A Closer Look at Cultural Issues Surrounding Breastfeeding

By Emma Pickett, IBCLC

As lactation consultants, we’ve been reading about breastmilk for a long time. It makes a nice contrast from the science of oligosaccharides to learn about the importance of goat meat soup to a lactating mother in Somalia or about the huge variety of cultures worldwide that emphasizes the importance of a mother avoiding ‘cold’ foods postpartum to seek spiritual balance. When it comes to reading about different cultural practices surrounding breastfeeding, there’s a lot that is simply fascinating.

Photo by mrcharley via Flickr Creative Commons

There’s a fabulous article by a breastfeeding mum named Ruth Kamnitzer which I would encourage you to read. In it, she talks about her experiences as a Canadian mother moving to Mongolia. She describes how feeding in public becomes a very different experience when complete strangers bend down to kiss your baby’s cheek – while he is feeding! Then, as he pops off in surprise, the giver of the kiss gets a face full of milk and everybody laughs. Try and picture that scene taking place in your local mall!

We enjoy reading about the fact that Japanese kindergarten admission forms might ask matter-of-factly whether a child has weaned from the breast. Or, that in Korea, an IBCLC declaring a baby to be beautiful would be going against the cultural practice of not commenting that a baby is healthy, fat or beautiful for fear of making the mischievous Gods jealous.

But once we’ve satisfied that natural boob and baby-obsessed curiosity, how do we balance our desire for evidence-based practice with some of the cultural messages that may seem harder to support?

Cultural practices fit into only 3 categories: beneficial, harmless or harmful.

Many Muslim families wish to practice the sunnah of ‘tahneek’. A softened date is sometimes rubbed on the baby’s palate before the first feed so the baby will enter ‘a sweet world’. Traditionally, if a date cannot be found, anything sweet will do. An IBCLC might guide a family towards a clean finger dipped in glucose water rather than the boiled hard candy from uncle’s pocket.

Other beliefs are more of a struggle. One study of 120 cultures showed that 50 withheld the infant from the breast for 48 hours or more due to the belief that colostrum was “dirty”, “old”, or “not real milk”. In central Karnataka in India, 35% of infants were still not breastfeeding at 48 hours, yet at 1 month 94% were. A mother who may be reluctant to give colostrum feeds in a western hospital may be passionately committed to exclusive breastfeeding later on.

Some of us can be a little smug when it comes to looking at cultural practices from around the world. We may feel uncomfortable when we hear of the lives of women in Kenya who are strongly instructed to avoid breastfeeding after quarrels to prevent “bad blood” entering the milk and affecting baby. This may mean breastfeeding is paused or a mother’s rights are infringed by family members or neighbors , yet she doesn’t speak up for fear of conflict. Several cultures – traditional groups in Papua New Guinea and the Gogo tribe of Tanzania among them – emphasize the need for the woman to be celibate during breastfeeding. A mother may be torn between her desire to breastfeed – in an environment when food after weaning may not be plentiful – and her desire to satisfy her husband. A husband who is often not expected to also remain celibate.

Those descriptions may be hard to hear but I have no doubt there are women pitying the cultural constraints put upon many woman living in Western industrialized cultures. These poor mothers are still often expected to be separated from their healthy babies after birth. Their baby may sleep in a separate area of a large building (“the hospital nursery”) because culture says “that’s best”. These poor mothers feel obliged to feed according to the clock and feel like failures if their babies feed more frequently. The babies in this culture are often weaned prematurely because the breast is over-sexualized and it’s deemed inappropriate for older children to feed at the breast. Many of us live in a culture that values privacy, scientific “measurement”, control, infant independence. It’s hard to imagine a set of cultural norms more incompatible with breastfeeding.

Is any of this really any less harmful in the long-term than avoiding colostrum feeding?

As an IBCLC, how do you educate yourself about the cultural issues within your community?

With a background of teaching in inner-city London, Emma Pickett, IBCLC came to breastfeeding support after she had her first child in 2004. She trained as a breastfeeding counselor with the UK-based charity the Association of Breastfeeding Mothers (ABM). Now sitting on their central committee, Emma continues to volunteer on the National Breastfeeding Helpline and the ABM’s own helpline as well as running three support groups in North London. Emma qualified as an IBCLC in 2011 and has a private practice alongside her voluntary work. Her work focuses on how breastfeeding impacts on a woman’s sexuality and relationships but also crucially how the sexualization of Western society affects the initiation and continuation of breastfeeding. She is keen to encourage open dialogue in an area which even breastfeeding supporters sometimes shy away from. You can her discuss Breastfeeding and Sexuality on a recent episode of The Boob Group.