UAMS Researchers Find Culturally Adapted Pediatric Care Can Help Marshallese Moms Overcome Breastfeeding Barriers
| FAYETTEVILLE — Culturally adapted group pediatric care can help Marshallese mothers in the United States overcome barriers to exclusive breastfeeding to improve nutrition and prevent childhood obesity among Marshallese children, according to researchers from the University of Arkansas for Medical Sciences (UAMS).
Researchers from the UAMS Institute for Community Health Innovation conducted a culturally adapted pediatric intervention called “Kokajjiriri” — meaning “to raise a child” in Marshallese — to educate Marshallese moms about infant nutrition and food portions to help reduce childhood obesity. They found that Marshallese mothers accepted the intervention and desired more breastfeeding education and nutritional guidance to help improve their child’s nutrition.
According to the study, many Marshallese women in the U.S. want to breastfeed their babies exclusively but experience numerous barriers, including perceived low milk supply, stigmatization surrounding breastfeeding in public, a lack of female familial support and maternal employment.
To help combat some of these barriers, UAMS researchers designed a culturally adapted pediatric care initiative by placing the culture and social context of the Marshallese population at the center of the intervention. Some of the culturally adapted aspects that researchers incorporated include:
- Using words or images in the lessons that represent Marshallese culture
- Using food models of traditional Marshallese foods, such as white rice
- Using a Marshallese community health worker as the facilitator in a centralized location in their community
The Centers for Disease Control and Prevention (CDC) recommends exclusive breastfeeding — meaning a baby receives only breastmilk — for six months. Exclusive breastfeeding has been shown to reduce the risk of childhood and life-long obesity.
“Many Marshallese moms raise their children the same way their mother, aunt or another female relative raised them and don’t entirely understand the importance of education about breastfeeding and nutrition,” said Philmar Mendoza Kabua, a nurse educator at the UAMS Institute for Community Health Innovation. “When we provide more culturally appropriate education for our Marshallese moms, then they feel more confident making nutritional choices for their families and themselves.”
Marshallese mothers who participated in the study expressed positivity with the project and a desire to learn more about lactation support, when to introduce solid foods to their infants, portion control and local resources.
“Marshallese moms decide what the family eats, so our goal was to identify what mom was eating to determine what Marshallese babies are eating,” said Britni Ayers, Ph.D., an assistant professor in the UAMS College of Nursing. “If we can understand the dietary and nutritional needs of Marshallese families, we can create culturally adapted nutrition interventions to ensure infants and children are getting the nutrition they need.”
The UAMS Institute for Community Health Innovation is working to ensure families across the state have access to the support, education and care they need. Through mobile health initiatives and targeted training for community health workers, UAMS is creating innovative strategies to fill the gaps in maternal and child health. Learn more about UAMS’ strategies at communityhealth.uams.edu.
UAMS is the state’s only health sciences university, with colleges of Medicine, Nursing, Pharmacy, Health Professions and Public Health; a graduate school; a hospital; a main campus in Little Rock; a Northwest Arkansas regional campus in Fayetteville; a statewide network of regional campuses; and eight institutes: the Winthrop P. Rockefeller Cancer Institute, Jackson T. Stephens Spine & Neurosciences Institute, Harvey & Bernice Jones Eye Institute, Psychiatric Research Institute, Donald W. Reynolds Institute on Aging, Translational Research Institute, Institute for Digital Health & Innovation and the Institute for Community Health Innovation. UAMS includes UAMS Health, a statewide health system that encompasses all of UAMS’ clinical enterprise. UAMS is the only adult Level 1 trauma center in the state. UAMS has 3,485 students, 915 medical residents and fellows, and seven dental residents. It is the state’s largest public employer with more than 11,000 employees, including 1,200 physicians who provide care to patients at UAMS, its regional campuses, Arkansas Children’s, the VA Medical Center and Baptist Health. Visit www.uams.edu or uamshealth.com. Find us on Facebook, X (formerly Twitter), YouTube or Instagram.###