We had an excellent 2 day meeting in Los Angeles with staff of some of the
hospitals that are working hard to increase their breastfeeding rates (we
would have needed a MONTH to talk to all of them - the number of hospitals
in the area are astounding to me!).  

One issue brought up was the "traveling nurses" - staff that come in to
cover only a few shifts and then leave - and often bring with them their own

"breastfeeding information and support" often more personal than
evidence-based.  Has anyone ever addressed this issue with the agencies that
actually contract for the nurses to the hospitals?  How about the risks they
take not following protocols?

Another issue brought up was the large number of Filipino nurses - who
believe that formula is best and that poor mothers need to feed formula
because they make poor milk (as was described in the video - thanks for
sharing it!) and mothers who are rich hire nannies so they can rest and
recover 40 days...which means they don't breastfeed either!

Lack of support was also reported among the Vietnamese medical community.  I
saw a similar issue discussed in a Lifestyle channel program where a new mom
was torn between wanting to respect the elder nanny and wanting to care for
her baby as SHE thought would be best...then 2 days later met a young
Vietnamese medical student who, with tears in her eyes, described how the
nanny her mother paid for was insisting on formula-feeding when she was at
school!

So many barriers!  We need a multi-pronged approach and collaboration of
those who can best communicate to the multicultural staff and moms!

Just as we have found that Peer Counselors from our African American
Churches work very well with African American moms, and Promotoras with the
Hispanic moms, a project/program needs to address the health care
professionals who continue to bring in their own cultural biases into the
health care setting - to the detriment of the health of their patients!  

Jeanette Panchula, BSW, RN, PHN, IBCLC
California, USA

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