A collection of stories by and about those in the AANHPI community

Asian American Native Hawaiian Pacific Islander (AANHPI) Breastfeeding WeekTelling our own stories. Elevating our voices— is coming to a close.

On Friday, the U.S. Breastfeeding Committee AANHPI Caucus presented the AANHPI Lactation Community Forum, an open panel discussion where AANHPI community members shared about their journeys to becoming lactation support professionals as well as provided guidance on how we can further build community capacity to support AANHPI families.

Photo by Samrat Khadka on Unsplash

Other opportunities as part of the celebration included visiting the Asian American, Pacific Islander, and Native Hawaiian Breastfeeding Week Facebook page and engaging with activities like the AANHPI Coloring Pages Contest. The Alameda County’s Asian, Southeast Asian, Pacific Islander (ASAP!) Breastfeeding Taskforce AANHPI Social Media Toolkit produced shareable social media content including messages and captions in the toolkit which have been translated into 11 different AANHPI languages: Chinese (both traditional and simplified), Farsi, Hindi, Hmong, Japanese, Korean, Native Hawaiian, Samoan, Tagalog, and Vietnamese.

In an engaging discussion from last summer, Tonya Lang, MPH, CHES, IBCLC and Grace Yee, described the diversity that exists under the AANHPI umbrella, shaking away the stereotypical idea that Asian culture is monolithic.

The Asian Pacific Institute on Gender-Based Violence begins to describe the complexity of AAPNHPI groupings and the forces that shape identity in Census Date & API Identities. AAPI DATA, which provides demographic data and policy research on Asian Americans and Pacific Islanders, compiled some wonderful visuals to help shape the numbers.

The overgeneralization of the API community has led to some misleading data about breastfeeding rates. On an aggregate level, initiation and duration rates are relatively high, but the statistics don’t account for stark disparities within these population groups. This piece covers this phenomenon in more depth and offers strategies for tailoring infant feeding support in the Chinese American population.

As Dr. Magda Peck has pointed out, numbers and data are important because they drive decisions and policies, but they also have the potential to sanitize humanity. That’s where stories come in. Not only do they humanize the numbers, they can also help us make sense of the data.

In celebration of AANHPI Week and in hopes of demonstrating the complexity and diversity of this population, we have collected several stories by and about those in the AANHPI community.

Photo by Dragon Pan on Unsplash

First up, is To-wen Tseng and her contributions to the San Diego County Breastfeeding Coalition’s blog. Tseng wrote most recently about her ‘why’ reflecting on National Breastfeeding Month. Read that piece here.

Joanne Datangel-Gallardo, MD, DPPS of the National Children’s Hospital, Philippines has worked extensively with relactation efforts. Read about Dr. Datangel-Gallardo’s work here.

Also out of the Philippines is a piece by Micaela Papa detailing how breastfeeding saved one baby’s  life and helped her mother recover from the stress of Typhoon Odette.

Not far south from this archipelago, is the island nation of Timor Leste. Here, emergency response efforts to protect breastfeeding have saved the lives of many. Community members manage and intercept artificial baby milk and other ultra-processed food product donations among other components of the nurturing care model. Read about these efforts here.

In Indonesia, efforts are also underway to combat commercial milk formula companies. Find a simple model for reporting Code violations here.

Jenny Lei Ravelo writes about the tangle of infant feeding complexities on Indonesia’s remote islands complete with stunning photos in partnership with the 1000 Days Fund.

In India, the Foundation for Mother & Child Health (FMCH) works to empower families from vulnerable communities with actionable information and services, resulting in health seeking behavior and nutritious food choices in order to tackle maternal child malnutrition, ultimately breaking the cycle of poverty. Read about the organization’s impact here.

In the spring, the Asian Pacific Islander Breastfeeding Task Force (APIBTF) a part of Breastfeed LA, tailored the Dietary Guidelines for infants and toddlers for Chinese and Vietnamese communities, a project that augments APIBTF’s sister organization Alameda County’s Asian, Southeast Asian, Pacific Islander (ASAP!) Breastfeeding Taskforce’s Continuity of Care (CoC) Blueprint Project Prenatal Toolkit for AANHPI families. You can find out more about the efforts to center culture in health here.

Elisabeth Millay/BreastfeedLA and API Breastfeeding Task Force

Also exemplifying culture centered in health is the Hmong Breastfeeding Initiative (HBI). With funding from Reducing Disparities in Breastfeeding through Continuity of Care Identifying Care Gaps grant from National Association of County and City Health Officials (NACCHO), the Hmong Breastfeeding Coalition (HBC) conducted an environmental scan of the Twin Cities (Minneapolis and Saint Paul, Minn.) on breastfeeding promotion and support for child-bearing age Hmong women and families. Read more here.

Tiffany Pao Yang has played a crucial role in this work. The daughter of Hmong refugees, she is especially invested in helping change the narrative around infant feeding in the Hmong population. Read part of her story here.

 

More to explore

 

Breastfeeding in Emergencies: The Struggles of New Mothers in the World’s Largest Refugee Camp

A Journal of Aboriginal and Indigenous Community Health: Community Influences on Breastfeeding Described by Native Hawaiian Mothers

Breastfeed LA’s Current APIBTF Projects

API Breastfeeding Task Force Video Library

AANHPI Lactation Collab 

The Cost of Not Breastfeeding from Alive & Thrive Downloadable PDFs for several Asian countries

For many, grandmothers are the village

Reflecting on her experience as a first-time grandmother, one of my colleagues and mentors expressed that, for most of us, “grandmothers are the closest thing to a village that we have.”

This colleague, a lactation care provider herself,  described the intricacies, sweetness and sacredness of watching her daughter step into motherhood. My colleague’s notes described her thoughtful presence without overbearance, leaving space for her daughter and her new family to learn and to bond. For instance, she cleans the house, prepares their bed with sun-dried sheets, and sits at the foot of the bed while her daughter and granddaughter nurse. In this dreamy scenario, grandma, baby and parents are all met with challenges, however those challenges haven’t become insurmountable thanks in part to this level of grandmotherly support and care.

This week we bring to you some work that details grandmothers’ powerful influence on the perinatal experience and beyond. A 2016 systematic review found that “a grandmother’s positive breastfeeding opinion had the potential to influence a mother up to 12 % more likely to initiate breastfeeding. Conversely a negative opinion has the capacity to decrease the likelihood of breastfeeding by up to 70 %.”

Healthy Children Project’s own Barbara O’Connor, RN, BSN, IBCLC, ANLC – Faculty Emerita designed and authored the Grandmothers’ Tea Project for the Illinois State Breastfeeding Task Force (2011).

Through O’Connor’s interactive curriculum, grandmothers are invited to learn about breastfeeding through three activities that pose breastfeeding scenarios:

“The Grandmothers’ Apron activity updates grandmothers’ knowledge about the importance of breastfeeding.

During the Grandmothers’ Cell Phone activity, grandmothers talk about breastfeeding myths and barriers.

In the Grandmothers’ Necklace activity, participants create a beaded necklace to remind them of ways they can offer support through loving encouragement, updating their breastfeeding knowledge, and being helpful.” (As described in A Grandmothers’ Tea: Evaluation of a Breastfeeding Support Intervention)

Source: United States Breastfeeding Committee.

Author Jane S. Grassley, RN, PhD, IBCLC and colleagues encourage perinatal educators to explore the curriculum for A Grandmothers’ Tea as they found that grandmothers and mothers who attended the teas in their study enjoyed their interactions with one another and with the class content.

Their work also unearthed a phenomenon of defensiveness in grandmothers who did not breastfeed their own children. The authors explain  “Grandmothers who did not breastfeed may feel defensive about their infant-feeding decisions because of the current emphasis on the health benefits of breastfeeding (Grassley & Eschiti, 2007)”  and advise that “perinatal educators can invite grandmothers to share their experiences and validate the cultural context in which these experiences took place.”

In this realm of validation and healing, Midwife Andrea Ruizquez of Partera Midwifery explores the implications of the Mother Wound. On Partera Midwifery’s Instagram page, Ruizquez writes:

“Props to all the people navigating complicated mother child relationships as adults. Now that I am in my 40’s I find myself reconnecting with my own mother in a deeper way. There was a time when we were estranged from each other. I learned how to recognize that I needed boundaries and practiced maintaining them. I am learning not to get triggered by my mother’s ways, and have compassion for her reasons behind them. I extend this sentiment to all of my grandmas ancestors who are in my lineage.

I am having more compassion for myself, and the ways I am like her my mom. I am learning to love myself deeper and become a more conscious mama to my children. I am still learning to love my child self that did not get all of her needs met, and I reparent myself with love. I feel myself heal.”

Source: United States Breastfeeding Committee.

Cultural beliefs held by grandmothers have the potential to influence healthy infant feeding practices. In Grace Yee, Retired IBCLC and Tonya Lang’s, MPH, CHES, IBCLC  Cultural Dimensions in Promoting, Protecting, and Supporting Lactation in East Asian Communities, they explained the prominent roles of aunties and grandmothers in the early postpartum. One example includes how colostrum is sometimes regarded in older generations as impure or unhealthy. Yee and Lang suggest that instead of positioning tradition and culture as a hindrance, to reframe barriers to breastfeeding into potential strengths. Respect of elders’ traditions and cultural practices will establish trust and foster positive relationships, as noted in Monique Sims-Harper, DrPH, MPH, RD, IBCLC, Jeanette Panchula, RN PHN, BA-SW, and Patt Young’s, Health Educator, CLE work entitled It Takes A Village: Empowering Grandmothers as Breastfeeding Supporters.

The physiological imprint of breastfeeding withstands generations and the sensations of milk production may surface decades later as mothers become grandmothers. Grandmothers who have previously breastfed have reported the tingling sensation of a phantom milk release when holding their grandchildren.

In South Sudan, grandmothers are relactating to help manage severe acute malnutrition. This practice has been documented elsewhere like Natal, South Africa and Vietnam for example.

Barry Hewlett and Steve Winn’s study on allomaternal nursing indicates that while this practice occurs in many cultures, “it is normative in relatively few cultures; biological kin, especially grandmothers, frequently provide allomaternal nursing and that infant age, mother’s condition, and culture (e.g., cultural models about if and when women other than the mother can nurse an infant or colostrum taboos) impact the nature and frequency of allomaternal nursing.”

Photo by Наталия Игоревна from Pexels

For an illuminating anthropological perspective, read A Biocultural Study of Grandmothering During the Perinatal Period by Brooke A. Scelza and  Katie Hinde. Their “findings reveal three domains in which grandmothers contribute: learning to mother, breastfeeding support, and postnatal health and well-being” and “show that informational, emotional, and instrumental support provided to new mothers and their neonates during the perinatal period can aid in the establishment of the mother-infant bond, buffer maternal energy balance, and improve nutritional outcomes for infants.”

We would love to learn about your perinatal and infant feeding experiences as grandmothers or with grandmothers. If you’d like to share, please email us at info@ourmilkyway.org.