BREASTFEEDING
SIKH WOMEN
NURSING CARE
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Lynam, Gurm & Dhari (1997) states that breastfeeding is "An important traditions that has been eroded in India- prior to immigration- as a result of formula interventions in India (p. 17). There are also a myriad of traditions within the Indo-Canadian culture and Sikh religion which can impact breastfeeding practices among these women. Some barriers that Indo-Canadian women face in relation to breastfeeding include, adaptation to living in a new country, expectations, isolation, traditions, and lack of support (Lynam, Gurm & Dhari, 2000; Lynam et al., 1997).
Adaptation to a New Country
There are various factors related to immigration that can affect women's thoughts about breastfeeding, and the duration in which they breastfeed. Research suggests that "...immigrants tend to adopt cultural practices of the new country, and these newcomers all too often show their adaptation by bottle-feeding" because it is seen to some as a symbol of affluence (Riordan & Gill-Hopple, 2001, p. 216; Lynam et al., 2000). Women who are new immigrants to the country also have an increased probability of bottle-feeding because they have a lack of knowledge in regards to where to gain possible resources, so they require additional support (Lynam et al., 1997).
Expectations
During the postpartum period there are several expectations that Indo-Canadian women face. Within the Indo-Canadian community there can by a differing amount of diversity. Each family has unique and different expectations for family members due to their beliefs and experiences (Lynam et al., 1997). Women in the Sikh religion are recognized for their attributes of "...putting others before self, self-sacrifice, and erasing one's ego" (Choudhry et al., p. 79). A patriarchal belief within the Sikh culture is that women are expected to support and maintain the health and well-being of their families (George & Ramkissoon, 1998). Another expectation is that women will work outside the home shortly after their infants are born. Lynam et al. (1997) states that returning to work early may discourage women from initiating breastfeeding, and start bottle-feeding early. These women believe that bottle-feeding will help establish a pattern for the infant, which makes the caregiver's job easier (Lynam et al., 1997). Modesty is a virtue that is expected from Indo-Canadian women. This modesty can directly impact breastfeeding practices due to the possibility of exposing their breasts while feeding. This modesty can lead Indo-Canadian women into isolation, so that they are able to maintain modesty while continuing to breastfeed.
Isolation
As mentioned above, modesty is a major factor in women choosing to breastfeed behind closed doors (Lynam et al., 2000; Lynam et al., 1997). However, there is one particular tradition within the Indo-Canadian culture, which contributes highly to the isolation experienced by these women. The tradition, which can cause isolation is known as "Sava maheena shelha" when translated it means the "Forty day rest period for new mothers" (Lynam et al., 1997, p. 15). During this forty day period women are encouraged to care for themselves and their infants. One positive attribute of this tradition is that women have the chance to rest and continue breastfeeding. The negative aspects of this rest period include, women being isolated from community services such as drop-ins, which prevents them from gaining knowledge about caring for an infant.
Traditions
There are several traditions held within the Indo-Canadian culture in regards to practices during the postpartum period. One such tradition is maintaining balance between hot and cold foods. When colostrum is expressed it is considered to be "hot" therefore it will cause an imbalance in the newborn (Lynam et al., 2000; Lynam et al, 1997). Due to this fact, women are discouraged from "...breastfeeding prior to the mother's milk coming in" (Lynam et al. 1997, p. 17). Sons being valued more than daughters is another tradition that exists in this culture. This tradition stems from the belief that males are more valuable and pure than women, as mentioned previously. Indo-Canadian women are at greater risk for depression and being abused if they have no sons (Choudhry et al., 2002). Traditionally, within the Indo-Canadian culture, once a child is born many guests come to the house to congratulate the family. This tradition reflects the Sikh religious belief of integrating the extended family in issues that may only directly impact a small number of people (Coward et al., 2000; Lynam et al., 1997).
Support
Indo-Canadian women need support from health care professionals, their spouses, and family and friends to initiate breastfeeding, and increase the duration in which they breastfeed. Spouses and partners are the primary source of support in regards to women's choices to breastfeed (Dennis, 2002). Dennis states that "...regardless of maternal age, education level, ethnicity, and marital status, women who indicated that their partners preferred breastfeeding were significantly more likely to initiate breastfeeding, when compared with women whose partners were ambivalent or preferred bottle-feeding" (p. 18). Although research indicates that spouses and partners are more influential on women's choices to breastfeed, health care professionals, family members and friends still impact women's decisions to initiate and continue breastfeeding practices. Indo-Canadian women state that they do not always agree with the elders in the family, in regards to their views on particular health care practices. These women are faced with a major dilemma, which is to go against the beliefs and values of the family, or suppress their own beliefs about how to care for their new baby. These women need the support from their nuclear families and extended families, so that they are encouraged to make their own decisions (Lynam et al., 2000; Lynam et al., 1997). This literature indicates that spouses and family members need to increase their knowledge about the benefits of breastfeeding (Lynam et al., 1997).
References
Dennis, C. (2000). Breastfeeding initiation and duration: A literature review. Journal of Obstetric, Gynecologic, and Neonatal Nursing, (JOGNN), 31 (1), 12-32.
Choudhry, U.K., Jandhu, S., Mahal, J., Singh, R., Sohi-Pabla, & Mutta, B. (2002). Health promotion and participatory action research with South Asian women (health policy and systems). Journal of Nursing Scholarship, 34 (1), 75-82.
George, U., & Ramkissoon, S. (1998). Race, gender, and class: Interlocking oppressions in the lives of South Asian women in Canada. Afflia Journal of Women and Social Work, 13 (1), 102-120.
Lynam, J., Gurm, B., & Dhari, R. (2000, April). Exploring perinatal health in Indo-Canadian women. The Canadian Nurse, 18-24.
Lynam, J., Gurm, B., & Dhari, R. (1997). Indo-Canadian women's health in the perinatal period: Women's perspectives. A focus on traditional and contexts of learning. A research project for the Indo-Canadian Women's Organization of British Columbia, Unpublished.
Created By Selena Sumal - Kwantlen University College Nursing Student 2003
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