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1/25/2017
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Effective Collaborations &
Breastfeeding Promotion Strategies
Asian, Southeast Asian
& Pacific Islander Communities
California Breastfeeding Summit January 27, 2017
We hope to share
• Cultural factors and social determinants that may influence breastfeeding for Asian, Southeast Asian, or Pacific Islander families
• Stories and strategies from communities
• Resources for culturally and/or linguistically appropriate breastfeeding education materials
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Cantonese Mandarin
Hakka
Fuchow
Formosan
Wu
Korean
Mon-Khmer Thai
Laotian
Vietnamese
Mongolian
Gondi
Tibetan
Burmese
Karen
Pangasinan
Micronesian
Marshallese
Ponapean
Nepali
Chinese ≥50%
Japanese
Hmong
Kazakh
Uighur
Azerbaijani
Turkish Mien
Tagalog
Indonesian
Bisayan
Sebuano
Ilocano
Pampangan
Kusaiean
Palau
Polynesian
Tongan
Sinhalese
Persian
Gujarati
Bengali
Panjabi
≥30%
Telugu
Kannada
Malayalam
Tamil
Cham
Javanese
Malay
Bikol
Chamorro
Melanesian
Samoan
Fijian
Hindi Urdu
Marathi
Oriya Sindhi
Hawaiian
≤30%
Linguistic Isolation
Source: U.S. Census Bureau, 2009-2013 American Community Survey
Karakalpak
Burushaski
Balinese
Malagasy
Carolinian
Mokilese
Yapese
Tokelauan
Nukuoro
Bihari
Kirghiz
Karachay
Dravidian Munda
Kachin
Gilbertese Trukese
Maori Rajasthani
Assamese
Kashmiri
Data withheld to avoid disclosure.
In California: Asian, Southeast Asian, & Pacific Islanders
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Cultural and Social Considerations When Promoting Breastfeeding in the Chinese & Vietnamese Communities
Postpartum Confinement “Zuo Yue Zi” 坐月子
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Postpartum Confinement “Zuo Yue Zi” Foods
“One-Month” Confinement “Zuo Yue Zi” Foods
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“One-Month” Confinement “Zuo Yue Zi” Foods
Vietnamese New Mother’s Postpartum Experience
http://scaifebabywatch.blogspot.com/2013/02/vietnamese-postpartum-diet-care.html
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Viet Postpartum Practices & Foods
http://mamaescapade.blogspot.com/2013/08/vietnamese-postpartum-tradition.html
Chinese Cultural Practices & Breastfeeding
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“Yue Zi” Helper or Yue Zi Center
Vietnamese Cultural Practices & Breastfeeding
https://everyone.savethechildren.net/sites/everyone.savethechildren.net/files/wp-content/uploads/Case-Study_Vietnam_Hue_Jan2012_Credit-Tran-Xuan-Canh-2.jpg
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Influence from Family
While you “zuo yue zi”, you should not move around too
much, must rest in bed, do not bathe or wash your hair, cannot eat fresh
fruit…
Other Sources of Influence on Breastfeeding
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We Need Support to Breastfeed
Stories and Strategies from Communities
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Resources Chinese • Breastfeeding Association of Taiwan http://www.breastfeeding.org.tw/main/main.php • Hong Kong Breastfeeding Association http://www.breastfeeding.org.hk/ • La Leche League - China http://www.muruhui.org/ Vietnamese http://nature.berkeley.edu/departments/nut/extension/vietnamese.html https://www.healthinfotranslations.org/pdfDocs/BreastfeedingBasics_VIET.pdf http://here.doh.wa.gov/search-by-language/materials-in-vietnamese/ https://www.breastfeeding.asn.au/bf-info/other-languages • MULTIPLE LANGUAGES Consumer Health Information including Breastfeeding https://nnlm.gov/outreach/consumer/multi.html#A4
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10
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40
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60
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80
90
100
Initial Any Initial EBF EBF 1mo EBF 3mo
Pe
rce
nt
of
all b
irth
s
CA
CA Asian
CA PI
HP 2020
California Initiation and Duration Asian and Pacific Islander Compared to Total
Maternal Infant Health Assessment (MIHA), 2013-14 California Department of Public Health In-Hospital Breastfeeding Data, 2014
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Exclusive Breastfeeding by Ethnic Group Alameda County 2014
0
10
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30
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50
60
70
80
90
100
EBFInitiation
EBF 1 week EBF 1month
EBF 2months
EBF 3months
AC All
AC Asian/PI
AC Black
AC Hispanic
AC White
Healthy People2020 EBF 3-Month 44.3%
Maternal Infant Health Assessment (MIHA), 2013-14 California Department of Public Health In-Hospital Breastfeeding Data, 2014
Pe
rce
nt
of
all b
irth
s
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Asian
Southeast
Asian
Pacific
!slander
Breastfeeding
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Community Engagement
Culturally Appropriate Education
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Provider Engagement
Lactation Accommodation
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Public Information Campaign
Workforce Development
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Call to action!
How well do you know your community?
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What is important to your community?
How does breastfeeding relate to their concerns?
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How are you collaborating with Asian, Southeast Asian and/or Pacific Islander communities to promote breastfeeding?
References 1. Donaldson, H. CNM, MS; Kratzer, J. CNM, MS; Okutoro-Ketter, S. CNM, MS; Tung, P. CNM, MS. Breastfeeding
among Chinese Immigrants in the United States. Journal of Midwifery and Women’s Health. 2010; 55(3):277-281.
2. Hue Thai, UWSOM, R/UOP-III. Postpartum Practices among Vietnamese and Chinese Patients. 3. Ngyuen, H. T. Eriksson, B. Tran, T.K. Petzold, M. Bondjers, G. Nguyen, T.K.C. Nguyen, L.T. Ascher, H.
Breastfeeding Practices in Urban and Rural Vietnam. BioMed Central Public Health 2012, 12:964. 4. Yui Siu Chung. Only 2% Hong Kong Mother Breastfeed, Friendly Policy Helps with Decision. Wen Wei Po
Newspaper, Hong Kong, Health Information Page, February 2, 2016. 5. https://ww2.kqed.org/bayareabites/2015/05/09/new-mom-turns-to-ancient-chinese-recipes-for-
postpartum-recovery. 6. Raven, JH. Chen, Q. Tolhurst, RJ. Garner, P. Traditional Beliefs and Practices in the Postpartum Period in Fujian
Province, China: a qualitative study. BioMed Central Pregnancy & Childbirth. 2007; 7:8. 7. U.S. Census Bureau, American Community Survey 2009-2013
http://www.census.gov/data/developers/updates/acs-5-yr-summary-available-2009-2013.html 8. Maternal Infant Health Assessment (MIHA), 2013-14
http://www.cdph.ca.gov/data/surveys/MIHA/Pages/MaternalandInfantHealthAssessment(MIHA)survey.aspx 9. California Department of Public Health In-Hospital Breastfeeding Data, 2014
http://www.cdph.ca.gov/data/statistics/Documents/HospitalxRace-EthnicityReport2014.pdf 10. Lipson, J., Dibble, S., and Minarik, P. Culture & Nursing Care: A Pocket Guide. UCSF Nursing Press, 1998.
All photographs used with permission.
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Thank you!
Jeanne Kettles, MA, IBCLC Jeanne.Kettles@acgov.org
Tonya Lang, MPH Tonya.Lang@gmail.com
Grace Yee, IBCLC Grace.Yee@sfdph.org
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