Understanding equity in Islington's infant feeding services: Health equity analysis and qualitative research on lived experience of breastfeeding from diverse voices
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Authors
Sidonie Sakula-Barry
Tara Hendry
Monique Taratula-Lyons
Jane Brett-Jones
Saloni Bhuptani
Emilia Bernecka
Alexandra Hancock
Marian Dufie Oppong and Mayra Alvarado.
Contact
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Issue Date
06-May-26
Type
Conference Abstract
Language
Keywords
Neighbourhood health & place-based working , Working with people and communities , Embedded researchers
Alternative Title
Abstract
Background
Many mothers experience challenges with breastfeeding, and rates vary widely by age, ethnicity, and deprivation. Islington's breastfeeding rates are above the national average and supported by a well‑established infant feeding offer. Previous audits identified lower initiation and continuation among younger mothers and some ethnic minority groups, alongside reduced engagement with breastfeeding peer support. This research aimed to understand whether these demographic differences reflect unmet need and contribute to health inequity.
Objectives
• Examine demographic variation in breastfeeding rates and breastfeeding peer support service use.
• Engage less-heard voices to explore knowledge, attitudes, and lived experiences of breastfeeding and infant feeding support.
• Develop recommendations for infant feeding services in Islington, focusing on reducing inequity.
Methods
A mixed methods design was used. A health equity analysis examined routinely collected NHS data on breastfeeding at the new birth visit (10–14 days) and 6–8 weeks (2021–2023), alongside engagement data from Islington's breastfeeding peer support service, stratified by age, ethnicity, and geography. Qualitative research explored lived experience through four focus groups (n=24) with mothers from socioeconomically deprived areas and diverse ethnic backgrounds. Participants were recruited through voluntary and community sector organisations, community researchers and parent champions, with interpretation provided when needed. Data was analysed using deductive thematic analysis.
Findings
The analysis showed lower engagement with peer support among mothers under 25 and among Asian Bangladeshi, Black African and Black Caribbean mothers. Asian Bangladeshi mothers experienced both low engagement and low exclusive breastfeeding rates, while some groups achieved average outcomes despite reduced engagement. Qualitative findings demonstrated strong intention and motivation to breastfeed across all groups, shaped by cultural expectations and a sense of parental responsibility. Key barriers included limited local support networks, discomfort breastfeeding in public, inconsistent healthcare interactions, and a lack of timely, practical information. Language barriers also restricted access to essential health services.
Discussion / Learning for the wider community
Findings highlight the need for flexible, culturally responsive and well timed infant feeding support embedded within integrated maternity and early years pathways. Support models should reflect the diversity and lived realities of local communities and acknowledge the complexity of breastfeeding. Repeated, proactive engagement can help ensure mothers receive the right support at the right time.