East-Aisan Breastfeeding Practices

Elvish, BSN, DNP, RN, NP · Dec 18, 2014

There are several cultures - some of them Asian, if I'm not mistaken - which believe that colostrum is harmful to baby. I've run into it too.

I absolutely agree with respecting someone's culture while gently educating on what science tells us.

If they absolutely aren't going to put baby to breast (Asian or otherwise), it's important they learn about pumping and/or hand-expression and milk storage. Skin-to-skin as much as possible to increase supply. These moms will still need to know about feeding cues and all the signs of good latch and milk transfer.

missnurse89 · Dec 19, 2014

The Hispanic population in our community seems to supplement no matter what and also until their milk "comes in." I really despise that phrase...

BF is very cultural and in my experience the most effective thing to do is explain to them the benefits of colostrum including tummy protection, concentrated in antibodies, and the fact that it is slower flowing than the mature milk. I really like that fact because I like sharing with the moms that the colostrum is like practice milk and because it's slower flowing it allows baby to learn how to breastfeed which is very important to having success with BF. I agree it's important to respect the culture. UT we shouldn't ignore when there is a need. Just be that person to share some information. Careful how you word things. I like to say "I can see why you think that" or "you know, I used to think the same thing", then proceed to ask them if they would like to hear something you just learned about it. Maybe this: Can I share with you something I find helpful? Presentation and wording goes A LONG way!

With it being cultural, do your best to educate and hopefully that will influence a change (eventually) in the way their culture views colostrum. I always refer to it as "liquid gold." I feel like I am always competing with formula companies to "upsell" breastmilk. Mostly I find moms need reassurance more than anything. Also have you read "Breastfeeding Made Simple"? I highly recommend it! It's a great book!!

1koolRNchick · Apr 25, 2015

Hi, I would like to share with you that as being An Asian (Chinese/ Vietnamese) myself, we usually prefer breast feeding too. Just to clear up any misconception that Asian thinks breast milk is harmful to baby. In fact, most Asian kids are raised by breast milk since formula would be too expensive to afford in Vietnam and China. In the case of your patient, maybe there are other reasons that these mothers prefer not to breastfeed? Perhaps there's no milk despite multiple attempts and Asian usually are very humble and overly considerate at times that they hate to trouble nurses to keep trying to show them how to get the milk to come in. Help that helps you understand a bit more of Asian culture.

Stay calm, stay humble and carry on...âœŒï¸

klone, MSN, RN · Apr 25, 2015

I don't think the OP is talking about not breastfeeding at all, but just the first few days before mature milk. A lot of Hispanic moms are the same way. We just educate and encourage.

missnurse89 · Jun 4, 2015

It is important to identify trends but treat all as individuals.

tareija · Jun 23, 2015

This is something we see a lot in my hospital, as we have quite a high Asian (primarily Chinese) population where I live. It seems to be a stronger belief with newer immigrants. I've never heard anyone refuse to feed the baby colostrum or voice that it's harmful to baby, and they do seem quite motivated to breastfeed. However, the first few days, when they have a normal amount of colostrum, often they say they have "no milk". For this population, often the grandmothers (either mom's mom or dad's mom or both) are very involved in caring for the new mom and baby, which is great. Sometimes I think the grandmothers hold this belief strongly as well, and maybe this influences the new mom's position.

Anyway, we have some of our breastfeeding pamphlets translated in to a few different languages, and I try to provide these if it seems helpful. Even if Mom's English is fine, a lot of the time the grandmas only speak Chinese, so I might give the Chinese pamphlet for grandma to read, so that she has the current information as well. I also explain how baby's tummy is tiny, and in the first few days it's normal to just have small amount of milk, but there's lots of calories and antibodies in that milk. Also, that the more baby breastfeeds, the more often it will help to have the mature milk come in.

As for supplementing, it depends on the situation. If, after appropriate patient teaching, a mom is insistent, I will give them formula, since it's her baby and her choice. If a patient is a multip, I will ask if she supplemented previous babies, and if she had any supply issues. If she did and had no issues, then I'm less concerned. If she is a primip, I explain that sometimes giving supplements can make the mom make less milk, because baby doesn't breastfeed as often, and that we can't predict in advance which moms this will happen to. It might be fine, or it might cause issues, and we don't know what will happen for each individual baby. Even with primips, again I think as long as you do the teaching, it is the mom's choice whether to give formula or not, so I will give it if the mom gives an informed consent.

TexRN, BSN, RN · Jul 8, 2015

Another thought to add, with our "bottle culture" that is so prevalent in the US... It's been known that immigrants to our country tend to adopt the practices of the new country, even if their previous country had high breastfeeding rates. Also make sure to give breastfeeding information pamphlets in their native language.