Breastfeeding+in+China

by M. Piazza =Introduction= toc Breastfeeding to provide infant nourishment is said to be a traditional practice in China (Lui et al., 2013), but research shows that the rates of breastfeeding among Chinese mothers is much lower than in other nations (Guo et al., 2013).

=Influencing factors= The primary factors that influence Chinese mothers' decisions about breastfeeding their children are medical attitudes, societal beliefs, social status, family dynamics, and national attitudes.

Medical attitudes
The attitudes and recommendations of medical professionals have an effect on Chinese mothers who are making their decision about breastfeeding. In their research on Chinese female nurses and physicians, Ouyang, Xu, and Zhang (2012) found that among these medical professionals, there is generally poor medical knowledge about breastfeeding. While the majority of the medical professionals do believe that breastfeeding promotes the infant's health, only 1/3 know that breastfeeding promotes the mother's health. The majority believe that breastmilk will be insufficient for the infant to consume. The medical professionals have also reported that they have experienced a significant lack in clinical updated about breastfeeding.

Since China's medical attitudes and recommendations have an effect over Chinese mothers' decision to breastfeed, medical professionals have power to encourage Chinese mothers to breastfeed within this scientific worldview (Koltko-Rivera, 2004) by displaying more positive, scientifically accurate attitudes and knowledge.

Societal beliefs
Chinese culture holds a strong belief that infant formula is the healthier option for feeding, indicating a societal lack of accurate knowledge, as well (Lui et al., 2013). In addition to the general lack of breastfeeding experience amongst Chinese citizens due to fewer children by the one-child act, there is also significant push from marketing schemes for infant formula. These aggressive marketing schemes are sway Chinese mothers toward choosing infant formula over breastfeeding.

One example of a Chinese marketing scheme for the infant formula, [|firmusk], makes claims about the formula's specificity for Chinese bodies in regard to qi regulation (Sripanawongsa, personal communication, 2014). Qi is a Chinese concept of life force within the body which can affect energy flow in the body in a number of ways, according to Chinese culture. The [|firmusk advertisement] makes the claim that it can help prevent the negative effects of qi in the infant's body and it grows and develops. The advertisers' use of this concept in their marketing scheme is an indicator that Chinese culture's spiritual belief in qi holds relevance and can affect decision-making in China.

Overall, the general public belief is that infant formula is actually superior to breastfeeding, which is counter-active to the spread of accurate health information in favor of breastfeeding (Lui et al., 2013). China's growing economy could be partially responsible for this shift toward buying infant formula. The Chinese public have been persuaded to believe that infant formula is the option that is best for their child, hence there was a shift toward purchasing formula rather than breastfeeding for free. This is in line with the rapid economy boost that China has experienced starting in the 1980s (Weijun et al., 2011).

Social status
Women in China are more likely to breastfeed if they are apart of a lower socio-economic status, a rural region, a lower education level, or a younger age group. These breastfeeding statistics associated with these social identifiers are opposite to most first-world nations (Qui, Zhao, Binns, Lee, & Xie, 2009 as cited in Lui et al., 2013).

Socioeconomic status
In China, rural areas are typically lower socioeconomic regions, as well (Qui, Zhao, Binns, Lee, & Xie, 2009 as cited in Lui et al., 2013). Parents who are apart of this demographic may have no choice but to breastfeed their children, regardless of the general cultural preference for formula, because they may not be able to afford the cost of formula. Infant formula has actually become a sign of wealth and social status in Chinese society (Lui et al., 2013).

Occupation
Additionally, a mother's occupation, which is affected by their education level, has proven to have a correlation to their breastfeeding.



Chinese mothers who are well-educated often hold professional jobs. For them, breastfeeding may not be a feasible or appealing option because of the culture and demands of their jobs. Having a busy job may prove to be too time-consuming to breastfeed (Hawkins, Griffiths, Dezateux, Law, & Millenium Cohort Study Child Health Group, 2007 as cited in Lui et al., 2013). Also, they feel that breastfeeding in the workplace creates a negative image for them, largely because of the culturally-held belief that infant formula is a status symbol. According to Storti (1999), these trends indicate that the professional work culture in China has a more monochronic attitude toward time due to the sense of urgency.

These professional Chinese women tend to have a stronger desire to regain their non-pregnant physical image, as well (Lui et al., 2013). This could be explained by the traditional Chinese sexological worldview valuing androgynous, suppressed sexuality and defeminized image among women (Pei, Sik-Ying, & Ng, 2007 as cited in Weijun et al., 2011). These women may prefer to uphold this type of image by ridding themselves of the pregnant shape and function of their body more quickly by choosing not to breastfeed.

Family dynamics
There is no doubt that the one-child policy has affected the Chinese family dynamic in numerous ways.

Grandmothers
One of the effects that the one-child policy has had on family dynamics is the increased child-rearing role of the grandmother in Chinese household. By having a larger child-rearing role in the Chinese family, grandmothers have a stronger influence on mother's decision to breastfeed (Lui et al, 2013). This is characteristic of China's family-oriented, collectivist culture (Storti, 1999).

Gender of children
The one-child policy has also had an effect on the parent-child relationship. In rural areas, the one-child policy allows the parents to have a second child if their first-born child is female (Guo et al., 2013). This allows them to try for a male child if they would like to since males are preferable in China. Lui et al. (2013) found that strictly in rural areas, children are more likely to be breastfed if they are female rather than male.

Considering the value attributed to infant formula among Chinese society, parents of two children (a first-born female and a second-born male) residing in these poor rural regions may not be able to afford the preferred infant formula for both of their children. If they can afford infant formula for one child but not the other, they may develop a plan to breastfeed their first-born female child just to save money for their second-born child's infant formula with the hope that it will be a male child.

Also, since males are the preferable gender in China, mothers may decide not to breastfeed a first-born daughter knowing that breastfeeding decreases future fertility. They may not want to take the risk of breastfeeding their first-born female child only to lose their ability to conceive a son (Lui et al., 2013).

National attitudes
Following an authoritarian power structure, China as a nation is taking steps in favor of breastfeeding. In 2001, the government proposed a goal to increase breastfeeding rates to 85% (Ministry of Civil Affairs of the People's Republic of China, 2001; Zhao, Huang, & Zhang, 2006 as cited in Dai, Guan, Li, You & Lau, 2013). In 2009, China implemented a national "baby-friendly" initiative in all birth hospitals. The [|baby-friendly initiative] is a movement that dictates hospitals' regulations around breastfeeding. [|Baby-friendly hospitals] are taking steps to support breastfeeding and do not support infant formula products (UNICEF, 2009 as cited in Liu et al., 2013).

media type="youtube" key="exey1MB7cJQ" height="357" width="596" =References= Dai, H., Guan, X., Li, X., You, L., & Lau, Y. (2013). Psychometric properties of a mainland Chinese version of the Iowa Infant Feeding Attitude Scale among postpartum women in China. //Contemporary Nurse: A Journal For The Australian Nursing Profession, 44//(1), 11-20. doi:10.5172/conu.2013.44.1.11

Guo, S., Fu, X., Scherpbier, R. W., Wang, Y., Zhou, H., Wang, X., & Hipgrave, D. B. (2013). Breastfeeding rates in central and western China in 2010: implications for child and population health. //Bulletin Of The World Health Organization, 91//(5), 322-331. doi:10.2471/BLT.12.111310

Koltko-Rivera, M. E. (2004). The Psychology of Worldviews. //Review of General Psychology, 8//(1), 3-58.

Liu, J., Shi, Z., Spatz, D., Loh, R., Sun, G., & Grisso, J. (2013). Social and demographic determinants for breastfeeding in a rural, suburban and city area of South East China. Contemporary Nurse: A Journal For The Australian Nursing Profession, 45(2), 234-243. doi:10.5172/conu.2013.45.2.234

Ouyang, Y., Xu, Y., & Zhang, Q. (2012). Survey on breastfeeding among Chinese female physicians and nurses. Nursing & Health Sciences, 14(3), 298-303. doi:10.1111/j.1442-2018.2012.00699.x

Storti, C. (1999). Figuring foreigners out. Boston, MA: Intercultural Press.

Weijun, Z., Zhou, X., Chi, Z., Wei, L., Lu, L., & Hesketh, T. (2011). Detraditionalisation and attitudes to sex outside marriage in China. Culture, Health & Sexuality, 13(5), 497-511. doi:10.1080/13691058.2011.563866