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CDR Sheila Weibert, WHNP, IBCLC
Culture is defined as practices, beliefs, values and norms which can be learned or shared, and which guide the actions and decisions of each person in the group (Leininger, 1985). A woman's attitude towards breastfeeding and how she chooses to feed her baby are closely linked to the woman's culture. Anyone working with pregnant women assesses the culture of each individual woman and how it impacts her decision to breastfeed.
In evaluating the cultural impact on breastfeeding, several key questions can be asked. One can ask the woman about where she grew up and if her mother, aunts or friends have breastfed a baby. What kind of family organization (roles, decision making) does she live in? What does she know about infant feeding? Did anyone in the family breastfeed? What support from family or friends does she have? Are there any rituals, special values, or taboos? An effective way to evaluate the cultural value or ritual is to consider if it is beneficial, harmless, or uncertain in outcome (Williams & Jelliffe, 1972).
Women of East Asian and Southeast Asian cultures (Cambodian, Chinese and Vietnamese) may follow a custom called "doing the month". Women are thought to be vulnerable to cold, wind and magic. Therefore, they are to stay home, avoid drafts, and dress warmly in the first 30 days following childbirth. If the woman comes from rural areas of Vietnam, Cambodia, or Laos, infants are typically breastfed for one year. Breastmilk may be supplemented with pre-chewed rice paste. If women come from urban areas, infants are more likely to be formula-fed. Following immigration to the United States, only 10 percent of women from East and Southeast Asian cultures continue to breastfeed. The presence of a family member to assist
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the mother during the postpartum period has been shown to be positively correlated with breastfeeding initiation in the United States.
Having healthy children is highly valued in the Japanese culture. Breastfeeding is viewed as necessary for the health of the child. There are some Japanese kindergarten admission applications that ask how long the child was breastfeed. A figurine or plaque may be given to the breastfeeding mother to help her prayers for sufficient milk. Breastfeeding may continue for a year or longer. Many Japanese women are caught between the traditional values and customs, and "modern" concepts of working outside the home, formula bottle feeding and how women in the United States feed their infants.
Women from Latin America and Mexico have grown up in a culture where 80% of the women breastfeed for at least 4-6 months. Sadly though the breastfeeding initiation and duration rates fall to about 48% after immigration to the United States (Williams & Pan, 1994). The main reason for the decline is that women are returning to work or school and are embarrassed to breastfeed in public. Colostrum is considered dirty or stale milk and Hispanic mothers may not put babies to breast for several days after birth. Professionals working with these women may change this practice by having the women express a few drops of the colostrum and then place the infant to the breast. Hispanic culture teaches that any stress or emotional upset may change the quality, quantity, and even sour the breastmilk. If this occurs, the Hispanic mother may provide formula feedings because she does not want the baby to be harmed by her milk.
Islam is more than a religion, it is a way of life. Religion is also a "cultural group". For example, the teachings of the Islam religion require that mothers (even if divorced) are to breastfeed their children
continued on page 3
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Published by: SDCBC
Printed Courtesy of:
San Diego County Children and Families Commission
Editors:
Kelly Barger, RD, CLE, CDE
Meredith Kennedy, MPH
Jo Ann Shaw, RD, IBCLC
Nancy Wight, MD, FAAP,IBCLC
Leslie Wynn, RN, PHN
Designed by:
Creative Impacts
www.creative-impacts.com
Inquiries can be sent to:
San Diego County Breastfeeding Coalition
Children's Hospital
3020 Children's Way, MC 5073
San Diego, CA 92123-4282
Or
mmkennedy@chsd.org
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