Journal of Health Psychology 18(8) 1023–1035 © The Author(s) 2012 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1359105312454041 hpq.sagepub.com Policy statements from international, national, and provincial levels of government, as well as health professional bodies, emphasize the importance of providing information to enable women to make informed feeding choices— with the preferred choice being breastfeeding (World Health Organization, 2004). As stronger links are drawn between breastfeeding and pre- vention of disease throughout the life course, breastfeeding promotion is increasingly posi- tioned as a priority of health agencies and among health professionals. Despite convincing evi- dence supporting the health benefits of breast- feeding, and a wide array of efforts by a range of professionals and lay practitioners support- ing breastfeeding, many Canadian women do not breastfeed. This article addresses the extent to which lay and professional practitioners engage with notions of health literacy in their breastfeeding promotion practices in a rural area of Atlantic Canada where literacy levels and breastfeeding rates tend to be lower than national averages. Multiple domains of health literacy as reflected in breastfeeding promotion practice: A Canadian case study Doris E Gillis 1 , Nicola J Gray 2 and Elizabeth Murphy 3 Abstract A model of multiple domains of health literacy was mapped to 30 practitioners’ accounts of their breastfeeding promotion practice in a region of Canada. Fundamental/basic literacy themes were consistent with earlier literature regarding practitioners’ discomfort in addressing literacy issues with their clients. Scientific literacy was reflected in practitioners’ dilemmas about using jargon and scientific evidence when discussing breastfeeding. Cultural literacy themes related to practitioners’ understandings of the sociocultural context influencing adoption of breastfeeding. Civic literacy was reflected in the use of advocacy for creating supportive breastfeeding environments. Building capacity for health literacy, however, was not a conscious focus of practice. Keywords community health promotion, infancy, practice, qualitative methods, women’s health 1 St Francis Xavier University, Canada 2 Independent Pharmacist Researcher, UK 3 University of Leicester, UK Corresponding author: Doris E Gillis, Department of Human Nutrition, St Francis Xavier University, PO box 5000, Antigonish, NS B2G 2W5, Canada. Email: dgillis@stfx.ca 454041HPQ 18 8 10.1177/1359105312454041Journal of Health PsychologyGillis et al. 2012 Article by guest on April 12, 2016 hpq.sagepub.com Downloaded from