A community-centered intervention to improve infant feeding practices among Pakistani and Bangladeshi families living in the UK

母乳喂养被认为是喂养婴儿的最佳方式。与奶瓶喂养的婴儿相比，母乳喂养时间较长的婴儿患严重感染、婴儿猝死的风险较低，而且在儿童时期超重的可能性也较低。延长母乳喂养时间也有助于降低产妇患癌症的风险。英国是世界上母乳喂养率最低的国家之一，按照世界卫生组织的建议，只有不到1%的母亲在6个月前完全母乳喂养。大多数针对母乳喂养的方案或额外支持都是针对处境不利的白人母亲的，他们被认为是最需要母乳喂养支持的，而对少数民族母亲的关注要少得多，而少数民族母亲被认为母乳喂养率相对较高。在观察母乳喂养率（或其他健康行为）时，印度、巴基斯坦和孟加拉国血统的母亲往往被归为一个“南亚”群体，从这种角度来看，她们的母乳喂养率似乎相对较高。然而，我们最近的研究将这些群体分开，并确定来自巴基斯坦和孟加拉国社区的婴儿比来自印度社区的婴儿更不可能母乳喂养。这意味着，来自巴基斯坦和孟加拉国社区的家庭很容易受到关于母乳喂养和配方奶喂养的错误信息的影响，这可能对这些社区的健康产生重大影响。研究表明，这些社区中有特定的文化信仰和习俗，可能不利于母乳喂养的成功开始和维持，或者可能鼓励过早断奶。这意味着需要采取具体的干预措施，敏感地处理这些社区特有的信仰和做法。为了成功地改变被认为是社会规范的做法，需要一种使社区参与并与他们合作制定适当战略的方法。在这个项目中，我们将采用一种新颖的、以社区为基础的干预发展方法（REPLACE方法），该方法是为解决切割女性生殖器官或其他由社会或文化规范驱动的做法而开发的。我们将在目标社区举办参与活动，并招募六名“社区研究促进者”，他们将帮助我们接触研究参与者，并在一系列13个研讨会中促进与他们的交流。每个研讨会将讨论一个感兴趣的研究领域，讨论社会规范和信仰，并讨论行为改变的机会。我们将在为保健和社区从业人员举办的三次研讨会上介绍这项研究的成果，并邀请他们讨论与目标社区合作所需的资源和培训。然后，我们将开发一个资源工具包（包括以多种语言提供的关键信息、图像、信息图表和用户手册），供社区和医疗保健从业者使用，使他们能够提供具有文化敏感性的信息和支持。

Breastfeeding is known to be the best way to feed an infant. Compared to bottle-fed babies, those who are breastfed for longer have a lower risk of serious infections, sudden infant death, and are less likely to become overweight as children. Breastfeeding longer also helps to reduce the risk of maternal cancers. The UK has one of the lowest rates of breastfeeding in the World, with less than 1% of mothers exclusively breastfeeding until 6 months as recommended by the World Health Organisation. Most programmes or extra support for breastfeeding are targeted at disadvantaged, white mothers, who are thought to be most in need of breastfeeding support, and much less attention has been paid to mothers from ethnic minorities who are thought to have relatively high rates of breastfeeding. Mothers of Indian, Pakistani and Bangladeshi origin are often grouped together as one 'South Asian' group when looking at breastfeeding rates (or other health behaviours), and when viewed this way it appears that their breastfeeding rates are relatively high. However, our recent research has separated these groups and has identified that infants from Pakistani and Bangladeshi communities are much less likely to be breastfed than infants from Indian communities. This means that families from the Pakistani and Bangladeshi communities have been left vulnerable to misinformation about breastfeeding and formula feeding and this could have significant consequences for the health of these communities. Research has shown that there are specific cultural beliefs and practices in these communities that may be harmful to successful initiation and maintenance of breastfeeding or might encourage early weaning. This means that a specific intervention is required which sensitively addresses the beliefs and practices unique to these communities. In order to successfully change practices that are considered social norms, an approach is required which engages the community and works with them to develop appropriate strategies. In this project we will employ a novel, community-based method to intervention development (the REPLACE approach) which has been developed to tackle female genital mutilation or other practices which are driven by social or cultural norms. We will host engagement events in the target communities and recruit six 'community research facilitators' who will help us to approach research participants and facilitate communication with them in a series of 13 workshops. Each workshop will address an area of interest to the research, discuss social norms and beliefs and discuss opportunities for behaviour change. We will present the outcomes of this research in three seminars for health and community practitioners and invite them to discuss their resource and training needs for working with the target communities. We will then develop a toolkit of resources (including key messages, images, infographics, and a user manual, available in several languages) that can be used by community and healthcare practitioners to enable them to offer culturally sensitive information and support.