Cultural aspects of breastfeeding
Historical, family, cultural and ethnic background shaped their breastfeeding experience for many of the women. Several talked about the bottle feeding culture of previous generations in the United Kingdom and how they hoped that their daughters would go on to breastfeed because of the example that they had set. One woman talked about the divide between the breastfeeding and bottle feeding culture (see 'Breastfeeding away from home').
She thinks that breastfeeding her children changed attitudes within her extended family and she...
I think that when you are looking, when you do speak to people, anybody that's had children, if they haven't breastfed, which a lot of people that I spoke to hadn't, they've always got a reason for it and it's usually something like, 'I couldn't because I didn't have enough milk', 'it hurt', 'the baby wouldn't ever settle', 'the baby didn't like it' you just, you hear more, you know, 'I had cracked nipples', 'I was engorged' and I think I'd, in my head had this picture of this horrible painful experience which it wasn't something that you would look forward to when you're having your baby. I wanted, you know, I wanted breastfeeding to be lovely and beautiful and, I'm an idealist I know I am and, I think that the thought of it being painful or, the baby not sleeping or, you know, nobody else being able to sort of participate in the care of the baby, all of these things, you know, they're all reasons not to, if you like, so when you think about things like that you do start to think, 'Oh am I going to be able to actually do this?' you do, you doubt yourself. It's not until you're actually doing something and you're doing it well that you realise you can do it.
So it's a confidence game?
Absolutely yeah, you have to, you have to get confident before you're happy about anything so, once you're doing it and you realise you can do it that's, that's when you feel happy about something.
I know one thing we haven't covered is, well we've kind of touched on it, is the father's role in all of this. You've said how supportive he was, does he come from a breastfeeding background?
Well, apparently he was breastfed but his brother wasn't, my mother-in-law is very helpful, very, very supportive but, you know, we have had, in terms of the support that she's given both of us, there have been times when she's said, 'Oh don't you think that, the baby should be on a bottle now?' and we've just said, 'Oh not yet we'll, you know, we're seeing, seeing how we go'. And the two of us were there with all of the children and one of the neighbours came in and, I started feeding the baby as you do and, it turned out that the neighbour's daughter was pregnant and my mother-in-law and her ended up having a conversation about breastfeeding and my mother-in-law was saying how, even breastfeeding for one month gives them such a wonderful start and, I remember [husband] and me coming away and saying, 'Did you hear what she said? Wasn't that amazing?' And I really think that, you know, considering to start with she wasn't that supportive and he didn't feel like, you know, it wasn't a foregone conclusion that, you know, he didn't have any strong feelings either way about breastfeeding but he feels that sort of the attitudes within the family have changed a lot now. And he, I mean he is really, really supportive, he doesn't, he never wants me to do anything that's not right for me, he would never force me into doing anything, he would never make me feel guilty about anything, I mean he is so, you know, so amazingly supportive, he wants us to do, you know, wants us to do what's right for us and for our family. But he, you know I think he's very happy and, he pointed out to us the other day, which I thought was really nice, he said that, as a result of this, my daughter who is seven will probably breastfeed, because this is her culture, this is what she's, she's now grown up with and that made me feel so proud [laughs] that, you know, one person, if seeing me breastfeed makes one person breastfeed then that makes me happy.
Some women talked about sections of the population where bottle feeding is still the norm and how difficult it is for women from those sections to break the cycle. A few women talked about the culture surrounding weight gain, not just in babies but through all stages of life (see 'Monitoring baby's growth').
She thinks that people are conditioned to behave in certain ways and that the barriers to...
Did you have a health visitor or anything like that?
Yeah there'd be a health visitor and she was, she was nice and that was all fair enough she didn't, I don't think she, you know, there's a whole sort of culture of like the baby's weight and going to visit and, [pause] and I suppose in some ways if you can breastfeed and it's all happening and it's all alright and you're not that bothered about all that side of the thing, and there's no failure to thrive business going on, 'cause [daughter] was exactly on the middle to, of the centile, she was right on the line she was, at birth she was seven and she just carried on, on that line so they, you know, they couldn't have me for that, you know?
Did you feel good about that?
Of course I was feeling the complete bloom of having a baby and like how beautiful it is to have a baby and, watch them and be with them and [pause], you know I felt all that, but at the same time I think, you know, my emotions were going quite up and down.
You said to me that, not many women in this area breastfeed, why do you think that is? What are the barriers?
Well one of the reasons they'd say that, one of the reasons that they'd say is because in a culture where, where man is sort of like prioritised, you don't, you don't, you don't put money into good nutrition of the woman so she can give, give breastmilk, you go down and get formula that is exactly right, that means that your kid will develop at exactly the right rate they're supposed to, so it does what it says on the tin, and you don't necessarily know that your wife is going to do what is, you know, going to do the same. So it's just a different culture. And also the whole body beautiful culture will be on the western working class women it's like, you know, you are some mad, middle class sandal-wearing hippy if you breastfeed, sort of and but I'm, I don't know, I think that's a prejudice. I reckon probably, I think that, I think the tide is turning and probably women are turning on to the fact that they're, it's the easiest thing to do is breastfeed, it's totally natural.
What do you think we can do to help push that tide along?
I think that's a good question that is. I think you should basically subsidise good food and so, you know, women really become conscious of the fact that the nutrition that they're giving their baby is part of the nutrition they're giving themselves and, that they have to look, you know, that, that it's good to look after yourself so that your baby thrives But I think women know that, women really know that anyway, it's only because of social reasons that people like, don't like you doing it here or.
So what sort of social reasons? Can you just…
It's so, it's just like, it, I came to the understanding that it was just one of the things under a whole, among a whole host of, you know, need to regulate that comes out of people and it's to do with the way they were abused as kids, and you really discover as a kid, you really discover as a mum, you know, you basically try and sort of fight off these different cycles of abuses coming at you, regulating you, saying, “No that's what happened to me so it's got to happen to them, no you can't possibly”, it's like a taboo reaction, you know, they're all like hysterical reactions, and so funny because you're like really emotionally charged with all your hormones as a pregnant woman and then, having given birth and you're, you're sort of at the same time extremely calm because of all this oxytocin you're pro
Some women from non-British backgrounds talked about breastfeeding being the norm in their family and how they wished to copy their own mother. Many women received a lot of support from their mother or mother-in-law in the days immediately after birth (see 'Going home with a breastfed baby') although for some it was not always of the right kind (see Interview 12 below). Some women followed religious guidance on breastfeeding, especially those of the Islamic faith where breastfeeding is recommended for up to two years (see 'Gathering information, making the decision and preparing for breastfeeding').
As a breastfeeding support worker she visited Muslim families to explain the importance of...
Majority yeah, majority first they do start breastfeeding and then afterwards they start, majority have a lot of pressure from the extended family, or some have pressures from their husbands.
Can you talk about that a bit more?
Of course, I've had so many cases when they're breastfeeding absolutely wonderful, no problem whatsoever, baby's fine, mum's fine when they're in the hospital and they go home and then afterwards when the baby gets a bit bigger then the mother-in-law wants to breast, mother-in-law sorry, wants to feed. So with breastfeeding that can't happen so mother-in-law will go out and buy the milk, and the sterilising and everything, so she'll make the milk and when the baby's hungry she'll start feeding the baby. And then the mum can't, she can't say anything then she has to go to the kitchen, then do the cooking and when the baby will cry the mother-in-law will say, 'No it's okay you do what you have to do I'll feed her, or I'll feed him' and even with the husband the majority of the daughter-in-laws have them, if they are living with the extended family they've got older mother-in-laws or father-in-laws so even the husband will feel sorry for the mother, say, 'Why should my Mum cook? Why don't you cook?', you know, 'you just had a baby, doesn't mean that you're ill or, you know, anything like that, I can, Mum can look after whoever baby he or she' so it's a lot of pressure on a, especially young mums and mums who are, who have come from abroad or something, they feel that they have to or they feel they have to bottle feed they don't have that confidence to breastfeed and even if they do breastfeed they'll breastfeed when they go to their own room or at night, but in the daytime they have to bottle feed.
What can we do about that?
That's where basically where we come in, that's where we come in, lot of support, lot of home visits, a lot of contacts, a lot of phone calls and speaking to the families, I have spoken to mother-in-laws, I've spoken to extended families and every and they understand, they understand perfectly fine and I think even though I haven't spoken to this Mum, the particular Mum I'm talking about with her mother-in-law there and her husband there, and mother-in-law she said, 'absolutely fine' she was up for it she said, 'If she wants to breastfeed she can breastfeed' but I think also, also what it is, the daughter-in-law she feels bad, she feels guilty so she says, 'Okay then I'll, you know, that's fine, no problem' then she'll say, 'okay then I'll give both, I'll start mixed feeding' and that's what we do, we give a lot of help and a lot of support, make sure that just breastfeed exclusive for six months then when you start weaning your baby, I don't say, I never to bottle feed never, I said breastfeed for two years and sometimes, the majority of times I do bring religion into it, maybe sometimes I shouldn't but I feel, I feel if you're, if you're really a practicing person and if you're fasting for the month of Ramadan, and if you're praying five times a day, and if you've done Hajji, and if you're following what it says the Koran obviously it says all the good stuff then why shouldn't you be breastfeeding for two years which it says clearly, because it's a man made, it's a God given thing which you should be giving.
Can you talk to me about Ramadan and breastfeeding?
Yes definitely, Ramadan it comes once in a year when all the Muslims are supposed to fast between dawn and dusk, it's a spiritual thing it's keeps, it keeps away from bad acts, bad speech, bad stuffs that we do night and day, watching TV, dinner
Three important factors have influenced Zainab’s attitude towards breastfeeding: religion, economics and practical issues.
So I love doing it [breastfeeding] in a way it’s cheaper, it’s less time consuming than bottles and stuff like that you have to sterilise, you have to do this, so basically apart from, with the religious perspective I would say and then been convenient and cheaper and stuff like that make me to carry on breastfeeding.
In many of these cultures where breastfeeding was the expectation, the women had not seen other women breastfeeding in public and, in a few cases, not even within the family. Many women would not breastfeed in front of male family members other than the baby's father (see 'Going home with a breastfed baby'). One woman said that, contrary to her culture, she had lost her shyness or reserve, breastfeeding wasn't private anymore, she often didn't even realise that she was exposing some of her breast and it had become normal for people, mainly health professionals, to come and have a look and see how the baby was feeding.
Originally from Colombia, she says that most women breastfeed there. Her mother came to the UK to...
Well thank you that's lovely. Is it the norm for people in Colombia to breastfeed? Do most women in Colombia breastfeed?
I think most of Colombian women do that, I don't think there is a question of, no, I'm not thinking about breastfeeding or, no it's completely different, and their reaction, I mean kind of the effect, the reaction people have here, it was very surprising to me, because people thought that I was, kind of a more sexual thing or also outsider's opinion has a lot to do with what you actually do with your baby or not, and I don't think there's that factor in Colombia, just nature is there you go and use it basically.
So it's just assumed that you will breastfeed?
Yeah, I don't think I've ever heard anyone like, thinking, 'I might or might not do it' it's just there.
Right. How old were you when you came to the UK?
I came to the UK when I was, I married when I was thirty-one, so it was effectively four and a half years.
Right so you had most of your life'
And you saw women breastfeeding there frequently or not?
Having said that, and although it's part nature, and we do it normally, I don't think we do it in public that much, I don't remember my Mum having done it in public, she was always covering herself. And, and I see her point I mean, I don't mind to breastfeed my baby where he needs to be breastfed, and if he's hungry and you have the right to go to a restaurant, my baby has exactly the same right, and I'm there so. But I try to be private, because it's a very private thing, and I don't think anyone else could possibly share it, the affection we exchange at the moment of feeding, and as I said before sometimes it's sore and it's been a year and now that he's got teeth it's kind of going back to the beginning, and there's like 'Oh' but it's still, the easiest way to get a smile from me, even when he bites me and when I said to him in Spanish that I love him when he's eating and he had to let it go to laugh and look for me again and eat, as something that it has to be mine.
So that's an emotional response?
Yeah very much so. Yeah I can go to tears.
And how long did your Mother stay?
A month, for a month she stay here for a month.
You've already said that she held your hand when it was sore, she rubbed your back and she told you how to position the baby.
What else did she do?
She was here. And, you make me cry again, because, I hadn't seen my Mum for two years and she was here doing everything, everything for me, for us, and in the m
Her mother-in-law was supportive even though she had not breastfed herself. She talked about the...
This notion of expressing so that your husband could give the baby a bottle, where did that come from?
Just from, just I think it was just a personal choice knowing it was available to do and the personal choice that it'd be contact time for my husband or for mother-in-law or father-in-law to have that time with baby just to keep breastfeeding longer, more than anything else, not that we didn't have a huge social life as such beforehand but it gave you a bit of a break, of knowing that yes I can go out and have dinner and watch a film or go out for a whole evening to somebody else's house and not have to go upstairs to breastfeed and miss out on what everything is going on downstairs, knowing that you had the opportunity to take a bottle with you but it was still breastmilk.
So if you had gone out in the evening to friends and taken the baby'
'you would have had to go to another room to feed?
I wouldn't have felt comfortable breastfeeding in front of other males except for my husband in our country culture it wouldn't be deemed acceptable, not at all and I wouldn't feel comfortable breastfeeding in front of say my brother or close male friends that I have or my father.
Even in your own home?
You won't breastfeed in front of your father?
Or close male relatives?
So you go out of the room?
Or they go out of the room. We have separate lounges anyway so it was never a huge issue at home I mean I have my brother-in-law who lives here as well and as soon as it would be time for breastfeed I'd either go nip into the other room or they would say, 'Do you want us to go?' so it wasn't, it wasn't an issue but there was no way I was going to breastfeed I didn't feel comfortable breastfeeding in front of other males.
But in front of women relatives it was fine?
Yeah, that was fine yeah totally fine, yeah.
During breastfeeding, whether it's traditional it's not quite the right word we have a very strict diet during breastfeeding it might be what you'd say an acquired taste [laughs] first few days it's very, very, very bland foods.
Oh actually the first five days it was just a mixture of finely ground nuts made in milk, a spoonful of that in milk and that was the diet for the first five days nothing else.
Why do you think this is, what's the reasoning behind that?
It depends who you speak to, I think the only reason that I can go with would be something simple, I thin
She said that the Jewish culture is very pro-breastfeeding and the women are well looked after in...
Does that have any, any impact on breastfeeding? Are there any laws or beliefs, cultural beliefs, lay beliefs?
I think it's, it's a very pro-breastfeeding culture. I don't know anything, I think I know for example for very religious women in very religious communities, they go to a special house for the first few days after they've had their baby, very much like our mums did in the U.K., everyone was in hospital for five to ten days post baby, these days you're churned out after a few hours, but in that, in those special houses they get a lot of support and a lot of breastfeeding support. And interestingly I'm now training to be a National Childbirth Trust breastfeeding counsellor and there's a group of counsellors and trainee counsellors in my area and I think we're all Jewish [laughs]. So I think maybe it is something part of the culture but not explicitly so. I mean certainly a lot of my Jewish friends have breastfeed, have breastfed but then I've enjoyed breastfeeding but then I've also got Jewish friends who haven't. So I don't know that there's a particular issue one way or the other but it certainly is within religious communities it's very much, even though there are modesty issues within Orthodox Judaism, breastfeeding isn't part of that at all as in, you know, it would, I know that I have breastfed in the synagogue, not during the service but somewhere discreetly but not completely hidden away. It wasn't actually during a service it was in a festival there was a party going on for kids and I just went off into the corner and I felt comfortable doing that. So certainly in my synagogue it's very much natural and there's not an issue around it.
And are there do and don'ts?
Not that I am aware of, not that I'm aware of. Well I am an Orthodox Jew but there are always different levels and different degrees and there are many, many, many more people who are much more religious than I, I don't cover my hair, I don't wear a sheitel [wig], there could well be things I don't, don't know about, but I don't think so, I think it's known to be natural and good for the baby, good for mum, so I thinks it's supported.
Zainab doesn’t like the idea of herself, or other women, breastfeeding in public. She thinks some people may feel uncomfortable.
Okay you feel kind of pressured not to do it?
No, no ,no it’s not pressure but you’re just thinking somebody next to you might be like really uncomfortable because he knows what you’re doing, you’re breastfeeding your baby, do you get what I’m saying because I, I would, I love it in a way but I’ll tell you the truth sometimes I find it really irritating to just see the breastmilk like going out or something, do you know what I’m saying, I feel that my breast is my personal, do you.
So sometimes I find it like why should I be bringing it out, but because as I told you I felt it’s the right of the child to have it, I shouldn’t deprive him from his right.
So I have two mixed feelings.
Okay that’s very interesting.
Yes, I don’t really, really like, you know some mothers would say it’s really enjoyable that attachment connection and stuff like that but I personally would tell you I just, to see a woman bringing out her breast and feeding is just irritating to me.
Oh in front of others?
Yes even my one, to bring it out and others will just like it’s not comfortable it’s so uncomfortable for me to view.
Some women had given birth and breastfed both overseas and in the UK and compared their different experiences. A young woman from Uganda, who came from a breastfeeding family background and had a caesarean section in the UK, said that she felt cheated out of the skin-to-skin contact that she would have experienced in her home country. A French woman was dismayed by all the advertising of infant formula in women's magazines in both France and the UK (see 'Thinking about the breastfeeding environment'). One woman talked about her experience of having a premature baby in Germany while her husband was serving in the armed forces.
Although she is westernised, she talked about Thai traditions and how they differed from...
You talked about the hill-tribes?
And the women there not having very good food?
But they still breastfeed?
Yes in my country, traditional in my country, I think it different from British because British is like the high education, high in education, high income no breastfeeding, but in my country it is low income, low education go to breastfeed because in my country may be, may be, a lot like expensive like the powder of milk and like the, because, it is if expensive may be in low income have a problem to buy it, but in my country as well, and everything, like the advertisement in the television about the bottle of milk about the, like the a lot, if you go to my country you can see a lot of the, like the powder of milk for children, a lot.
You see it advertised a lot'
Yes a lot.
And you have like a promotion if you health professional like me and like my husband. You can have like free of bottle milk and free of powder of milk to try, to try, two or three bottle.
Yes free sample, it's good, it's good for.
What do you think about that?
At first I didn't think, I don't think anything when I didn't have like pregnant but after that I pregnant and I try to like the breastfeeding, I didn't like to get it, collect it to my house, I think it's like the nature, it's easy way, it is not like the pay for or buy it, is a free, it's good, but I think it's have a like a struck in my opinion in my attention to breastfeeding, if I have a bottle in front of me, I think this is easy and everybody in my house, is very, this is easy, make my son grow like breastmilk right, I think it is a problem if I have, if I have it in my house.
When you said you tried to do what was normal, do you mean you tried to bring your baby up like a western person would, rather than traditional Thai methods?
Yes, because in my country if the baby just born you should to stay in the home, long, and one month and you should keep warm in your body and the baby like the, like you use to hold him with the blanket.
So you wrap him and keep him warm.
Yes, wrap him and keep him warm in here is like the freedom and take him in the sleeping suit or something like that, in my county no, you should to like hold him and wrap him with the blanket and something like that and you should to wear the hat and wear the glove, everything for him, to like the warm, keep warm all day, all night, or something like that and his mother as well, you should to like hold hat, with a sock or something like that.
So mother and baby are kept very warm?
And they stay at home for one month?
Yes, at least one month, it
Her first baby was born in the Middle East. She talks about the support that Omani women received...
'I'm trying to get what you know and understand of'
'and your experiences in the Middle East'
'compared to your experiences here. In the hospital, were there any major differences that you would put down to culture?
In terms of culture, well having babies in the Middle East, in Oman, was very much women's work and so there tended to be an awful lot more women visitors. Breastfeeding would only really be done in front of husband, you know, it wouldn't be acceptable if, I mean you just wouldn't get visited as a post-natal woman by a close family friend who happened to be male, that just didn't happen. But breastfeeding was very much the norm and if you asked a woman when she was pregnant, you know, 'Will you breastfeed?' she'd look at you as though you were daft and said, 'Well of course'. You know, so it was very much the norm and artificial feeding really in the hospital I was in was only for medical indication so having, having spent quite a few years in the Middle East you then come back and you see all the advertising for baby milk and things like that, and it is, it felt really strange to walk into somewhere you know, like a, a high street chemist or whatever and see all these tins of baby milk because it wasn't that common to see it in the Middle East it was in a special part of the supermarket and you'd have to go and look for it rather than it being sort of staring you in the face. So breastfeeding was the norm, having said that, women spent much more time in the home. So, me going back to work when my, in the Middle East, when my first baby was three months, old was relatively uncommon. And I think that probably helped, you know, there wasn't this pressure to get back on to the, almost like a treadmill of life as there often is in, in the U.K. so that helped I think, probably women to, in the Middle East to breastfeed from much, much longer, and my understanding is that it's almost, breastfeeding is mentioned very positively in the holy Koran and, you know, it is considered as standard to feed your baby for up to two years, so it's all kind of inextricably tied up really, breastfeeding, faith and also quite a lot of government pressure as well to breastfeed in the Middle East because they see it as good for the health of the nation, as much more positive reinforcement of feeding your baby.
So you said when you left the maternity hospital that was it, you were on your own?
What's your sense of how other women would have been?
Well as an Omani woman you would have had an extended family, so for example, I have, I still have friends who are Omani, and I do know that they would have left hospital and have gone to their mother's home, they would have stayed there for up to forty days, and then not come back home to the, the husband's home, the family, the marital home until that forty days. And for that forty days while they were with their mum, their mum, their sisters would have basically looked after them, the mum herself, the mother of the baby feeds the baby, there's no domestic work to do, you wouldn't think for a minute of going into the kitchen to make a meal for anybody. It was, I think that was probably really crucial, husband would visit, the mother's family home, so his mum-in-law's home, and but he's very much a visitor, and he'd go after his allotted time and go back home and, you know, there was this huge famil
She described the routines in the German hospital where she gave birth. Staff members were...
So did you set up some sort of a routine in the hospital?
Yeah you do, you have to work around their shift patterns if you like and also allow for the doctors making their rounds, so there were certain time when, when nursing staff were changing over shifts that you couldn't go because they obviously have to have briefings and, and things like that, and also we were very lucky in that our girls were only in there because they were, they were simply early and thankfully there was nothing wrong with them, whereas there were other babies there with, you know, significant problems which, you know, were far more important than ours. But yeah you sort of, they, they worked on a four hourly feeding pattern so we made sure that we were always there at the four hour point to feed, either breastfeeding or with bottles and just stayed all day virtually.
So was your daughter fed between those four hours at all?
No they're very regimented in Germany and they were fed every four hours and that was it, and during the day they didn't cry for feeds in-between so I only hope that they didn't during the night as well. But I mean when, when we brought her home she, she was trained, you know, I can't think of any other way to describe it and we just carried on in exactly the same fashion and I didn't need to feed on demand, I just fed at seven o'clock in the morning, eleven o'clock in the morning, three o'clock in the afternoon, seven o'clock in the evening and, and, you know, so it went on.
And nothing at night?
Through the night as well, just on that same pattern, yeah, seven, eleven, three. Yeah.
What sort of support did you have at that time?
In Germany? I had the support whilst I was in the hospital of the, the nursing staff there and when I got back home it's a very similar set up to the UK, you have a health visitor assigned to you, I had a midwife assigned to me, but I don't know I suppose they're there if, if you want them, they were, they were very helpful, my health visitor was lovely and she would call me regularly especially when Amy was still in the Kinder Clinic, and they're very encouraging but they weren't very what I would call hands-on, you know, I can remember speaking to the health visitor and breaking down in tears and saying I'm having trouble expressing and I'm worried about breastfeeding and, and they would just say things like, 'Well it's okay'. You know, 'Just keep trying and, and it will come'. And you think well no, you know, I need you to be a just a little bit more specific than that, and in the hospital, you know, we actually had nurses t
Last updated September 2015