Thai cultural influences on breastfeeding behaviour

Abstract

© 2015 RCM Midwives. All rights reserved. Background. Breastfeeding is recognised as a complex behaviour that is influenced by many factors. This creates challenges for all breastfeeding mothers and health professionals seeking to support women in their breastfeeding journey. Personal, psychosocial, cultural and economic factors create a complicated interplay that affects breastfeeding practices. Maternal motivation is acknowledged as a determinant of breastfeeding behaviour; however, it is important to recognise that motivation is influenced by the culture and environment in which women live. Understanding how culture influences behaviour offers researchers insight into breastfeeding practices. Aim. The aim of this study was to identify the contextual and cultural influences that are communicated through breastfeeding instruction within a Thai setting. Methods. Observational data were collected at national, corporate and individual levels using the Attention, Relevance, Confidence, Satisfaction (ARCS) educational model (Keller, 2010) and Gardenswartz et al's (2003) cultural model to gain a deeper understanding of key factors influencing breastfeeding education and maternal motivation. A total of 75 hours of observation were completed in eight maternity environments. The data collected included national data profiles, corporate policies, protocols and everyday practices. Ethical approval was obtained from universities in Northern Ireland and northern Thailand. Findings. Published national breastfeeding rates were 49.6% for initiation and 15% for duration at six months. Breastfeeding policies in seven settings were identified and analysed. These were all based on the Baby Friendly Initiative (BFI) guidelines. Organisational culture was evident in the timing, venue and structure of the breastfeeding classes with individual and group breastfeeding classes prenatally and postnatally and specific self-efficacy and postnatal discharge classes. The maternity staff took pride in what they termed 'the Thai way' of breastfeeding and this was indicative of a specific cultural identity. Conclusion. This observation of Thai breastfeeding behaviour has demonstrated strong cultural influences as being inextricably linked to individual and national goals. The systematic process of gathering information about the educational and cultural components of breastfeeding behaviour and practices in a Thai setting using a combination of the ARCS model by Keller (2010) and Gardenswartz et al (2003) provided an enriched understanding of the interplay between the individual and societal factors evident in this unique culture.