The issue of breastfeeding in Hong Kong

Breastfeeding may be the best start to your infant's life, but some mothers still feel awkward nursing in public, write Tara Jenkins and Karen Pittar

PUBLISHED : Sunday, 17 February, 2013, 12:00am
UPDATED : Sunday, 17 February, 2013, 4:06pm

It's natural, healthy and best for baby - so why does breastfeeding in public create such a furore? The volatile issue hit the headlines in Australia recently, with popular TV chat show host David Koch coming under fire for suggesting mothers be more discreet while nursing their babies.

More than 100 women and their infants protested outside his studios, staging a "Nurse-In" to promote women's rights to feed their babies.

Closer to home, it's a battle first-time mother Lily Jameson can relate to. She was mortally embarrassed at an international club in Hong Kong last year, when a staff member tapped her on the shoulder and suggested she might be more comfortable breastfeeding her baby in the toilet. Historically, the city has lacked private places in which to breastfeed, and while this hasn't hugely improved, the good news for mums such as Jameson is that breastfeeding in public is slowly becoming more acceptable.

"With my eldest daughter, I was always looking around for special feeding rooms, change rooms or nice bathrooms in hotels, and it was a nightmare," says Sarah Benhacine, mother of four-year-old Jessica and eight-month-old Alice. "With my youngest, I bought one of those feeding capes and basically just fed wherever and whenever; I felt quite comfortable doing so."

You may sometimes need to do smaller feeds...don't make yourself a slave to breastfeeding
Hulda Thorey

So while secluded places for new mothers include designated rooms at specialist shops Tiny Footprints or Bumps To Babes, there are also parents' rooms in malls including IFC and ICC, dressing rooms at Lane Crawford, or the 1st floor washroom at the Mandarin Oriental. So it isn't as unnerving as it used to be to breastfeed publicly.

Hulda Thorey, director at Annerley, a maternity and early childhood specialist that helps parents adjust to the demands of new arrivals, says: "Try not to make it such a big deal, once the initial challenges are behind you. Sometimes you just have to follow Nike's slogan: Just do it!

"When you are out and about you might sometimes need to do smaller feeds on the run and catch up at home, but most babies are happy with this. So don't make yourself a slave to breastfeeding.

"Also, try not to listen too much to all the different strong opinions about breastfeeding that you hear. People are very judgmental and have strong views. And myths are everywhere. Do what you want. As a working mother, it was one of the nicest things for me to come home and breastfeed the baby I had not seen all day."

Jessie King agrees, and says she has comfortably breastfed in public countless times. "I use a bib or a blanket," explains the mother of four-month-old Sebastian and 20-month-old Penelope. "I have found Chinese people generally avoid eye contact, anyway, so they often do not stare or make you feel uncomfortable doing it in public. Any comment made is generally positive - 'that's great you're breastfeeding your child. He or she will be healthier because of it.'

"But while it seems breastfeeding is making a comeback - it's certainly more popular now than in my parents' generation - it still needs to be encouraged with new mothers."

King had both her babies at international hospitals in Hong Kong, and found breastfeeding hard at first.

While the nurses were helpful (advocating home remedies involving frozen cabbage, oatmeal, papaya, Chinese soups and herbs), as soon as her babies started losing weight, the staff suggested introducing formula milk.

"Hospitals do not always encourage women to breastfeed as much as they should, and do not place enough emphasis on the health benefits. They should be pushing breastfeeding by providing lactation nurse visits, pumps for patient use to stimulate milk supply, and time spent on the breast with the baby right after birth."

Caroline Carson, a La Leche League leader, agrees, saying having a new baby is overwhelming at the beginning. Her organisation helps promote and support mothers who wish to breastfeed. "If you are informed and educated about breastfeeding, you get the best start. Often, mothers are told early on in hospital that they don't have any milk, their baby is hungry and needs to be given formula. A significant number of healthy babies are given formula in their first 24 hours of being in hospital, so even if the mother wants to breastfeed, she's off to a bad start."

Nevertheless, it looks as if the much-needed information is gradually filtering through to the public hospitals, where breastfeeding rates are on the rise. According to Dr Marie Tarrant, associate professor at the University of Hong Kong's School of Nursing, the rate of breastfeeding initiation has increased steadily over the past 10 to 15 years. The latest survey from the Baby Friendly Hospital Initiative HK Association showed about 83 per cent of mothers now start breastfeeding in the hospital; higher than Britain (81 per cent) and the US (75 per cent), but lower than Australia (95 per cent).

"The rate of women continuing to breastfeed drops off considerably after birth, but this aspect is also improving," she says. "In our latest study at three months postpartum, 46 per cent of mothers who started breastfeeding are still doing so, and at six months 30 per cent are still feeding."

Tarrant says breastfeeding is strongly promoted in both maternal and child health centres, as well as public hospital antenatal clinics and postnatal wards, but more can be done. "The nurses who work on the postnatal in-patient wards of public hospitals are very supportive of breastfeeding, but they are also very busy and often do not have the time to provide one-on-one help to new mothers. So more resources are needed in the public sector to support new mothers. There also needs to be more support after mothers leave hospital, especially when they return to work."

Outside the hospitals, there is support from many different areas, but you have to know where to look, says Thorey. "It's important to get information and support from hospitals and people like us here at Annerley who know about, and support, breastfeeding. Also, the government hospitals have improved breastfeeding support."

Annerley and the La Leche League are invaluable sources of information and encouragement for new breastfeeding mothers, as are classes held at many hospitals, including Matilda and Adventist.

From a mother's perspective, King thinks still more could be done to improve breastfeeding rates in the city. "More lactation nurses, education, literature, articles in newspapers, nurses in hospitals, breastfeeding mummy forums and groups to help with questions/issues/problems in different locations around the city."

She says a friendlier maternity leave policy and work environment could also make it more appealing. "Hong Kong is about comfort and ease, and breastfeeding is not the easiest thing to do. Because domestic help is so easily and readily available, mothers can spend less time with their kids, including time spent breastfeeding," King says.

"Also, with maternity leave limited to 10 weeks [whereas countries like Sweden allocate a year], it does not give a mother time to commit to breastfeeding. The benefits of breastfeeding need to be advertised. If mothers understood how the benefits outweigh the time commitment or potential difficulties, they might be more interested in giving it a go."