In Regina’s North Central neighbourhood, issues of addiction continue to jeopardize the parenting roles of First Nations mothers. Residents of this neighbourhood frequently encounter poverty, injection drug use (IDU) and domestic violence – all of which affect their caregiving ability. In one support program offered to residents of the neighbourhood, breastfeeding re-established the caregiving role of mothers.
In the 1980s, a young First Nations population moved to Regina, Canada, looking for a new life, away from their culture and its traditions [1]. At this time, however, Regina had a burgeoning drug market with a sex-trade industry and gang affiliations to support it. With little support for positive lifestyle choices, many of the youth succumbed to a lifestyle of drug and alcohol use. This lifestyle continues for many within the population today, and has a profound affect on their parenting ability. In 2010, a review of the province’s child welfare system identified that 80% of children in government care were of First Nations descent, a population that makes up only 10% of the province’s population [2]. A national survey of human immunodeficiency virus (HIV) cases further identified that the number of cases in North Central Regina were three times greater per capita than anywhere else in the country; 92% were associated with IDU and 69% were associated with First Nations ancestry [3].
Healthiest Babies Possible Program (HBPP), a prenatal/postpartum support program in North Central Regina provides support to, on average, half of the neighbourhood’s expectant mothers. The program, set up by First Nations women in the community, brought support to mothers with caregiving roles. An increased focus on breastfeeding became a part of the program when the Baby-Friendly Initiative (BFI), a program promoted by the health region, was introduced. The BFI has been a part of the World Health Organization health action to support breastfeeding world-wide, particularly in emergent situations. In HBPP, commitment to breastfeeding was further strengthened with the recognition of breastfeeding as a part of women’s life-giving role in First Nation’s beliefs, recognized to promote a caregiving relationship for the mother with her infant. These beliefs also link mothers to the cosmic realm for ancestral support in this relationship with breastfeeding [4].
HBPP participants experienced empowerment effects from breastfeeding, which in turn significantly enhanced perceived ability to care for their infants in other activities. As self-confidence for caregiving increased, drug and alcohol use stopped. Realizing the power of breastfeeding to increase an overall sense of caregiving-empowerment, HBPP staff and participants set out to measure this effect to further promote mothers’ breastfeeding opportunity, not always supported by healthcare providers.
First nations breastfeeding practice
Caregiving was historically significant for women in First Nations tribes and included the kill of small game, planting of crops, care of children and childrearing that included teaching children traditional values [4,5,6]. The teepee, has been used as a symbol of mothers in this role. The poles are seen to be in the shape of a woman; and the buffalo skin like a shawl wrapped around her (see Fig. 1). The family is often shown inside the teepee further recognizing the mother’s protective role for her family [5]. Infants were kept in the constant watch of their mothers who carried them in a moss bag, secured to their backs. Keeping infants in this proximity encouraged the mother-baby relationship and promoted breast milk supplies. Fathers encouraged a high quality of breast milk by providing mothers with the best cuts of their “kill.” Other women in the tribe supported breastfeeding by assisting with the care of older children or breastfeeding an infant when the biological mother could not. This was done when Chief Crazy Horse, a memorable First Nations chief from the Lakota tribe, was orphaned as a young child. In addition to this support, older women, known as “Kohkoms,” assisted mothers with their knowledge of herbal remedies, such as the topical use of balsam to relieve engorged breasts [6, 7].
Impact of Western society on first nations breastfeeding
Many First Nations people lost traditional cultural practices as a result of colonization and changes enforced by the Indian Act in 1876 [4, 8]. When land designation went to males instead of females, family roles were dismantled and the females’ leadership role for caregiving was undermined. First Nations food sources became food rations provided by colonizers, creating dependency by First Nations for their daily existence. Indian Agents, sent out by colonizers, enforced the use of milk powder for infants, thereby implying a mothers’ milk was substandard.
In a review of the Canadian National Database for Breastfeeding, a drop in Indian and Inuit populations’ breastfeeding was observed from 1960 to 1980 [9]. Early in the 1960s, breastfeeding rates were 69.4%, significantly higher than the 38% reported for the general population at that time. By 1980, breastfeeding rates had dropped to less than 60% in the Indian and Inuit population while the rates in the general population rose to 76%. A lower percentage of women breastfeeding within these populations continues today [10].
Traditional caregiving practices and support for breastfeeding came under new scrutiny when government workers were brought onto reserves to monitor mothers’ caregiving in the 1960s. Not fully understanding how the First Nations mothers’ caregiving had been devastated by colonization, First Nations women were portrayed by the workers “as demanding, filthy and prone to drunkenness.” [4] Government workers relocated many children far away from their homes, placing them in government foster care or residential schools in an action referred to as the Big Scoop [1]. It was this action that brought young people to Regina, seeking a sense of identity that fit with Western society and a life they believed to be better than what they would have remaining on their reserve. Ultimately, this move created devastation for the youth and their lives.
Empowering mothers caregiving in disadvantaged circumstances
Research underlines the value of accomplishments with caregiving to create a positive self-worth by mothers dealing with disadvantaged circumstances, such as being adolescent, having low income or education, and marginalization in society [4, 11]. Positive affiliations with families and peers for caregiving are important to support caregiving practices such as breastfeeding. In one study, relocation of mothers from rural communities in India to urban Mumbai slums showed increased autonomy with caregiving despite continued partner abuse and isolation by their culture’s class system [12]. The change was linked to increased peer contacts and as well as observation of other mothers’ autonomy by social media. This led to increased responsibility for families’ healthcare, lifestyles and some income.
Locklin [13] noted an enhanced sense of self in the caregiving role for a small group of mothers from Hispanic descent with successful breastfeeding experiences. The mothers, who were multiparous, had attempted breastfeeding in the past, but discontinued prior to three weeks postpartum. With this experience, weekly support for breastfeeding was provided by peers who assisted the breastfeeding practise. Mothers became strong enthusiasts for breastfeeding, empowered by their breastfeeding success. Evaluations of the empowerment effect were limited, however, to self-reporting at a four-month postpartum interview.
A study conducted by Mossman, Heaman, Dennis, &. Morris [14] found adolescents who breastfed had increased self-worth, believing themselves to be valuable family members and having more confidence in social groups, enhanced by a sense of self following breastfeeding success. Evaluation of these indicators was at 28 days postpartum. First Nations mothers identified in the study were two times less likely to initiate breastfeeding as compared to other mothers, possibly related to a decreased sense of self with caregiving. Epstein [15], a research psychologist and breastfeeding activist, recognizes the value of a positive sense of self for mothers with breastfeeding. She credits the breastfeeding relationship between a mother and her infant to her ability to re-frame negative images of herself into positive ones. Caregiving accomplishments, as with breastfeeding, are recognized as significant to promote mothers’ caregiving roles, particularly when disadvantaged.
