RESUMEN
AIM: To examine low birth weight (LBW) in First Nations babies born in a large metropolitan health service in Queensland, Australia. MATERIALS AND METHODS: A retrospective population-based study using routinely collected data from administrative data sources. All singleton births in metropolitan health services, Queensland, Australia of ≥20 weeks gestation or at least 400 g birthweight and had information on First Nations status and born between 2019 and 2021 were included. The study measured birthweight and birthweight z-score, and also identified the predictors of LBW. Multivariate regression models were adjusted by demographic, socioeconomic and perinatal factors. RESULTS: First Nations babies had higher rates of LBW (11.4% vs 6.9%, P < 0.001), with higher rates of preterm birth (13.9% vs 8.8%, P < 0.001). In all babies, the most important factors contributing to LBW were: maternal smoking after 20 weeks of gestation; maternal pre-pregnancy underweight (body mass index <18.5 kg/m2); nulliparity; socioeconomic disadvantage; geographical remoteness; less frequent antenatal care; history of cannabis use; pre-existing cardiovascular disease; pre-eclampsia; antepartum haemorrhage; and birth outcomes including prematurity and female baby. After adjusting for all contributing factors, no difference in odds of LBW was observed between First Nations and non-First Nation babies. CONCLUSIONS: First Nations status was not an independent factor influencing LBW in this cohort, after adjustment for identifiable factors. The disparity in LBW relates to modifiable risk factors, socioeconomic disadvantage, and prematurity. Upscaling culturally safe maternity care, focusing on modifiable risk factors is required to address LBW in Australian women.
RESUMEN
STUDY AIM: This study examined urban Aboriginal and Torres Strait Islander mothers' breastfeeding experiences to inform support for mothers and their families. STUDY DESIGN: The research took a strengths approach, using qualitative methodology. Twenty semi-structured in-depth face-to-face interviews were conducted and analysed thematically. SETTING AND PARTICIPANTS: Indigenous mothers of infants 3 to 12 months were recruited through a Brisbane Indigenous health service. KEY FINDINGS: All mothers recounted considerable physical and emotional energy invested in breastfeeding. Although early introduction of formula made sense for some mothers under stressful circumstances, timely pro-breastfeeding support from family and health professionals facilitated continued breastfeeding. Professional and social/family contacts play key roles in steering infant feeding outcomes. CONCLUSIONS: Mothers' experiences strongly influence infant feeding strategies. Aboriginal and Torres Strait Islander community strengths are underutilised in supporting breastfeeding mothers. FUTURE IMPLICATIONS: Indigenous mothers, family and community strengths present points for engagement in future breastfeeding promotion and support initiatives.