With both eyes still closed, she would express her desire in a gentle and lovely tone “Māmā, NǎiNai” [妈妈, 奶奶], which means “Mummy, milk milk” in Chinese. Whenever I hear this, my heart melts with an irrepressible feeling of content and proudness of being a mother able to breastfeed her.
I am still breastfeeding my girl, who will turn 2 in a few months. This surprises myself and also my friends and family members both in the UK and back in China. The great support and amount of information I received in the UK during my pregnancy and after childbirth made a huge difference and made my breastfeeding less worrisome and a more satisfying experience.
I thoroughly appreciate and enjoy the love and bond nurtured between me and my baby through breastfeeding, which I am sure any mother, especially those breastfeed their babies, also feel.
Although the benefits of breastfeeding are widely recognised, in practice most mothers opt either for bottle feeding or give up breastfeeding after only a few weeks.
In countries like China, breastfeeding is traditionally seen as a “duty” or the “natural” thing to do, something that a mother is supposed to do if they are able.
However, over the past few decades several factors have reduced the numbers of mothers who breastfeed. One major factor is the increased commercialisation of formula milk, often advertised as a better alternative to mother’s milk. But another factor is the pressure on mothers to return to work, often much earlier than in the West. In fact the choice is often taken away for many mothers.
“I would have liked to have breastfed my baby,” Lulu [not her real name] explains, “but I did not have enough milk because I was not allowed to feed my newborn for two weeks after giving birth.” She, like a lot of expectant mothers, had elected to have a caesarean, something that is often discouraged for a first child in Europe and especially the UK unless there are medical reasons. But even those having a caesarean in Europe are still nonetheless encouraged to breastfeed and it is common for the newborn to be brought to its mother within an hour of being delivered.
But in some parts of China mothers who have had a caesarean are put on a drip of antibiotics and many doctors disallow mothers from breastfeeding their newborns. With caesareans having risen to around 46% of all births in China, and with breastfeeding falling, it is no surprise that the demand for formula milk is rising. The rise of elected caesareans is often due to pregnant mothers fearing painful natural births or worry their vaginas might be stretched or damaged by a normal delivery. Some women also prefer the operation because they mistakenly believe it is less risky. “I had a caesarean because I heard that a woman had experienced problems giving birth naturally at the hospital where I was due to give birth,” says Lulu.
As well as some mothers essentially being prevented from breastfeeding, most have to give up breastfeeding due to domestic pressures. Chinese mothers are not offered the same length of statutory maternity time off as seen in developed countries, and often have to return to work within three months. Of course, better off mothers can take more time off work, if they can support themselves financially, though their job is not protected and may be gone once their child is fully weaned.
In the West expectant mothers are positively encouraged to breastfeed. There are many prenatal classes, and even special breastfeeding classes where even dads are encouraged to attend in order to understand the process.
Information and advertising is also very different. While companies manufacturing formula milk want to encourage parents to buy their product, many actively promote breastfeediing and even print such advisories on their packaging.
One firm that particularly encourages mothers to breastfeed is Hipp Organic. Indeed they actively state on much of their publicity material that “Breast is best”. Of course, there is also an important commercial reason behind such messages. In the minds of many it can build up trust in a particular company, thus when a mother decides to quit breastfeeding she may be more likely to switch to a company that’s been more open and honest.
While most new mothers see breastfeeding as better, many find it difficult. Sore nipples and other physical issues certainly play a part in mothers giving up, but there are social pressures too. Many mums feel embarrassed trying to feed their child in public, indeed it would not be uncommon for breastfeeding mums to get disapproving glances and even requests that one desist. Even where mothers have been discreet there are many stories of breastfeeding mums being asked to move to another part of a restaurant or stop feeding altogether, this despite laws which now prohibit such discrimination. In China, the thought of asking a mother to stop feeding her child would be unheard of.
However in both China and the West the biggest factor in women not persevering with breastfeeding is the need to return to work. All these factors have had an affect on the way a mother feeds her child.
Rise and fall in breastfeeding
According to the Infant Feeding Survey conducted every five years by The NHS Information Centre, the proportion of babies breastfed at birth in the UK rose by 5% from 76% in 2005 to 81% in 2010.
Figures also indicate that across the UK, rates of “some breastfeeding” showed a rise. At six weeks, the number of women breastfeeding at was 48% in 2005 and 55% in 2010, while at six months they were 25% in 2005 and 34% in 2010.
Regarding those who exclusively breastfed, at three months the number of mothers was 17% in 2010, up from 13% in 2005, and at four months, it was 12% in 2010, up from 7% in 2005. However, exclusive breastfeeding at six months remains at around 1% in the UK.
In contrast, the breastfeeding rates in China have declined dramatically over the 10 years up to 2008 and there have been few signs of improvement since.
According to the World Bank, the rates of exclusively breastfed babies up to 6 months old in China slumped from 67% in 1998 to 27.6% in 2008, with the rate in cities only reaching 16% in 2008.
As from 2008, there were no big changes, with the rate of exclusively breastfed babies up to six months old in China’s cities remaining at only 16%, among the lowest in Asia. Even in rural China breastfeeding hovers at around 30%.
Meanwhile the number of breastfed babies at 2 years old is only 9% in China, much lower compared to other Asian countries such as Myanmar which showed the highest proportion of breastfed babies at around 65%.
While the percentages are certainly higher than those seen in the West there is a definite shift in how breastfeeding versus formula feeding is developing. Commercialisation of formula milk powder, a lack of parental support as well as a lack of knowledge and education all play a part in reducing the numbers taking up breastfeeding in China.
Excessive promotion of formula milk and the message that it is better than human milk has also helped fuel the problem. In 2005, only 500 million US dollars worth of formula milk was sold in China. By 2012 this had risen dramatically to 3.5 billion US dollars. And that figure is still rising at a rate of 15% annually.
Some 66% of Chinese mothers incorrectly believe that breast milk will be much less nutritious after six month of feeding. There are also social pressures too, with families encouraging weaning at a much earlier age than is the norm in the West, or even recommended by the WHO.
In China it is not uncommon for parents to begin weaning as early as 3 months old, well below the usually recommended 6 months and still below new advice that 4 months is suitable for some.
At least one survey showed that some 54.6 % of parents began to feed their babies solids before they were three months old [link]. The survey also revealed that only 16.6% of babies were breastfed within one hour of being born. One factor in this as already discussed is the rise in caesarian births. The proportion of women who underwent a caesarean section in the 1970s was only 5%. By 2012, this had risen to 46.5% [link].
On its website the World Health Organisation recommends that mother breastfeed for as long as two years and that babies be “exclusively breastfed for the first six months of life to achieve optimal growth, development and health.”
Furthermore, “exclusive breastfeeding from birth is possible except for a few medical conditions, and unrestricted exclusive breastfeeding results in ample milk production,” the WHO state.
At the end of the day it is a mother’s choice whether or not to breastfeed. However in both the East and West there need to be changes in education, understanding and support for mothers such that they can offer the best nutrition for their babies.
This piece is part of a series of articles dedicated to exploring parenting expertise by looking at cultural backgrounds and the pros-and-cons of various traditions. This special series is also posted with acknowledgement to International Children's Day which is observed on the 1st June.
If you enjoyed this article please check out “Colourful Childhood: exploring cultural impacts on kids and parenthood” , “Cultural differences in potty training” and "Cultural divides in raising a vegetarian child".