Gathering More Voices: The Asia Pacific Panel at the 2014 Lactation Summit

The 2014 Lactation Summit was designed to listen and learn from the missing voices of the profession so that strategies for dismantling institutional oppression within the profession can be developed.

Much was learned from the 2014 Summit, but there is still listening to be done. Over the next few weeks, Lactation Matters will be breaking out the Summit findings from each community that spoke at the Summit. Our goal is two-fold: to shine a brighter light on the concerns raised in each session, and to solicit other voices who were not present at the Summit.

The 2014 Summit was the result of a year-long planning effort by a 22-member design team made up of diverse representatives from seven countries of the world. It was hosted jointly by International Board of Lactation Consultant Examiners® (IBLCE®), International Lactation Consultant Association® (ILCA®), and Lactation Education Accreditation and Approval Review Committee (LEAARC).

The design team recommended a structure to hear from 26 individuals representing the following categories:

• African Americans in the U.S.
• Hispanics in the U.S.
• Native Americans in the U.S.
• North and South America
• Asia Pacific
• Russia and Europe
• Communities that cross geographic and ethnic lines (males, lay breastfeeding support groups, those working in remote regions of the world, and the LGBTQI community)

While there are specific barriers unique to various racial, ethnic, geographic, and other groups, several general themes emerged that were common to many of the groups. These findings will help guide future discussions and action plans needed to dismantle institutional oppression.

The following is a summary of the assessments made by individuals representing the panel on Asia Pacific. Read our other posts on the assessments made by individuals representing the panels on African Americans in the U.S., Native Americans in the U.S., Hispanics in the U.S., and North and South America. To access information on all of the panels presented, read a complete summary of the report here.

In future posts, we will be highlighting the assessments made by other communities in the order they were presented in the Summary Report.

We hope that, after reading, you will consider sharing your comments, ideas, and suggested solutions. Please click here to offer your input.

Asia Pacific – Japan, China, New Zealand, Australia

As in many other parts of the world, the needs and issues of both predominant and underrepresented communities vary throughout the Asia Pacific region. While enormous strides have been made to advance the lactation profession in this region of the world, access to the profession is difficult even for dominant cultures and those with socioeconomic resources. Inequities experienced by underrepresented aboriginal, Maori, and Chinese communities make access even more difficult.

Australia
It was noted that 240 years ago the population of Australia was mostly aboriginal. Today, 95% of the population of Australia consists of immigrants or descendants of immigrants. The cultural diversity throughout the country and large distances between communities means that lactation education must be taken to the people. While there are more than 1,000 IBCLCs in Australia, significant barriers abound, including:

• Distance, transportation and cost – are barriers to acquiring required lactation education and clinical instruction.

• Fears — that the IBCLC exam is too hard or difficult to attain.

• Discrimination against aboriginal populations – make inequities an ongoing reality and concern.

China
Significant barriers to the profession exist in China. Despite the large geographic size and population of the country, only a small handful of IBCLCs exist there. This represents both a challenge and an opportunity. Common barriers identified include:

• Language barriers – exist, with no comprehensive breastfeeding education texts in Chinese. This makes it virtually impossible to advance the profession in culturally appropriate ways unless people also speak English.

• Education and exam costs – are prohibitive. In China, health care providers are not paid at levels similar to those in the United States.

• Lack of educational opportunities – result in breastfeeding education not being readily available for health providers. This means it is also not available for aspiring IBCLCs.

• Low numbers of IBCLCs – create a noticeable gap in professionals who can provide training and mentorship opportunities. Lack of knowledge about the IBCLC profession makes it hard for others to understand and accept it.

• Enormous strides – have been made in a relatively short period of time. Over 200 peer counselors have been trained, and this core group is now energized to want to become IBCLCs. Another avenue for outreach is the field of mother-infant care specialists who provide breast massages, the only certificate that the government of China has issued. IBLCE has now included a simplified Chinese section to the IBLCE website, and a Chinese blog on lactation now has nearly a million followers from across the country. An online chat group has begun purchasing English texts and each member of the study group translates a portion of the book and then shares what they learned to help one another prepare for the IBCLC exam.

• Resources and education – are desperately needed for Chinese IBCLC candidates. These aspiring IBCLCs need books and educational resources in Chinese, online training opportunities in Chinese, and opportunities in hospitals and private practices to acquire clinical experience hours. In addition, the IBCLC exam needs to be translated into Simplified Chinese in order for more people to be able to sit the exam. Lactation consultants from other countries are welcomed in China to provide training and assist in the growth of the profession.

Japan
Japan experienced phenomenal growth in the lactation profession from 1995 when the first IBCLC was certified to 2013, when there were 891 IBCLCs in the country. Much of this rapid growth was attributed to targeted outreach. Nonetheless, significant barriers make expanding the profession quite difficult.

• Heavy reliance on the profession grounded in the medical field – makes it more difficult for others to feel welcomed into the profession. The majority of current IBCLCs in Japan are also midwives or nurses; 11% are also physicians.

• Recertification – is a significant barrier for current IBCLCs. The time, energy, and cost required for continuing education are significant. The value of having become IBCLC certified is not always appreciated among current members of the profession in the country.

• Exam entrance requirements – are difficult. The health science education required is expensive and difficult to locate and access. Many resources and training programs, including online programs, are not available in Japanese.

• Significant language barriers – exist in Japan, making it difficult for many members of the community to access the education required. This is of special significance for minorities in Japan who often do not speak English and lack literacy in Japanese, as well. Internal communications remain a challenge in Japan.

New Zealand
In New Zealand significant issues exist with regard to the monetary exchange rate, which often makes it impossible to access U.S. based lactation courses, ILCA membership, and other resources. The Maori are the largest native community within New Zealand, yet they are not well represented in the profession of IBCLCs. High rates of teen pregnancy and lack of access to traditional resources, including basic Internet access, pose additional challenges.

We welcome your comments, ideas, and suggested solutions. Please click here to offer your input.