Hi all,

I am hoping to get information from those of you experienced with the trends
of breastfeeding in Mexico or in hispanic moms in general.  Although I live
in rural Kansas, our community is said to be one of "the most culturally
diverse in the United States."  We have large beef packing plants and
related industries and have a large hispanic population.  Many families have
lived here a number of years, but many are newly immigrated.

I am working with this population in a new grant that is focused primarily
on providing "enhanced pediatrics" to the families of our clinic.  One of
the outcomes we are hoping to see is increased breastfeeding rates.
Although the families are not actually enrolled in the program until after
the birth of their babies, I believe strongly that we must promote
breastfeeding and educate prenatally.  I am developing a prenatal class for
the Spanish speaking population of our clinic and hope to get some
suggestions from all of you in Lactnet Land.

When asked prenatally about their plans on infant feeding, most hispanic
mothers in our clinic reply, "I want to do both."  The nurses at the
hospital are only too glad to take them a bottle and the physicians don't
take a strong stand either.  Consequently, you know what happens in many
cases.  Some manage to go on to breastfeed but many find that "there is no
milk" and "the baby doesn't want it."  In addition to those two common
occurrences, I also observe these mothers to keep their babies snug and
swaddled with several layers of clothes, hat, mittens, and fuzzy blanket.
They try to put the baby to breast without unwrapping so the baby cannot
really get to the breast or quickly falls asleep. Another thing I notice, is
the discomfort that a crying baby causes for these moms - they quickly
abandon efforts to get the baby to latch on and reach for the bottle saying,
"See, he/she doesn't like it."

My hispanic friends and colleagues say that this trend to "do both" is in
response to the mothers knowing that breastfeeding is best for their babies,
but believing that bottle feeding is what modern, American women do.  Most
seem to think that women in Mexico mostly breastfeed and that formula is not
very available.  Having read the book Infant Feeding in Mexico, I think
there may be more to this issue.  Data obtained from 59 health facilities in
3 regions of Mexico (Mexico City, Chiapas, and Sonora) revealed that only
half of mothers on admission wanted to breastfeed exclusively, that only 7%
of mothers were offered any choice on feeding, all babies recieved a series
of prelacteal feeds, most received supplemental bottles, and half of mothers
did not feed their infants at all.  This information is greatly surprising
to us Americans who think formula companies haven't yet made it to the
depths of Mexico.  Actually, the breastfeeding environment at the Mexican
health care facilities sounds worse than here in my community.

I am planning to offer prenatal classes in Spanish and utilize peer
counsellors. I have Spanish videos and handouts but would like responses
from anyone who works with the kind of issues I am describing.  I would also
love to hear from anyone who could provide insight as to where the "do both"
trend comes from and what cultural issues are involved here.  Most of the
women I am describing are very family oriented, stay at home moms and are
totally devoted to their babies.

Thank you to all who respond.

Esther Oppliger, RN, MSN, ARNP, IBCLC
Garden City, Kansas