Lactar bonito (breastfeeding artfully): knowledge, attitudes, and practices among the Nasa indigenous people in Colombia.

BACKGROUND: Breastfeeding (BF) among indigenous people is considered a natural and socio-cultural practice that stems from worldviews and ancestral knowledge aimed at strengthening bonding and affection and transmitting history and language for cultural survival. Our study aimed to describe the knowledge, attitudes, and practices about BF under the Nasa cosmovision of an indigenous people in southern Colombia. METHODS: This qualitative study is part of a project focusing on Community Based Participatory Research (CBPR). The photovoice technique was used with beneficiary mothers of Community Care Units (CCUs) attached to the Intercultural Early Childhood Program administered by the Nasa Paez Huila Indigenous Reservation. Fourteen CCUs participated, and 27 photographs and stories about BF in the community were collected. Data analysis was conducted using Grounded Theory analytic tools and ATLAS.ti software. RESULTS: BF under the Nasa cosmovision, women are seen as protagonists who, by breastfeeding, influence cultural scenarios such as their homes, community, ancestral settings (house, tul,tulpa, rivers, trees), symbolic elements (chumbe), and knowledge (medicinal plants and foods) that contribute to the care of mothers and newborns in connection with Uma Kiwe (Mother Earth). Positive and affirming attitudes (lactar bonito) toward BF associated with cultural survival and care for the community and Mother Earth are emphasized to the point of elevating BF to the status of a children's right. Traditional and Western practices coexist to prepare women in puerperium through traditional medicine practices to improve breast milk production, quality, and duration. CONCLUSIONS: Nasa's knowledge of BF incorporates indigenous beliefs about the interconnectedness and interdependence of caring for women, children, and Mother Earth. The attitudes involve the feelings of different family and community members who are prepared to take care of both the mother and the 'new being', which implies the revitalization of the food and ancestral culture of the indigenous people. Finally, BF practices are implemented from pregnancy to puerperium and aim to improve milk production, infant feeding, and nutrition. Some alternative uses of breast milk were also identified, as well as synergies between traditional and Western practices that promote BF, and the tensions and risks associated with BF in the region.