HEALTH SCIENCE JOURNAL®

Volume 6, Issue 2 (April – June 2012)

Cultural views and practices related to breastfeeding Maria

Daglas1, Evangelia Antoniou 1
1. Department of Midwifery, Technological Educational Institution of Athens (TEI), Athens,
Greece - National School of Public Health, Athens, Greece

ABSTRACT

Background: The feeding method of neonates and babies and, especially, the issue of breastfeeding is one

of the most important for public health. Despite the sensitization, the intention and recommendations of

the world scientific community, only 39% of babies, on an international level, are fed during the first six

months of their lives exclusively with mother’s milk.

Aim: The present study attempted a bibliographic review of the studies about cultural practices and beliefs

for breastfeeding. The research question focused on whether cultural and social standards lead up to what

degree a process as breastfeeding is accepted by the mothers in a society.

Method: We studied all articles at the period 1988-2008 in the Pubmed which associated the initiation and

duration of breastfeeding with the cultural status of a certain society. The key-words were society,

breastfeeding, initiation, duration, cultural status.

Results: The process of breastfeeding is often not determined by biological factors, but it is mainly based

on the habits, standards and behaviors existing in each society. Views on the function of female breasts,

the quality of mother’s milk as well as traditional practices related to breastfeeding are often the reasons

that lead to how much this process is accepted by the mothers.

Conclusion: Public health policies worldwide must take into account and study the cultural status of a

society in order to create favorable conditions for the initiation and duration of breastfeeding.

Key words: Society, breastfeeding, initiation, duration, cultural status.

CORRESPONDING AUTHOR

Maria Daglas
38 Paradeisou Str.

17123 Nea Smirny

Athens, Greece

E-mail: daglam@fks.uoc.gr

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_GENERAL ARTICLE_
Quarterly scientific, online publication by Department of Nursing A’, Technological Educational
Institute of Athens

INTRODUCTION T
he regards objectives the proper of public health as diet of a child are
and artificial feeding- and children’s care can save more than 5,000 lives per day4.
the natural development and nutrition,
Improper practices, however, as regards
the avoidance of complications related to
the babies’ diet contribute even more to
the diet and the prevention of chronic
childhood malnutrition. Childhood
diseases. Issues of special interest for
malnutrition is responsible for half of the
public health include the diet of
remaining deaths of children every year4.
neonates and babies, as many of the
causes of child mortality are due to diet
Social and cultural factors related to the
practices1,2,3.
initiation and progress of breastfeeding According to Unicef 4 more than
Only 39% of the babies are exclusively
10,000,000 children die every year,
breastfed on an international level
mainly from causes that can be
during the first 6 months of their lives6.
prevented, such as diarrhea, pneumonia,
Furthermore, it is estimated that 63% of
measles and malaria. Some of these
the babies younger than 6 months in the
causes of child mortality, at least to
developing countries have not breastfed
some degree, are related to the diet of
to a satisfactory degree7. However, in
neonates and babies and more
some Asian countries, such as Thailand,
specifically, to water quality, sterilization
breastfeeding percentages increased from
of objects etc.
90% in 1987 to 99% in 19938, while in
However, it is estimated that 3,500
countries, such as Uzbekistan, there is
children could be saved on a daily basis
an increasing tendency in the
if every baby was exclusively breastfed
breastfeeding percentages9. The small during the first 6 months of their lives5.
percentages of exclusive breastfeeding
According to the best estimates,
observed internationally10,11,12,13,14 are
exclusive breastfeeding can prevent at
mainly due to the fact that such a
least 1,300,000 deaths of children,
natural process is not only determined
mainly, due to the biochemical
by biological factors, but it is also
composition of mother’s milk, while the
supported by the habits, standards and
mixed diet, that is breastfeeding plus
behaviors prevailing in each society15-20. artificial feeding, some 587,000 more4. In
Examples such as the lack of support and
other words, the combination of these
encouragement from family members,
improvements in the diet –breastfeeding
such as the mother, the grandmother,
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HEALTH SCIENCE JOURNAL®

Volume 6, Issue 2 (April – June 2012) the sister etc, the role of women in the
consider that the sexual behavior which
society and their place in the workplace
involves the breast is unnatural and
and the family, as well as the standards
perverted; at the same time they cannot
related both to the female body as well
easily believe that the breast is an object as human reproduction21, are some of
offering pleasure both to men and
the socio-cultural changes on which the
women23. Such an atmosphere, of
milk industry relies from time to time in
course, facilitates the initiation and
order to promote the need for artificial
continuation of breastfeeding.
feeding22. But this supposed need
On the contrary, in developed countries,
undermines maternity and, generally, the
such as the USA, the breast is
role that women play in the development
incorporated in a wider cultural context
of their children, as it creates questions
which is mainly based on the following
and doubts to the mother about her
admissions23: 1) the primary role of the
ability, which is provided by nature, to
female breast is related to sexual
feed her child.
behavior and pleasure; 2) breastfeeding
This study shall mainly deal with the
must be restricted only to neonates; and
cultural practices and views and ideas of
3) breastfeeding must take place only in
various cultures and the way they
private spaces, the same as sexual
determine how much a natural and
behavior. For the aforementioned
biological process, such as breastfeeding,
reasons, breast enlargement procedures
is accepted.
are a daily routine in these countries.
The above approach to an organ of the
Symbolisms of female breasts
human body reflects cultural and social
In some developing civilizations, such as
standards that do not often favor the
Mali in Western Africa, Sierra Leone and
initiation and progress of breastfeeding;
Nepal, the breast does not create sexual
especially when they are also
associations both in men as well as in
accompanied by the women’s fears that
women. In these countries, the breast
the changes brought upon their bodies
has maintained the primary biological
by pregnancy and the lactation process
function; it is considered an organ used
have made them unattractive to the to feed neonates and babies23. Women
opposite sex and their husbands or
expose their breasts in public places
friends. A common question raised by
freely and without reservations, as they
Greek mothers that have adopted
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Quarterly scientific, online publication by Department of Nursing A’, Technological Educational
Institute of Athens
American standards and behaviors to be
Africa. Furthermore, such cultures
answered by midwives (as the competent
believe that a man’s sperm who is not
health professionals during puerperium)
the child’s father is extremely harmful.
is usually: "How much will the shape of
The women of the Mende tribe,
the breast change if I do not breastfeed
therefore, choose to stop breastfeeding
or if I stop breastfeeding early or if I
early so that they can start their sexual
breastfeed for a small period of time?"
life again with their mates or husbands
Such a question often shows the
and get rid of the responsibilities borne
women’s anxiety about whether their
by them if the baby falls ill24. As a
breasts will continue to attract the
consequence, due to the specific ideas
interest of their husbands-mates and fill
about breastfeeding and the children’s
them with pleasure and enjoyment. The
weaning, the children die from
aforementioned factors along with the
malnutrition. Furthermore, these
strict rules concerning the femininity of
civilizations interpret the artificial
women, their reproductive abilities and
feeding of a child by the man in a public
the content of social relations influence
place as a sign of the child being
their free expression and pose often
accepted by the father and they believe
obstacles in the initiation and duration
that it helps the strengthening of their
of breastfeeding.
emotional bonding24.
In such civilisations, such as the Mende
Financial and social conditions
one, and for financial reasons mainly, a
influencing breastfeeding
woman must have a relationship and
The notion of “successful breastfeeding"
sexual relations with a man in order to
in some developing countries mainly
be able to survive; this happens because
includes the early weaning of the child
only a man can offer a woman the goods
and is completely different from the one
required for her life. Given, thus, the
recommended by the World Health
idea prevailing about the sperm
Organization. The women of the Mende
infectivity24, there are many women that
tribe in Sierra Leone (Western Africa)
resort to artificial feeding in order to
choose to stop breastfeeding early. This
continue their relations with their
civilisation believes that the sperm can
husbands or mates so that they can be
contaminate mother’s milk and, as a
financially secure23. We see, thus, how consequence, the baby can fall ill24. Such
social conditions and the roles of the two
a belief is spread all over the Western
sexes in a society create habits and
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Volume 6, Issue 2 (April – June 2012) practices which are accepted as “proper”
"afflicted" by the batash and was stale.
or “natural” procedures, although they
He advised them to stop breastfeeding
do not comply with the concept of the
and start artificial feeding.
natural function of the human body.
Such civilizations consider that mother’s
milk is made of blood. The colostrum is
Attitudes and ideas concerning the
also described as “thick” and is
quality of mother’s milk
compared to pus due to its appearance26.
As we know the percentages of exclusive
As it is believed in these countries, the
breastfeeding are supported by the
batash wind can afflict a baby either
habits, ideas, attitudes and behaviours
directly or indirectly changing the prevailing in each society15. Some of
composition of mother’s milk. Batash is
these ideas or attitudes are related with
associated with impurities and with the
quality of mother’s milk. For example,
impure liquids of the body, such as the
various beliefs prevailing in Pakistan are
blood. For the above reason, the ones
related to the sensitivity of mother’s milk
bleeding or breastfeeding are considered
to the powers of evil and similar ones
vulnerable. The feeling of weight or
exist in Bangladesh. In these countries, if
“swelling” that a mother can have during
a baby is sick or cries too much, the
the lactation period is one of the
quality of mother’s milk is examined in
symptoms that her milk has been
laboratories. The doctors in these
affected by the batash spirit26.
countries recognize that the “insufficient
One way to protect neonates is the milk syndrome” has a scientific basis25.
placement of specific objects under the
The study of anthropologists in
mattress during their sleep. Such objects
Bangladesh on the specific syndrome is
are usually a match box (because it is
characteristic26. According to Zeitlyn and
considered that fire scares and drives the Rowshan26, the parents were concerned
spirits away), a bone from an animal
by their newborn baby's cries. The
sacrificed by the Muslims on specific
interpretation of their neighbors was
days and a few hairs from a broom used
that the baby might have been affected
to drive the batash influence away26.
by the “batash” (an evil spirit or wind)
When a breastfeeding baby in
and this also was confirmed by a
Bangladesh falls ill, the popular belief
religious healer (Hazur). The healer
attributes the illness to the mother's
diagnosed that the mother's milk was
behavior that has either failed to
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Quarterly scientific, online publication by Department of Nursing A’, Technological Educational
Institute of Athens
maintain the temperature of her body or
According to Daglas et al29, Greek
has eaten foods that are not considered
mothers usually refuse to breastfeed or
proper for breastfeeding or behaved in
stop breastfeeding because they smoke.
such a way that made her and her baby
They are very much concerned about the
vulnerable to spiritual powers afflicting
weight and diet of their babies, and at
the milk. Therefore, the most proper and
the same time they are afraid that their
popular way of sending the evil spirit
breasts will change very much. Also the
away in such civilizations is the initiation
following factors as the initiation time of of artificial feeding26.
breastfeeding, the natural and pleasant
delivery, and the fact that the women do
The attitude of women in our country
not administer mixed diet after being
Nowadays, the increased social roles, on
discharged from the maternity hospital,
the one hand, that the Greek woman is
appears to have a positive effect on the
asked to play and, on the other, the
period of time that the Greek mothers
factors related to the production, trade
breastfeed. Other side, smoking are
and disposal of mother’s milk substitutes
negatively associated with the duration
as well as the state, professional and
of breast-feeding.
hospital practices existing in our country
Very often, women attribute the failure
do not facilitate women to choose
of breastfeeding to the fact that nature
breastfeeding. Therefore, although there
did not "endow" them enough so as to
are increased percentages in the
have the proper quantity of milk for the
initiation of breastfeeding, as it is shown
neonate27, and they claim that they
in various studies, Greek women end
either did not have sufficiently big
breastfeeding early27,28.
breasts or they had inverted, flat or sore A study 27 of the mothers’ intention and
nipples27.
of the actual progress of breastfeeding in
2001 in Greece shows that 85.8% of the
Conclusions
newly born infants were breastfed
When looking into the breastfeeding
(52.9% exclusively breastfed and 32.9%
issue from a more anthropological-social
with a mixed diet) at the maternity
point of view, we observe that the
hospital. The percentage of infants of
cultural practices and beliefs prevailing
foreign mothers breastfeeding for more
in a society are the ones that determine
than a year is quite high in relation to
to a considerable degree which
the one of the Greek mothers.
procedure will be considered natural
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