Barriers to Baby Friendly for Indigenous Patients in the United States

Although the indigenous populations of the United States experience substantial disparities in health outcomes, little information is available regarding barriers to their access to specifically baby friendly hospitals and baby friendly services in the United States. Access is important because indigenous patients, especially women, have higher infant mortality and childhood obesity than their white counterparts.
This systematic review seeks to uncover potential barriers to baby friendly hospital services for indigenous patients in the United States. This systematic review analyzed the current literature from select databases published between 2000 and 2020 and narrowed literature down into studies deemed relevant because of their focus on the BFHI or equivalent and on indigenous patients. 303 studies were found using a specialized search string and then after evaluation under exclusion and inclusion criteria, 21 were identified for use in this review.
Analysis of these selected studies revealed trends of barriers as well as disparities in indigenous participation in current research. The conclusion of this review is that baby friendly and its “Ten Steps to Successful Breastfeeding” must be altered to allow for implementation in different cultural settings, especially for indigenous patients. Additionally, there is a need for additional research that focuses on indigenous patients in this setting and is written by members of that community. Increased representation from this community will enhance future work towards deconstructing the barriers preventing indigenous patients to access BFHI resources.