Grant: Team Grant: Embracing Diversity to Achieve Precision & Health Equity -Indigenous

In 2019, the Breastfeeding Committee of Canada began a project to bring the Baby-Friendly Initiative (BFI) to hospitals across Canada. The BFI practices are a guide for hospital staff to support families giving birth to breastfeed. Although the project had many successes, an important gap came to the attention of the team: the BFI was not designed specifically to support First Nations, Inuit, and Métis (FNIM) families' experiences. However, there is a great need to have such supports for FNIM families, because FNIM people have historically faced and continue to face racism in the health system, and as a result, they consistently have lower breastfeeding rates than other groups in Canada and are at higher risk of many kinds of ill health. Our current proposal is meant to address the need for culturally safe, compassion-informed, and evidence-based breastfeeding supports in health system facilities serving FNIM people. This quality improvement project centres self-determination and self-governance of FNIM. Our team is committed to reconciliation. We will work with and be guided by FNIM researchers, healthcare providers, and communities across Canada to reclaim the traditional practice of breastfeeding. Together with FNIM partner communities and overseen by a Grandmothers Council, the research team will co-develop a framework to address anti-Indigenous racism and guide the implementation of the BFI in a way that centres and celebrates FNIM culture, ceremony, and ways of knowing. The framework will support implementation of the adapted BFI in health system settings in six FNIM communities and we will measure outcomes to describe how well the adapted BFI is working for patients and the health system, and whether it is improving breastfeeding rates and health equity.