Care In Context: Understanding Cultural Impact

Does your client’s culture affect their lactation experience?

You probably answered yes. Most of us are aware that factors like ethnicity, geography, and community powerfully shape the experiences of childbearing and infant feeding.

But what if someone asked you: “How does culture impact lactation?” Would you have a ready answer?

It’s a big question, and true understanding is the work of a lifetime. However, there are several common timepoints along the lactation journey when culture is especially important for many parents. Understanding these is a great place to start.

From the beginning, your lactation client’s decision to feed their milk took place in a cultural context.

If breastfeeding is the norm in their culture, they may be embracing the expectations of their culture by choosing to breastfeed. If it is not common, they may be going against cultural customs in choosing a different path.

Both possibilities bring unique elements to their decision, and will also color their feelings about the lactation challenge they are experiencing.

If human milk feeding is expected in their culture, having lactation challenges may make them feel as if they are struggling with something that should be automatic and natural.

If they are choosing to breastfeed when many in their culture do not choose it, they may fear that others in their support system will point to their challenge as a reason to quit, and they may wonder if they’ve made the right choice.

Understanding that even the choice to provide their milk to their baby occurs within a particular cultural context can help you better provide the support they need.

Will your client feed right away after birth? Or will they delay the first feed? In some cultures, colostrum is viewed as undesirable and is avoided.

And after that first feed, how will your client decide how often and when to feed their baby? Some cultures encourage frequent, responsive feeding, while others believe frequent feedings will spoil the baby and emphasize schedules right from the start.

Understanding the norms, messages, and beliefs around timing and frequency of feeding in your client’s culture can help you understand their expectations about when and how often they will be feeding in the early days–and help you decide how to best impart factual information about biological norms, frequent milk removal, and milk supply.

Beliefs and attitudes about supplementing are also culturally influenced.

In some cultures, supplementing is seen as a last resort. In others, some parents begin the lactation journey already planning to combine human milk and formula, as this is a more common practice. In Latinx countries, this approach has a name: “los dos,” for both breast and bottle.

Being aware that your client’s culture may inform their expectations and choices around supplementing can help you understand how best to communicate and help.

Does your client view experts as the most reliable source of lactation advice? Or is there another source of help, such as an older relative, whose knowledge and assistance carries more weight? Culture plays a big role in shaping this answer.

As you help a family, it’s important to understand, involve, and embrace all those who are important to your client. Work to respectfully understand the dynamics and perspectives involved. Without this step, your evidence-based recommendations may not be heard or absorbed.

Last but not least, age of weaning is perhaps one of the biggest areas where culture makes a difference. Is your client from a culture where teeth or the ability to ask for milk signal that it’s time to wean? Or do they come from a culture that celebrates nursing toddlers and young children?

Although how long to breast/chestfeed is a personal decision, each parent makes it against a backdrop of cultural messages and must carry out their decision within their family and larger community. Understanding how to best support their goals means understanding how that backdrop will affect them.

It’s easy to see that a parent’s culture plays a significant role in their lactation journey and decisions, starting as they contemplate how to feed their baby and continuing all the way through the end of the nursing relationship.

But here’s another variable: Any time you are interacting with your client about one of these pivotal choices, your cultural background is coming into the mix as well! What did you absorb from your culture about the decision to feed human milk? How long did your culture tell you babies should nurse? Your own beliefs and assumptions, often unconscious, affect how and what you communicate as you strive to provide caring support.

How do you begin to unpack your own cultural messaging and experiences, listen to and learn from your clients about their cultures, and integrate new understanding into your provision of care?

It’s the work of a lifetime. The above information is just a small part of our course, “The Impact of Culture in Lactation Support,” which is a great place to start. It provides a rich exploration and specific action steps. Whether you are an aspiring, new, or experienced lactation professional, this course offers thoughtful, practical guidance that will enrich your practice, open your awareness, and prepare you to help families.