Wendy Chu recently posted about some of the cultural practices of
Chinese/Chinese-American families and BFing, and this gives me a perfect
opening for questions that I've been working on for years. It's difficult to
ask cross-cultural questions without invoking stereotypes, but I hope to get
some insight, and I most earnestly hope to offend no one.

OK, here goes...In our community (Ithaca NY, home of Cornell University),
there are many, many Asians (my experience withy them is through both the
hosp. and WIC), both grad students & their wives (mostly from China, Korea,
& Japan) and a significant refugee population from Viet Nam, Laos, Cambodia,
& other Southeast Asian countries. Most of the Southeast Asians choose to
breastfeed, and do so without much "help" from us at WIC, etc. (Traditional
practices, etc.) The Chinese, Korean, and Japanese women associated with the
university, on the other hand, have a very difficult time BFing; they are
well-educated, very careful families, very eager to do the absolute best
thing for their babies, and they are well aware that that is BFing. So far,
so good. Here's the problem: there is a very pervasive belief among these
families that Asian women "can't make enough milk", at least in this
country, and there is a tendency to believe that that is the case even when
their own exclusively BF babies are huge, healthy, & massively thriving,
positively glowing with good health. I and my peers have been working on
this question for years, but I still don't have a good understanding of
what's at the root of this belief. I do understand the cultural differences
in most practices r/t BFing - diet, activity restrictions, traditional
herbal medical practices and their basis in beliefs, etc. - but I still
wonder what's at the root of the "no milk" thing. When I am able to
communicate verbally well enough to discuss this, I ask them if they know
what their mothers and grandmothers did, what women in their own country do
now, whether this "no milk" fear is common at home, etc - everything I can
think of. Apparently, the belief is that IN THIS COUNTRY they can't make
"enough milk"; at least here, it's become a sort of an "urban legend" among
the families. They are very willing to discuss it, and extremely agreeable
to information and education about how the milk is produced (supply &
demand, etc.); very often it is the husbands who will ask very specific and
highly technical questions, and they receive all suggestions very willingly.
Usually, in fact, unless someone (like an ignorant hcp, for example)
reinforces their fears that they can't make enough milk, they do a great
job, nursing for > a year.

I so much want to know what's at work here! Could it have something to do
with relative breast size - they look so small next to us Americans that
they just figure there's not enough breast tissue? I don't think that's it.
These are bright people, perfectly open to the fact that if Chinese (or
whatever) women couldn't make enough milk for their babies, they would have
disappeared from the planet long ago. I don't think it's just the
traditional diet (& the fact that those foods are not as readily available
here); when I mention the traditional soups and herbs, there is usually
someone nearby who will make those foods for the new mother, and they are
pleased to hear that their traditional practices make a lot of sense. Is it
that they are so far from their own countries, and their families and
traditional ways of doing things? I know that in their home countries, they
often are not exposed to or educated about caring for babies - even women
who have given birth to other babies in their native countries often know
nothing about infant care, presumably because so much of the "work" is done
by the female relatives. I always think about how I would feel, giving birth
in a strange country far from home, and how I would react to "advice" in
that situation - I would smile, nod my head, & do exactly as I believed was
right.

Does anyone know any answers on this? Is this unique to Ithaca, for some
reason? The women that have this belief tend to be from wealthier, more
educated families - do you think this has something to do with it? With the
international power available here on this list, I'm sure somebody must have
some thoughts. And thank you, Wendy Chu, for emboldening me to ask about
this particular aspect of cultural differences.

Cathy Bargar, RN, IBCLC Ithaca NY