Lactation consultants will encounter mothers with a wide variety of native languages, language skills, educational levels, learning styles, cultural backgrounds, degrees of acculturation, life experiences, abilities, and current living situations that impact their needs, options, perceptions of their breastfeeding problems or questions, conceptualizations of health and illness, appropriate health care, in general, appropriate breastfeeding support, in particular, and acceptable solutions and interventions. Cultural competence, briefly and in the context of breastfeeding, is the development of knowledge, skills and systems that allow the lactation consultant to work effectively with this diversity. Cultural competence includes cultural knowledge, cultural awareness and cultural sensitivity, but is much greater than the sum of these parts. The development of cultural competence is an ongoing, life-long process. It does not happen casually or unintentionally.
Part of cultural competence is the expectation and nonjudgmental acceptance of difference:

"Huge variations exist in all of human behavior, including breastfeeding. While some cultural beliefs and practices create breastfeeding difficulties, others do not. Leaders must be careful to distinguish "different" from "harmful" when they encounter breastfeeding beliefs and practices from another culture." (Good Mojab 2000)

Another part is actually *valuing* diversity:

"Every mother breastfeeds and mothers her child to the best of her ability based on her own experiences, worldview, and the resources available to her. What works well with one breastfeeding pair, in one family, in one society, at one point in history may not work well for other breastfeeding pairs in different circumstances. There is strength in this diversity: mothers and nurslings have survived and thrived in a variety of living situations around the world and throughout time." (Good Mojab 2000)

My favorite expression of valuing difference is this quote by the great Mexican poet, Octavio Paz (1967): "What sets worlds in motion is the interplay of differences, their attractions and repulsions. Life is plurality, death is uniformity. By suppressing differences and peculiarities, by eliminating different civilizations and cultures, progress weakens life and favors death. The ideal of a single civilization for everyone, implicit in the cult of progress and technique, impoverishes and mutilates us. Every view of the world that becomes extinct, every culture that disappears, diminishes a possibility of life."

Working daily on developing cultural competence,

Cynthia

Cynthia Good Mojab
Ammawell
Email: [log in to unmask] 
Web site: http://home.attbi.com/~ammawell 


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