Diversity in culture, ethnicity, and race in the United States requires nurses individualize care while being mindful of the patient’s cultural needs (Leininger & McFarland, 2006). Care must be patient specific, and this care cannot be delivered without proportionate cultural knowledge. Inspired by Madeleine Leininger, a nursing theorist who developed the Culture Care Diversity and Universality Theory, this project explores how culture impacts maternal infant feeding methods and decisions.
In 2007, the CDC published that 59.7% African Americans, 77.7% Caucasians, and 80.6% Hispanics breastfed in the United States (Jones, Power, Queenan, & Schulkin, 2015). Research suggests there are multiple factors that contribute to feeding decisions such as employment, education, socioeconomic status, and culture. While many of these topics have been researched, culture has not been a primary focus. Past research indicates that Hispanic mothers are more likely to breastfeed because it is “ingrained in their Hispanic heritage” and that “breastfeeding is what Hispanics do” (Hohl, et al., 2016; Reeves & Woods-Giscombe, 2015). African American women, are more likely to bottle feed due to cultural/ethnic opposition which began in the slave era, when African American women were forced to breastfeed and care for their master’s children (DeVane-Johnson et al., 2017). This imposed feeding role has resulted in many African Americans feeling sensitive to breastfeeding in the United States. In both cultures/ethnicities women are taught these ideas by their female family members, such as mothers and grandmothers (DeVane-Johnson et al., 2017; Hohl et al., 2016; Kaufman et al., 2010; Owens et al., 2018; Reeves & Woods-Giscombe, 2015). My thesis sought to explore how infant feeding choices and preferences are influenced by their cultural backgrounds of the minority Middle Eastern cultural groups in Northeastern Ohio. In the United States 3.7 million residents trace their roots to an Arab country (Exner, 2013). Ohio is home to 64,799 Arab residents, including 26,607 in the Cleveland-Akron area (Exner, 2013).
Research was conducted under ethnographic theory of qualitative study. Ethnographic theory is a framework used for studying the meanings, patterns, and lifeways of culture in a holistic fashion (Polit and Beck, 2014). Qualitative research is based on the investigation of phenomena collected in narrative form (Polit & Beck, 2014). Nine Orthodox Christian Middle Eastern mothers born or currently residing in Northeastern Ohio were interviewed during July to October of 2018. A semi-structured topic schedule, The Newborn Feeding Survey, titled "Decisions regarding newborn feeding by Latina mothers” was used during interviews (Jones, Reller, Knowles, Lin, & Lohr, 2018). The survey was adapted slightly to meet study needs.
Overall, the goal of my thesis was to explore cultural impacts on maternal feeding decisions in Orthodox Christian Middle Eastern Culture. The research contributes to Leininger’s Cultural Care Theory and continues ongoing efforts to create more culturally competent nurses. The results of this study are intended to be used by nurses and other healthcare professionals to improve cultural awareness and competency surrounding feeding practices in the Orthodox Christian Middle Eastern culture.