We hope to share - California Breastfeeding...

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Effective Collaborations &

Breastfeeding Promotion Strategies

Asian, Southeast Asian

& Pacific Islander Communities

California Breastfeeding Summit January 27, 2017

We hope to share

• Cultural factors and social determinants that may influence breastfeeding for Asian, Southeast Asian, or Pacific Islander families

• Stories and strategies from communities

• Resources for culturally and/or linguistically appropriate breastfeeding education materials

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Cantonese Mandarin

Hakka

Fuchow

Formosan

Wu

Korean

Mon-Khmer Thai

Laotian

Vietnamese

Mongolian

Gondi

Tibetan

Burmese

Karen

Pangasinan

Micronesian

Marshallese

Ponapean

Nepali

Chinese ≥50%

Japanese

Hmong

Kazakh

Uighur

Azerbaijani

Turkish Mien

Tagalog

Indonesian

Bisayan

Sebuano

Ilocano

Pampangan

Kusaiean

Palau

Polynesian

Tongan

Sinhalese

Persian

Gujarati

Bengali

Panjabi

≥30%

Telugu

Kannada

Malayalam

Tamil

Cham

Javanese

Malay

Bikol

Chamorro

Melanesian

Samoan

Fijian

Hindi Urdu

Marathi

Oriya Sindhi

Hawaiian

≤30%

Linguistic Isolation

Source: U.S. Census Bureau, 2009-2013 American Community Survey

Karakalpak

Burushaski

Balinese

Malagasy

Carolinian

Mokilese

Yapese

Tokelauan

Nukuoro

Bihari

Kirghiz

Karachay

Dravidian Munda

Kachin

Gilbertese Trukese

Maori Rajasthani

Assamese

Kashmiri

Data withheld to avoid disclosure.

In California: Asian, Southeast Asian, & Pacific Islanders

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Cultural and Social Considerations When Promoting Breastfeeding in the Chinese & Vietnamese Communities

Postpartum Confinement “Zuo Yue Zi” 坐月子

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Postpartum Confinement “Zuo Yue Zi” Foods

“One-Month” Confinement “Zuo Yue Zi” Foods

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“One-Month” Confinement “Zuo Yue Zi” Foods

Vietnamese New Mother’s Postpartum Experience

http://scaifebabywatch.blogspot.com/2013/02/vietnamese-postpartum-diet-care.html

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Viet Postpartum Practices & Foods

http://mamaescapade.blogspot.com/2013/08/vietnamese-postpartum-tradition.html

Chinese Cultural Practices & Breastfeeding

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“Yue Zi” Helper or Yue Zi Center

Vietnamese Cultural Practices & Breastfeeding

https://everyone.savethechildren.net/sites/everyone.savethechildren.net/files/wp-content/uploads/Case-Study_Vietnam_Hue_Jan2012_Credit-Tran-Xuan-Canh-2.jpg

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Influence from Family

While you “zuo yue zi”, you should not move around too

much, must rest in bed, do not bathe or wash your hair, cannot eat fresh

fruit…

Other Sources of Influence on Breastfeeding

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We Need Support to Breastfeed

Stories and Strategies from Communities

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Resources Chinese • Breastfeeding Association of Taiwan http://www.breastfeeding.org.tw/main/main.php • Hong Kong Breastfeeding Association http://www.breastfeeding.org.hk/ • La Leche League - China http://www.muruhui.org/ Vietnamese http://nature.berkeley.edu/departments/nut/extension/vietnamese.html https://www.healthinfotranslations.org/pdfDocs/BreastfeedingBasics_VIET.pdf http://here.doh.wa.gov/search-by-language/materials-in-vietnamese/ https://www.breastfeeding.asn.au/bf-info/other-languages • MULTIPLE LANGUAGES Consumer Health Information including Breastfeeding https://nnlm.gov/outreach/consumer/multi.html#A4

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Initial Any Initial EBF EBF 1mo EBF 3mo

Pe

rce

nt

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all b

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CA

CA Asian

CA PI

HP 2020

California Initiation and Duration Asian and Pacific Islander Compared to Total

Maternal Infant Health Assessment (MIHA), 2013-14 California Department of Public Health In-Hospital Breastfeeding Data, 2014

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Exclusive Breastfeeding by Ethnic Group Alameda County 2014

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60

70

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90

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EBFInitiation

EBF 1 week EBF 1month

EBF 2months

EBF 3months

AC All

AC Asian/PI

AC Black

AC Hispanic

AC White

Healthy People2020 EBF 3-Month 44.3%

Maternal Infant Health Assessment (MIHA), 2013-14 California Department of Public Health In-Hospital Breastfeeding Data, 2014

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Asian

Southeast

Asian

Pacific

!slander

Breastfeeding

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Community Engagement

Culturally Appropriate Education

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Provider Engagement

Lactation Accommodation

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Public Information Campaign

Workforce Development

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Call to action!

How well do you know your community?

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What is important to your community?

How does breastfeeding relate to their concerns?

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How are you collaborating with Asian, Southeast Asian and/or Pacific Islander communities to promote breastfeeding?

References 1. Donaldson, H. CNM, MS; Kratzer, J. CNM, MS; Okutoro-Ketter, S. CNM, MS; Tung, P. CNM, MS. Breastfeeding

among Chinese Immigrants in the United States. Journal of Midwifery and Women’s Health. 2010; 55(3):277-281.

2. Hue Thai, UWSOM, R/UOP-III. Postpartum Practices among Vietnamese and Chinese Patients. 3. Ngyuen, H. T. Eriksson, B. Tran, T.K. Petzold, M. Bondjers, G. Nguyen, T.K.C. Nguyen, L.T. Ascher, H.

Breastfeeding Practices in Urban and Rural Vietnam. BioMed Central Public Health 2012, 12:964. 4. Yui Siu Chung. Only 2% Hong Kong Mother Breastfeed, Friendly Policy Helps with Decision. Wen Wei Po

Newspaper, Hong Kong, Health Information Page, February 2, 2016. 5. https://ww2.kqed.org/bayareabites/2015/05/09/new-mom-turns-to-ancient-chinese-recipes-for-

postpartum-recovery. 6. Raven, JH. Chen, Q. Tolhurst, RJ. Garner, P. Traditional Beliefs and Practices in the Postpartum Period in Fujian

Province, China: a qualitative study. BioMed Central Pregnancy & Childbirth. 2007; 7:8. 7. U.S. Census Bureau, American Community Survey 2009-2013

http://www.census.gov/data/developers/updates/acs-5-yr-summary-available-2009-2013.html 8. Maternal Infant Health Assessment (MIHA), 2013-14

http://www.cdph.ca.gov/data/surveys/MIHA/Pages/MaternalandInfantHealthAssessment(MIHA)survey.aspx 9. California Department of Public Health In-Hospital Breastfeeding Data, 2014

http://www.cdph.ca.gov/data/statistics/Documents/HospitalxRace-EthnicityReport2014.pdf 10. Lipson, J., Dibble, S., and Minarik, P. Culture & Nursing Care: A Pocket Guide. UCSF Nursing Press, 1998.

All photographs used with permission.

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Thank you!

Jeanne Kettles, MA, IBCLC Jeanne.Kettles@acgov.org

Tonya Lang, MPH Tonya.Lang@gmail.com

Grace Yee, IBCLC Grace.Yee@sfdph.org