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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


World Breastfeeding Week: More babies are receiving donor human milk in Canada

By Jodine Chase

It’s been almost two years since the Canadian Pediatric Society called for a network of donor human milk banks across Canada to join the country’s single milk bank in Vancouver. Now, across the country, more babies have the option of donor human milk when mother’s milk is not available.

Photo via Calgary Mother’s Milk Bank

The British Columbia (B.C.) government has plans to build on the long-established milk bank at the Baby-Friendly-certified B.C. Women’s Hospital. They sent representatives to the Human Milk Banking Association of North America conference earlier this year and are exploring an expansion of milk banking throughout the province. A Donor Breast Milk Dispensary has opened at Chilliwack General Hospital. And Breastfeeding Matters South Vancouver Island is now raising funds to support the shipping of donor milk from Vancouver Island to the mainland for processing.

Photo via Calgary Mother’s Milk Bank

The country’s second milk bank, serving all of Alberta, opened in Calgary in the fall of 2011, bringing much-needed donor milk to babies in Neonatal Intensive Care Units (NICUs) to that province. This summer, Edmonton’s Grey Nuns hospital announced the launch of a collection depot for Edmonton donors. The depot allows mothers an easy place to drop off frozen milk to be shipped to Calgary for processing. The announcement came after a successful fundraiser by the Breastfeeding Action Committee of Edmonton (BACE) and strong support from Edmonton neonatologists Dr. Shariff Shaik and Dr. Ramneek Kumar.

Long-time breastfeeding advocates Johanna Bergerman, Janice Reynolds and Wendy Stefiuk of Saskatchewan also attended the HMBANA conference in Las Vegas this spring. A Saskatoon Health Region Baby Friendly Coalition working group that includes neonatologist Dr. Koravangattu Sankaran and staff from the NICU at the Royal University Hospital are exploring the feasibility of milk banking in that province.

Photo via Nancy Holtzman

Toronto has been a HMBANA developing milk bank for several years now and is close to opening. The Ontario Donor Human Milk Bank recruited a part-time coordinator last fall. Pediatrician Dr. Sharon Unger told a US FDA committee last year that two hospitals, Mt. Sinai and Sunnybrook, currently use donor human milk and all NICUs in the area are participating in a randomized control trial on the use of donor human milk. A quiet fundraiser has been operating on the Sunnybrook website to raise money for the project.

There are two efforts underway in Quebec currently and it is expected a milk bank will be operating soon in that province.

Although more babies are receiving donor human milk, there are still many areas of the country where donor milk is not currently available. Physicians and hospitals outside of Alberta, B.C., and the Toronto area can place orders from the country’s two operating milk banks, and parents who have funds to pay the processing fees and shipping can purchase milk with a doctor’s prescription from Vancouver and Calgary, if it is available. In the meantime, there are a number of robust milksharing communities active on Facebook and the Internet – Human Milk 4 Human Babies operates community sites on Facebook in all provinces and Territories, Eats on Feet has some less-active chapters in some areas, and MilkShare is active in Montreal.

Jodine Chase owns a public relations firm that specializes in news analysis for a select clientele. She is a longtime breastfeeding advocate with five children and three grandchildren. She has provided a variety of news briefing services for the breastfeeding community and currently curates Human Milk News, and is list mother for several information sharing lists in Alberta relating to efforts to re-establish donor human milk banks.  She joined the Alberta Breastfeeding Committee in 2011 and her focus has been providing support to develop ABC’s communications strategy. She is a founding member of the Breastfeeding Action Committee for Edmonton (BACE), Human Milk for Human Babies, and a supporter of the nascent Calgary Mother’s Milk Bank in Alberta. Her most recent campaign has seen her take on the removal of breastfeeding photos on Facebook.


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