Anishininew infant feeding experiences in Sandy Lake, Canada: a story of Waabeequanee

Global public health recommendations for optimal infant nutrition include exclusive breastfeeding for the first 6 months of life. Breastfeeding has several benefits; however, breastfeeding initiation rates and duration remain below recommendations in Northwestern Ontario, Canada. Sandy Lake First Nation is particularly interested in understanding infant feeding experiences of community members to support increased breastfeeding initiation and duration. Therefore, this project aims to understand Indigenous caregiver infant feeding experiences using qualitative and Indigenous methodologies. As part of the Sandy Lake Health and Diabetes Project, a community-based participatory project focused on the prevention of type 2 diabetes mellitus, qualitative semi-structured interviews were conducted with 32 Anishininew caregivers living in Sandy Lake, Ontario. These interviews were tape recorded and transcribed verbatim. The Anishininew medicine wheel and situational analysis were used to inform our methods throughout this work. We recruited 32 co-creators, ages 18-57 years, who contributed knowledge through 26 individual and group interviews that occurred between August and October 2019. Two overarching themes, community context and caregiver identities, were identified that encompass six and eight specific themes, respectively, representing infant feeding experiences in Sandy Lake. Community members provided a variety of recommendations to help support infant nutrition in Sandy Lake, including a focus on structural needs like higher income and water security. This work highlights the need for birthing supports within remote Indigenous communities, and the inclusion of local and Indigenous knowledge in programming.