Breastfeeding in Taiwan

Breastfeeding in Taiwan is on the rise.  According to a Department of Health announcement reported in the Taipei Times today, the rate of breastfeeding in Taiwan rose dramatically from 5.4 percent in 1989 to 61.8 percent in 2010.

The Department of Health attributed the higher breastfeeding rate to affirmative government policies — especially the establishment of breastfeeding rooms in public places.  Taiwan has put in place comfortable breast-feeding rooms at 17 MRT (subway) stations (with average usage of 691 visits a month), at highway rest stops and in other public places such as department stores.  Even Costco has a breastfeeding room.  This is in response to legislation passed in November 2010 that makes it illegal to prevent anyone breastfeeding in public, and which also compels the establishment of breastfeeding rooms in public places.

Having dedicated places to breastfeed is a positive development, but I wonder if this alone has led to such a large increase in breast-feeding rates.  A more likely source is the outcry over the melamine milk scandal that affected Chinese babies in 2008.  While Taiwan was not affected by infant formula to the same degree as mainland China, contaminated milk also infiltrated across the Taiwan Straits.  Global milk prices were high, and some food outlets had imported cheaper Chinese milk powder to make a range of Taiwanese delicacies from pearl milk tea to street=stall food such as custard or red-bean flavoured wagon-wheel popovers.

The whole melamine milk scandal left a sour taste in Taiwanese consumers mouths, so to speak.  Consumer power was always strong, but since then consumer groups began to demand higher-quality standards for both domestically produced and imported food.  This had an impact on everything from US beef imports containing ractapomine to lower-than international standard minimum residue levels for grain imports including wheat.  Imported food substances containing any contraventions were derided by the press as ‘unsafe’, while the organic foods are becoming more popular with health food chains such as  ‘Cotton Land’ branching out all over Taiwan.

And Taiwanese mothers are becoming more influenced by Western notions of parenting.  There is now more awareness of the health benefits of breast milk, and how it can help facilitate a baby’s healthy development.  This is quite different from say forty years ago, when women chose not to breastfeed because they were worried about sagging breasts.  (According to my doula, Penny Lin, this remains a consideration for some image conscious women.)

But still there are challenges to maintaining breastfeeding amongst Taiwanese mothers beyond the first confinement month. The report notes that breastfeeding rates decline significantly as babies get older, dropping to 50.9 percent at two months, 39.7 percent at four months and only 24.2 percent at six months.  According to lactation specialist Dr Cynthia Mao from Pojen General Hospital, most Taiwanese women begin with the intention to breastfeed but are discouraged when they encounter problems.

One of the key factors in the high-drop off rate is the fact that most mother’s return to work 56 days after commencing maternity leave.  With high property prices and increasing living costs in Taiwan (especially Taiwan), most families require two incomes to maintain their lifestyles.  I have met many mothers who resolutely pump milk at work to continue to feed their babies, but for some the pressure of juggling work and breastfeeding soon becomes too much. 

While postpartum confinement (坐月子, zuo yuezi) is designed to encourage lactation, some women emerge from their 30 to 45 days of seclusion finding they have little milk left to feed baby.  The problem is not the special foods that the women consume during their confinement, but rather a lack of close and constant contact with baby.  The focus in many confinement centers is on ensuring the mother relaxes and recovers from childbirth, and she does not always spend much time feeding and bonding with her child — especially during the evening, as prolactin (which helps produce breastmilk) is highest at night milk mothers are sleeping.  According to doula Angela Chang, many carers in confinement centers (or well-meaning family members) offer to look after baby to allow new mums to get sleep, but this actually prevents the mothers from producing enough milk.

Additionally, the influence of infant formula companies is still pervasive.  Most birthing classes are run by pharmaceutical or infant formula companies, so parents receive biased advice from the outset.  Television and other commercials sprout the line that their product will help increase intelligence and make babies strong; I have noticed that there do not seem to be the same restrictions on formula advertisements that are in place in Australia and other countries.  And recently, I heard from a well-placed source that hospital staff can receive up to NT$2,000 (around US$60) for each baby that samples formula while in hospital.  One Taipei hospital had their government subsidy reduced after it was found that they had developed an overly close relationship with formula companies.

For me, I had so many breastfeeding problems with my first, premature baby that it gives me strength to persevere with the comparatively minor problems I am experiencing with my second, fussy baby.  And while I do not want my child raised on formula, I am thankful that some was made available to him in hospital before my milk came in.  Taiwanxifu Baby was dehydrated, lost weight and developed jaundice.  So a bit of formula in his case, before I could produce enough to pump for him, was a blessing.  Everything in moderation and in its place.

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About taiwanxifu

‘Taiwanxifu’ (pronounced ‘shee foo’) means ‘Taiwan daughter-in-law’ in Chinese and has been my nickname ever since I married my Taiwanese husband, Sam. I love sampling Taiwanese food, even local specialties such as stinky tofu, pigs blood cake and Taipei beef noodle soup with offal. But there are many other options on the menu. Promise!
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11 Responses to Breastfeeding in Taiwan

  1. Angela Chang says:

    Hi Serina,

    I’m glad to see that breastfeeding is going well for you and that you have all settled in well together. It’s great to see Taiwan’s breastfeeding rates keep rising and I believe this is truly a wonderful country to be a breastfeeding mom in, there is suck a lack of negativity.

    Not to be fussy, but you mention the higher levels of oxytocin in the evening. Oxytocin is actually the loving, mothering, bonding hormone that is released while nursing but it is prolactin that helps produce breastmilk. Prolactin levels are highest is the night, while mom is sleeping. This is why it is so very important for moms to feed during the night every few hours to ensure their supply is good. I hope more postpartum centers, nurses and mother in laws encourage their daughters to feed around the clock instead of “helping” them by taking the baby at night and letting mom sleep through.

    Angie Chang

  2. taiwanxifu says:

    Dear Angie, thanks for pointing out my mistake. I will correct at once. And yes, b/feeding is mostly going well. Baby is fussy (big, hungry baby) but at least I have enough milk for him this time around.

  3. Pingback: Zuo yuezi: which rules I broke and why | Taiwanxifu 台灣媳婦

  4. Berta says:

    I took the prenatal classes through the birth center in Xinzhuang. Even though the lao ban niang (and instructor) is an IBCLC and the birth center itself is meets the Baby Friendly standard, I noticed my personal information was somehow obtained by a formula company, who insisted on making at least a couple of invasive and pushy phone calls to me.

    I do think that the bigger push and more outward support for breastfeeding through the government-issued maternal handbooks as well as local mother-to-mother support organizations are a big help, but I’ve been frustrated to see poor birth practices (encouragement of c-sections) and other “booby traps” stymie the intentions of some of my local friends. There’s also this attitude amongst some of my more well-educated, affluent friends (also common in the U.S., I think) of needing to know exactly how much baby is taking in, so mom’s will start to pump first (when it’s so much easier to build and maintain supply with direct feeds), sometimes pump themselves into exhaustion, and then resort to formula – instead of just trusting that if baby is gaining weight and soiling enough diapers a day, s/he is just fine.

    • taiwanxifu says:

      Thanks for sharing your experiences. I didn’t take any prenatal classes here in Taipei with this baby, but I did notice that a lot of them were run/sponsored by companies selling baby products. So I assumed they would be biased. But passing on information, deliberately or not, to formula companies is really bad.

      I so agree with your comment about people worrying about how much baby is taking in. This has been a frequent subject of debate between Mr Taiwanxifu and myself. He constantly worried about weight gain with our first son, and I think it is only because baby number two is as fat as a mini Milefo Buddha that he doesn’t worry quite as much. But my confinement nanny (in a well-intentioned way) was constantly wanting to know how much I was pumping and tried to guestimate how much the baby was eating. Because expressing and the baby sucking are so different (the baby extracts more with the latter more efficiently) you never really know so I prefer not to even try to guess … otherwise you can get stressed and start worry about not producing enough.

  5. Lizzie says:

    Any idea where I could find the Taiwan regulations regarding pumping breastmilk at work (ie – how much time the labor laws permit a working mother to pump each day?)

    • taiwanxifu says:

      Perhaps the Council for Labor Affairs? Most Taiwan companies seem to be aware of this issue and should have a breastfeeding room. I am finding, though, that not all rooms have a power point. My postpartum doula/nanny said some companies even supply pumps for working mothers.

  6. khng says:

    hi all, do you know where my wife can donate her breastmilk in Taipei??

    • taiwanxifu says:

      Hi, try the Taipei City Hospital which currently has the only milk bank in Taipei. http://taiwanxifu.com/2012/10/05/taipeis-human-milk-bank/ I really wanted to donate, but in the end I did not make the grade. Their hygiene standards are extremely strict. Having had a premature baby before, I thought I had good hygiene with pumping and storing but they are really strict. Good luck and I hope your wife’s good intentions are well rewarded. Please drop me a comment to let me know how it goes.

      • khng says:

        hi, thanks for the reply, but what is the standards requirement? Actually we are going for holiday in Taipei, without our kids, but my wife wish to continue EBM during the trip. We dont want to waste the BM. But I think we have limited time to go hospital and register as donor… Is there anyone out there who wish to have BM for their baby? We will be in Taipei in Apr 2014! email me at kokhon.ng@gmail.com.
        Thanks!

      • khng says:

        hi, thanks for the reply, but what is the standards requirement? Actually we are going for holiday in Taipei, without our kids, but my wife wish to continue EBM during the trip. We dont want to waste the BM. But I think we have limited time to go hospital and register as donor… Is there anyone out there who wish to have BM for their baby? We will be in Taipei in Apr 2014! email me at kokhon.ng@gmail.com.
        Thanks!

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