group. This community-engaged study aimed to identify: i) determinants of optimal breastfeeding, especially EBF for 6 months, and ii) strategies to improve EBF among RIW in Clarkston- a refugee resettlement community in Georgia.

Methods: This qualitative study was conducted in collaboration with Embrace Refugee Birth maternal support program. Non-Hispanic RIW who lived or received health services from Clarkston, had a 6–24-month-old child born in Georgia, and initiated breastfeeding were eligible to participate; those who gave birth to multiples or relocated as minors were excluded. We conducted in-depth interviews with 20 RIW (n=20), 12 health providers, and 5 focus groups with mothers from diverse cultural backgrounds. Data were analyzed using a qualitative framework analyses approach guided by the socioecological capability, opportunity, and motivation model for behavior change.

Results: Facilitators of EBF included knowledge of EBF benefits (capability), partner and family support (opportunity), cultural dietary practices (opportunity), and provider encouragement (motivation). The major barrier to sustaining EBF was limited access to breastfeeding education and practical support, shaped by opportunity-related challenges such as language barriers, limited awareness of resources or eligibility, and competing life demands. Participants recommended accessible prenatal breastfeeding education; community awareness initiatives; community-led postnatal breastfeeding support groups; a designated lactation resource center with lactation experts; dietary counseling to support milk supply; and workplace accommodations.

Conclusions: Findings highlight important gaps in breastfeeding support for non-Hispanic RIW. Implementing the recommendations could address underlying social, cultural, and environmental determinants that influence capability, opportunity and motivation for optimal breastfeeding-particularly EBF for 6 months- among refugee and immigrant families in Clarkston and beyond.

Funding Sources: Emory University MCH Center of Excellence