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An Interview With Felicity M. A. Savage, MA, BM, BCh, FRCP, FRCPCH, FFPH, FIAP, FABM

Griswold MK, Omer Salim A

J Hum Lact, 2017 11;33(4):653-657.
PMID: 28820954 DOI: 10.1177/0890334417726321
Fulltext A Participatory, Needs-Based Approach to Breastfeeding Training for Confinement Centres

Foong SC, Foong WC, Tan ML, Ho JJ, Omer-Salim A

Int J Environ Res Public Health, 2022 Sep 01;19(17).
PMID: 36078639 DOI: 10.3390/ijerph191710914

With a focus on traditional practices rather than evidence-based practices, breastfeeding support is sub-optimal in confinement centres (CCs). We used a participatory, needs-based approach to develop a training module for CC staff adopting Kern's six-step approach as our conceptual framework. Of 46 identified CCs, 25 accepted our invitation to a dialogue aimed at establishing relationships and understanding their needs. An interactive training workshop was developed from the dialogue's findings. The workshop, attended by 32 CCs (101 participants), was conducted four times over a four-month period. Questions raised by the participants reflected deficits in understanding breastfeeding concepts and erroneous cultural beliefs. Correct answers rose from 20% pre-test to 51% post-test. Post-workshop feedback showed that participants appreciated the safe environment to ask questions, raise concerns and correct misconceptions. An interview conducted 14 months later showed that while some CCs improved breastfeeding support, others made no change due to conflict between breastfeeding and traditional postnatal practices, which was aggravated by a lack of support due to the COVID-19 pandemic. A participatory approach established a trustful learning environment, helping CCs appreciate the value of learning and adopting new concepts. However, cultural perceptions take time to change, hence continuous training and support are vital for sustained changes.
Fulltext What makes a city breastfeeding friendly? A qualitative analysis of interviews with breastfeeding women from Europe and Asia

Tan ML, O'Sullivan EJ, Ho JJ, Omer-Salim A, McAuliffe FM

PLoS One, 2025;20(1):e0317374.
PMID: 39804854 DOI: 10.1371/journal.pone.0317374

BACKGROUND: The warm chain of support is the continuous enabling environment from the mother's first contact with healthcare professionals during early pregnancy, birth and immediate post-partum period, her transition from healthcare facility to home, through to work and the community at large. A breastfeeding-friendly city should be able to support a breastfeeding journey across the warm chain.
OBJECTIVE: To determine breastfeeding women's perspective of an ideal breastfeeding-friendly city.
METHODS: Between September 2021 and January 2022, twenty-two women who were breastfeeding or had ever breastfed in the last 5 years from Ireland and Malaysia were interviewed. A set of selection criteria was applied to ensure representation of a range of the characteristics known to be associated with breastfeeding success: diverse age groups, birth and breastfeeding experiences, culture and socioeconomical background. One-on-one semi-structured online interviews were conducted by the first author. Data were analysed using Braun and Clarke's Thematic Analysis framework.
RESULTS: One overarching theme of breastfeeding at the front and centre of the city, and three major themes were developed: 1. mothers feel supported when breastfeeding is prioritised; 2. when breastfeeding is visible in the environment, it becomes normalized; 3. there is a need to have seamless breastfeeding support across the continuum of the warm chain, and at all levels of society.
CONCLUSIONS: The findings demonstrated the importance of prioritized, and continuous support throughout the breastfeeding journey. The hopes and aspirations of a breastfeeding-friendly city expressed here would be useful for cities to consider when developing or implementing breastfeeding support programmes as well as guide development of indicators of a breastfeeding-friendly city.
Fulltext What makes a city 'breastfeeding-friendly'? A scoping review of indicators of a breastfeeding-friendly city

Tan ML, Mohd Shukri IA, Ho JJ, O'Sullivan EJ, Omer-Salim A, McAuliffe FM

Matern Child Nutr, 2024 Apr;20(2):e13608.
PMID: 38100143 DOI: 10.1111/mcn.13608

A breastfeeding-friendly city is one where there is an enabling environment to support breastfeeding throughout the first 2 years or more of a child's life. Indicators of a breastfeeding-friendly city have yet to be identified. What are the indicators or criteria used to define breastfeeding friendliness in a geographic area such as a city and the settings within, which we have classified as community, healthcare and workplace? Three major databases and grey literature were searched. Records were screened to identify publications describing criteria such as indicators or descriptions of a breastfeeding-friendly setting, defined as 'criteria-sets'. These criteria-sets were then categorized and summarized by settings. The search up to 2 September 2021 found 119 criteria-sets from a range of settings: geographic locations (n = 33), community entities (n = 24), healthcare facilities (n = 28), workplaces (n = 28) and others (n = 6). Overall, 15 community, 22 healthcare and 9 workplace related criteria were extracted from the criteria-sets. Criteria that were consistently present in all settings were policy, training & education, skilled breastfeeding support and physical infrastructure. Some criteria-sets of geographic locations contained criteria only from a single setting (e.g., the presence of breastfeeding-friendly cafes). Criteria-sets were present for all settings as defined in this review, but few were actual indicators. Specifically, there were no existing indicators of a breastfeeding-friendly city. Several common components of the criteria-sets were identified, and these could be used in developing indicators of a breastfeeding-friendly city. Future studies should determine which of these are important and how each can be measured.