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Breastfeeding Advocacy and Activism in China: An Inside Look

In China, breastfeeding has all but disappeared from the mainstream as a method for feeding babies. But Sascha Matuszak, a German-American journalist who's lived in, and written about, China for the past decade, wrote an article this past week detailing a burgeoning, grassroots Chinese pro-breastfeeding movement that's recently "managed to break into the international media and join the international breastfeeding community." Inspired by coverage of breastfeeding "flash mobs" and nurse-ins in the US and Europe, Chinese breastfeeding advocates have staged several similar events in their own country over the past year. The purpose of these 'mobs' has been -- as it often is here in the States -- to normalize breastfeeding in the public eye; moms who nurse publicly in China, as with those in the United States, do so in the shadow of a public perception that views breastfeeding as sexually charged, or, alternately, downright "repulsive." But advocates in China are also up against a widespread dirth of knowledge of breastfeeding's health benefits -- even among moms themselves, and amazingly, much of the medical community -- not to mention against the pervasive influence of infant formula companies there.

Matuszak's experience with breastfeeding ignorance and advocacy is personal. His own wife is among China's small, but growing, community of breastfeeding advocates and educators. (She's also studying to become a doula.) Moments after the couple's son was born in a Chinese hospital, they were pressured to feed him formula from a bottle. When Matuszak and his wife refused the formula and explained their intention to breastfeed, detailing the health benefits of colostrum, they were criticized by the medical staff for being "uninformed." Doctors and administrators in Chinese hospitals in fact receive financial reward for promoting formula-feeding to new mothers. (This issue has recently inspired controversy, and in some cases systemic changes, within the United States, too.) And although formula companies can't legally market their products in China as intended for babies under six months old -- a recent policy-change win for breastfeeding advocates there -- the promotion of their products to new mothers by doctors is some of the strongest marketing they could possible secure. It's one of the most daunting, culturally-specific challenges breastfeeding advocates and educators face in China; as Matuszak writes, "Grandparents dote so fiercely upon their single grandchild that any perceived risk — such as insufficient milk — is enough to make them reach for the latest foreign formula brand. Doctors are revered by the older generation; if a doctor states that formula is good or that a mother may not have enough milk, grandparents take it as gospel… Convincing an extended Chinese family that the newborn in their midst is best served by breast milk is a painstaking, laborious process."

In general, breastfeeding educators in China are discovering that this dialog-based process is required, one family at a time, in order to increase breastfeeding rates. Although the internet has served to provide the community with examples from overseas for promoting breastfeeding acceptance among the public, and debates rage between advocates and critics online, actually reaching Chinese families themselves requires face-to-face discussion and re-education within people's homes, where, Matuszak writes, "mothers and grandparents debate what’s best for their children." Unlike in the United States and Europe, many mothers in China aren't even aware of breastfeeding's merits from a health standpoint. So while public perception and support is certainly an issue, accurate information -- and its dissemination -- mark the starting point for most advocates in China.

Meanwhile, international formula makers are flooding the Chinese market -- which is obviously huge (read: $$$) -- and they're marketing hard. In 2008, the domestic food and dairy maker Sanlu landed at the center of a scandal when six infants died (and more than 800 were additionally hospitalized) from kidney damage; the chemical melamine had been added to milk to make its protein content appear higher. A few years before that, watered-down milk had caused additional infant deaths. Subsequent lawsuits resulted in several executions and life-sentences for those at fault (corruption and deception were of course all at play), but, more impactfully, the Chinese food market came under scrutiny, at home and abroad. (American companies like Starbucks and KFC dropped their Chinese dairy suppliers as a result of the scandal.) This may have been the perfect moment for a resurgence of breastfeeding education, but the Chinese market was instead opened up to international brands. Removing their influence from hospital maternity wards may prove to be the next big (seriously, BIG) challenge for breastfeeding advocates in the nation, but perhaps, as breastfeeding gains additional recognition and support among parents and policy-makers alike, advocates will be able to follow examples -- like these -- of what's working abroad, as they have thus far with the flash mobs.

Ultimately, moms who breastfeed in China face many comparable issues to those faced by moms nursing in America, Europe and other places in the world, but they also face challenges unique to Chinese culture today. Through re-education and grassroots activism, however, the status quo is beginning to change, much like in Brazil, where advocates for natural birth are making headway, despite a staggering national C-section rate (up to 99% in some private hospitals… China's is pushing 50%.) Parents -- everywhere -- do want information, and want to do what's best for their children. In the US, natural parenting is of course about making informed decisions around birthing, feeding, and all of that, but it also runs deeper as a paradigm shift, in terms of how we approach our children and our lives with them. This is, according to Matuszak, also true of the growing community of like-minded mamas in China. "For mothers involved in the flash mobs this year, and in the many online groups that spill over into real life," he writes, "breastfeeding is not only a nutritional and philosophical choice, but also part of a national effort to improve the lives of Chinese children by re-introducing humanity into the child rearing process."

I'm fascinated by so many aspects of this movement, from those that are shared internationally (literally, via the internet, and culturally, in terms of misperceptions and public resistance), to those that are unique to China right now. It'll be fascinating to watch China's grassroots activist community continue to create change amidst their own challenges, and I'm definitely cheering them on.

Do you think the natural parenting 'movement' in the United States has been reflective of our own cultural history, as well? (In terms of push-back against post-1950s normalization of medicalized birth, bottle-feeding, etc.?) Is the internet creating a truly international natural parenting community?