Traditions, misunderstandings, and mixed messages: new mothers' perceptions of contextual influences on breastfeeding in Hong Kong

Abstract

Although Hong Kong women are increasingly choosing to breastfeed, exclusive breastfeeding is rare and duration remains short. The aim of this study was to determine the participants' perceptions of contextual factors influencing their breastfeeding behaviors. Participants (n=260) were breastfeeding primiparas recruited from two tertiary care hospitals. Participants completed surveys eliciting attitudes and beliefs about infant feeding while in hospital, at 1, 3, and 6 months or until they weaned. Demographics and variables concerned with hospital practices, breastfeeding support and weaning were used in this analysis. Quantitative data analyses included descriptive statistics and 2-way ANOVAs. A sub-sample of participants (n=25) was interviewed in-depth concerning contextual influences on their feeding choices. Content analysis was used to analyze this data. Data from both sources were triangulated to enhance the validity of the findings. Data analysis revealed four main contextual influences on breastfeeding: (1) Chinese traditional cultural practices, (2) the health care system, (3) the pressures of urban life, and (4) misinterpretations of the lactation process. Traditional postpartum practices, health professionals' practices, life stresses (short maternity leave, family pressure to return to full-time employment, lack of work place support), and participants' poor understanding of the physiological process of lactation all contributed to early weaning. The unique cultural and social findings affecting breastfeeding women in Hong Kong are presented. Findings may be useful in informing health policy for new mothers, the development of breastfeeding promotion programs and to health care providers caring for the many Chinese women living outside of Hong Kong. LEARNING OBJECTIVES: 1.To identify factors that contribute to early weaning and breastfeeding failure in Chinese women in Hong Kong. 2.To identify strategies that will promote sustained and exclusive breastfeeding in Chinese women in Hong Kong.