Japanese Culture and Breastfeeding
Cynthia D. Payne, IBCLC
Williamstown MA USA
Report from the 2003 LLLI Conference
From: NEW BEGINNINGS, Vol. 20 No. 5, September-October 2003, pp. 181
One of the best panels I
attended at the Conference was "Birth and Breastfeeding in Mothers
of Japanese Heritage," given by Hiroko Hongo, MSW, IBCLC and Kazue
Nakamura MD, IBCLC, two Japanese women who have lived in the United
States and are very aware of the cultural differences between the two
countries.
The session began with a
brief history of breastfeeding in Japan. Historically, Japanese mothers
gave birth in their own homes with midwives, and co-sleeping was the
norm. After World War II, the Occupation Forces brought Western medicine
to Japan and forced Japanese women to give birth in hospitals, where
they kept the newborns in the hospital nursery and gave them formula.
Breastfeeding became rare. Midwives moved into the hospitals.
In current-day Japan, women
typically stay in the hospital up to a week after the birth. When the
mothers are discharged, they go to their own parents' homes to recuperate.
There, the new grandmother helps care for the baby, but now most grandmothers
have no breastfeeding experience and can't help the new mother.
In 1974, Japan began promoting
breastfeeding again. In 1991, Japan had the first Baby-Friendly hospital
in any developed country, and there are now 25 Baby-Friendly Hospitals
in Japan and 40 board certified lactation consultants (IBCLCs).
The traditional Japanese
method of breast massage has been reintroduced, but has become medicalized.
It is believed that mothers need breast massage to produce adequate
milk. Some of the new massage techniques are painful and the mothers
also have to pay for the breast massage. The official opinion of LLL
of Japan is that breast massage is neither discouraged nor recommended.
One of the most fascinating
parts of the sessions was on counseling the Japanese mother. The speakers
pointed out that Japanese people are uncomfortable with personal questions.
Japanese people avoid discussing their honest feelings in order to keep
harmony in the society. Even asking "How do you feel?" may
make a mother feel awkward and pressured. When information is given
to the mother she may nod and say "Yes," but that doesn't
mean she agrees. It just means she's listening and acknowledging that
she heard. When a Japanese person smiles, it doesn't necessarily mean
she's pleased. It may just be a "smile of self control." They
also avoid direct eye contact because this is considered staring and
is rude.
The speakers recommended
that when a breastfeeding counselor works with Japanese mothers, the
counselor should be careful to ask how the mother prefers to be called
(first name or Mrs.). Be respectful of the mother. Many Japanese mothers
are uncomfortable with being touched, especially hugging. Use concrete
breastfeeding suggestions and give simple written instructions (depending
on the mother's facility with English). Many Japanese people are very
respectful of authority, so a breastfeeding counselor should provide
additional reassurance and information from authorities such as the
AAP, the World Health Organization, and books written by breastfeeding
experts with titles and degrees.
Last updated Tuesday, October 24, 2006 by njb.
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