It really frustrates me the number of heart-ache stories that I hear from friends who’ve been totally convinced by the Japanese mass media that their breasts aren’t good enough for their babies. Just as depressing are the number of stories that I’ve heard where mothers in Japan who had previously believed that breast is best, have been convinced by their doctors (after only a few weeks of trying) that they’re not making enough milk and switched to formula or a mix of formula and breast milk. Whereas 90% of Japanese mothers when surveyed before giving birth suggest that they want to raise their child on breast-milk, only 3~40% of them are still exclusively feeding their babies breast milk by their three month check up. That is lower than most countries in Asia, and is extremely low when compared even with developing countries – what makes Japanese mums feel so unhealthy/unqualified that they can’t breastfeed properly? It’s not because they are rushing back to the work force, the vast majority are dedicated (and motivated) stay-at-home mothers. It’s because a combination of dated medical practices and an advertising dollar focused publishing industry has lead Japanese mothers to believe that there is a good chance that their breasts won’t be making enough milk. If you introduce me to another Japanese mum who cries to me that her breasts are 出が悪い (degawarui, don’t make enough milk) then I think I will take to her doctor with a knife! While I profess to have no official medical background, I’m hoping that my views as a novice Daddy-san in Japan will be able to save a few couples from resorting to an unnecessary evil. (This is the second article in this “Daddy-san” series. Make sure to also read part one).
To be very clear, I have absolutely no qualms with mothers using formula for lifestyle reasons: because they want to go back to work, because they want more freedom or because their husband wants to be a stay-at-home Dad, etc. I know many people who were raised exclusively on formula and they have been able to function as normal human beings. I’m angry because there is a significantly large number of mothers out there who want to feed their babies breast milk but are actively discouraged by (a) their pediatrician, (b) mass market literature claiming to offer information on bringing up babies, (c) stealth marketing by infant formula companies and (d) their parents (who grew up in a time where formula was erroneously thought to be better than breast milk.) Let’s be very clear about this. There is absolutely no doubt that breast milk is the best thing that your baby should be drinking. Your baby can and should be fed exclusively with breast milk (that also means no water) for approx. 6 months. Even after you gradually introduce real foods from 5~6 months onwards, your baby is best drinking breast milk at least until 12 months of age if not longer. The list of the benefits of breast milk over formula is very long and growing. My favorite is that despite it being totally free, it also provides higher immunity and hence lower medical expenses for the child’s entire life. You can find a long list of the benefits all over the web and in most English books on child rearing.
The Japanese deception starts the moment your wife begins reading the pregnancy magazines by Benesse and the like. Have you ever wondered why these publishers can afford to publish so many magazines on pregnancy so regularly despite Japanese mothers giving birth to less and less children every year? A healthy advertising budget from the infant formula companies help. Whereas English books often focus on the potential difficulty of breast-feeding and the need for support from the father, Japanese magazines seem to paint the world as if it is totally normal for a mother not to be able to make enough breast milk and that to top-up with formula is the norm. This is called kongo (混合, mixed) and refers to feeding your baby part breast milk and part formula.) Perhaps it works because of the perennial Japanese complex of having small breasts (which is known to be totally irrelevant) or perhaps it is just because first time mothers are lacking in confidence and hence willing to believe what they read in a magazine written by a company that runs English language schools (Benesse owns Berlitz remember!). Someone please explain to me – If the human race has survived for so many thousands of years, why on earth would breast milk not be enough to raise your child? Needless to say, I’m yet to see a Japanese book written by an academic that doesn’t paint the picture accurately. For some reason, it’s the colourful magazines written by editors – not academics – that survive on advertising and sales of other products to their readers, that have become the trusted source of information for Japanese mothers. If you are a new gaijin Daddy, I definitely recommend that you come to your own conclusions about breast feeding after reading a book or two written by an academic. Here are some great ones:
The New Father: A Dad’s Guide to the First Year by Armin Brott or
Baby Love: Everything You Need to Know About Your Baby’s First Year by Robin Barker
Unfortunately, “information” magazines are only the tip of the stealth marketing iceberg when it comes to Japanese formula companies. Most of the professionals that you have trusted (yes, your sanfujinka too) are probably on their pay-rolls. One of the key conditions for becoming a baby friendly hospital (BFH) is not to accept free samples or other forms of financial assistance from infant formula companies. Given that 70% of Japanese public hospitals are loss making, I guess you can’t blame them for seeking out private sector subsidies like this but is it fair to sacrifice the health and well being of our children while doing so? (See our article on BFHs in Japan for where to find one – they’re few and far between).
Take a look at these pictures taken in our nearby hospital (you can click to see a large version of them).
I guarantee you that there is not a single mother (or father, or grand mother or 3rd cousin twice removed) who doesn’t check out the photo of their loving little baby who’s just been born into this world. Better yet, this sign is right near the front entrance so even patients coming for other illnesses are likely to have a peek. What better subliminal messaging could you hope for than a rather unsubtle add from Meiji for their infant formula called hohoemi (ほほえみ) when you first see the face of the newest member of your clan? This hospital is known in our area to be highly respected for its sanfujinka (産婦人科, Ob/Gyn). With a reputation like this, why does it have to stoop to paid advertisements from one of Japan’s major formula manufacturers? Or is this hospital just like many other hospitals in Japan where the male Ob/Gyn’s claim that they can stimulate breast milk production through special Zen breast massages before resorting to formula when they proclaim that it is the mother’s fault as her breasts don’t produce enough milk. Rather than focusing on the joys of breast massaging, we need Japanese doctors to spend more time explaining how difficult breast feeding can be. Let’s face it, it’s not easy and it doesn’t come naturally to the baby or the mother.
Historically mankind have had grandmothers around to teach breastfeeding to the rookie Mums. But because the baby boomer generation decided that formula was “better” than natural breast milk, we can’t necessarily rely on the elder generation anymore. While America was just as guilty of throwing out the breast in the 70s, they’ve also come to the rescue of the younger generation with lactation consultants to take their place. We had a lot of trouble with breast feeding. My baby refused to grow in line with the pediatricians expectations for most of the first month of his life which was very stressful. Ironically, this is not that uncommon. It takes different babies (and mothers) different lengths of times to get into the swing of breast feeding – very few people get it right in the first week or so. We were lucky enough to have the support of two lactation consultants who helped my son and wife latch better. There is a vast shortage of internationally accredited lactation consultants in Japan so if you’re expecting or have just given birth you should book one ASAP (see the link below).
I’ve heard of some very unsettling stories in Japanese hospitals that have even resorted to giving formula to babies within the first few days of their lives. Even perfect breasts do not manufacture milk for 2~3 days after the baby has started suckling. You’re lucky if you get more than a teaspoon of a liquid called colostrum during that time. That is totally natural and your baby can survive for a few days on the fat stores that he built up in the womb. More to the point, the colostrum has vital nutrients to boost your babies immunity that are sacrificed if the Mother gives up breast feeding from day one (reference). While none of this is obvious, it only takes some caring advice from a responsible midwife to calm the first-time mother who is worried that it’s taking “too long” for her milk to come in. Then, except for a very small percentage of women, the amount of breast milk slowly increases as your child suckles on the breast, creating oxytocin. Oxytocin not only stimulates breast milk production but it also speeds up the recovery of the Mother’s body which is why mothers of formula fed babies are less likely to have a smooth and quick physical recovery.
Ironically, when your baby isn’t growing “fast enough” in the first few weeks of his life, your pediatrician is not necessarily the best person to rely on for information. He is there to ensure that your baby meets certain growth targets which are deemed to be “normal.” He’s not a lactation consultant and he hasn’t studied very much about the female body. It’s no surprise that he’s going to be quick to suggest a “boost” of formula to help your baby hit his growth targets. When we were in that situation, our lactation consultant kindly explained to us that we could sakunyuu (搾乳, express) milk from my wife’s breasts and feed it to him via a bottle or syringe (we actually elected for a blunt syringe as we didn’t want to promote nipple confusion). Unfortunately, in the vast majority of cases in Japan, the doctor is more likely to portray a “now or never” need of urgency and bully mothers into adding formula to boost their babies weight. Sure that is the easy option but it is rarely the only option. Less than 2% of the population actually have breasts that cannot produce “enough milk”. Make sure that you’re wife is seeing a lactation consultant from day one so you have the option to express before you’re forced into using formula. While it is a tiring process, expressing gives your baby a few more weeks to learn how to suckle independently. Better yet, you don’t have to worry about your babies weight-gain in the interim. If you are going to try it out, make life easy and go straight for the automatic ‘milking’ machine (for want of a better term). We rented ours from Medela after battling with a manual pump for way too long (you can find your closest rental agent on their homepage). I can’t stress enough, you should be able to supplement your babies milk intake with expressed breast-milk before you have to resort to formula top-ups. You’re wife is only going to have the confidence to do so if she’s been talking to a lactation consultant from day one.
The stealth marketing of the formula companies does not end there. One of my friend’s mother works at the local shopping center. She visits the baby section once a week or so to hold sessions for mothers on baby nutrition. If you’ve ever been to a Jusco or a big shopping center, you’ll know what I mean. In the area where they have the nappy changing tables and the baby scales, they often have a room which is used for these nutrition seminars. Sometimes it is once a week, sometimes once a month but local mothers come to get a free checkup on their baby’s health and to “learn” about how they should be feeding their child. What a great idea, huh? Apparently the advice that my friend’s mother give ranges from how many mls of miruku to feed your child each day and how to prepare solids for slightly older babies. Hold on a second. Did you say miruku? Yes, and that is specifically miruku (ie. formula milk) and not the natural stuff (母乳, bonyu). On further questioning, it turns out that my friend’s mother is not even employed by the local supermarket, she is employed (and trained!) by Otsuka Pharmaceutical Co. (大塚製薬). Yes, the company that makes the biggest selling brand of formula in Japan, Beanstalk (for some reason pronounced beanstark (ビーンスターク) but don’t get me started on that). How stealth is that? I guarantee you that every week, huge numbers of innocent, unsuspecting mothers around the country are being fooled into believing by their local “baby nutritionist” that they should be substituting their own breast milk for formula. Not only are the hospitals and the publishers working against us, but the supermarkets are, too. I guess it makes sense. The supermarkets get a free “entertainment act” that not only attracts shoppers but also promotes shopping, not to mention that this likely boosts formula sales right after the deed. Who can we trust?
So as a new-chum gaijin parent in Japan, what should you do? The simple answer is education. Read up a lot in English yourself and do your best to subtly pass on the more important messages to your Japanese partner. Try to find a lactation consultant and better yet find some decent literature in Japanese written by a medical professional. If you’re wife is struggling with breast feeding or not totally on board with the idea, I personally recommend this book (cover pictured here):
(Bonyuu nohoga raku data? Oppai de rakuraku sukusuku ikuji, “Breast feeding is easier?! Raising your healthy child on the breast with a minimum of effort”)
It’s written by an internationally accredited lactation consultant (Kitano Sumiyo, 北野寿美代) who realized one day after retiring as an official 助産婦 (josampu, midwife) that she’d spent her entire life focusing on babies and how the baby could get more nutrition while ignoring the mother completely. She then decided that there must be an easier way of breast feeding that was enjoyable and rewarding from the Mother’s perspective. That lead her to studying more about international standards of lactation and her ultimately coming up with this book which mixes the best of both Japanese and Western methods.
Finally, let me leave you with a list of the ingredients of Meiji’s Hohoemi formula – yes the one that advertises in my local hospital (See baby pics, with ads above). This is just taken from the back of the pack, I’m not sure if it includes the 30 different additives that the Japanese government approves for including in infant formula. (source: オーガニック食品最前線) or not. While I know that thousands of Japanese babies drink this every day and still grow up to be strong and healthy adults, I ask you – do you really think that this could be better than breast milk? Ironically, hohoemi means smile. I wonder who it is that is smiling.
Hohoemi Milk Formula Ingredients: Lactose (乳糖)、adjusted edible oils (調整食用油脂)、refined soy bean oil (大豆白絞油)、palm kernel oil (パーム核油)、fractionated pig fat (yummo!) oil (豚脂分別油)、refined fish oil (精製魚油)、milk serum protein (乳清たんぱく質)、butter milk(バターミルク)、casein (カゼイン)、fructooligosaccharide (フラクトオリゴ糖)、dextrin (デキストリン)、salt (食塩)、milk phosphatide extract (乳リン脂質抽出物)、yeast (酵母)、iron pyrophosphate (ピロリン酸鉄)、calcium phosphate (リン酸Ca).
If you have any stories about breast feeding in Japan, either happy or sad ones, we’d love it if you could share it with us in the comment section below so that hopefully the broader community of gaijin Dads (and Mums) can benefit.
Here are some more handy links and contacts that might help your breastfeeding challenge:
• La Leche League Japan (English), ラ・レーチェ・リーグ日本 (Japanese)
• Japanese Association of Lactation Consultants (NPO法人日本ラクテーション・コンサルタント協会)
• Japan Breast Feeding Association (日本母乳の会)
• Japanese Midwives’ Association (日本助産師会)
• Unicef: Ten Steps to Successful Breastfeeding (English), ユニセフ:母乳育児成功のための１０カ条 (Japanese)
22 thoughts on “Daddy-san (part 2): Breast is best and don’t let your Japanese OB/GYN tell you otherwise”
Nice article. I never thought to look at the contents of a miruku formula.. Geez! Pig fat! Damn.
My son was changed to miruku at 6 months. I think the wife just wanted to finish with the tit as soon as possible. Hmm… this struck a soft point.
You know, you’re totally right. I can only think of one Japanese mother that I know who wasn’t told that her breasts were ‘degawarui’. Where do the doctors get off creating such a ridiculous problem and then blaming it on the mother. As if the mother doesn’t have enough to worry about already. Mums around the world have been breast feeding for thousands of years, why on earth should that all of a sudden become a problem in the 21st Century. Surely the finger should be pointed at the Sanfujinka Doctors who aren’t teaching the Mums how to breast-feed properly. Is Japan doing anything about the low quality of education for Sanfujinka? Is this a well understood issue?
I know this probably sounds crass but the best lesson you can have in the merits of breast feeding is to smell a dirty diaper of a breast-fed baby and of a milk-fed baby. It really spells it out to you which is the natural one. Babies are designed to drink and digest breast milk. Because there is so little wastage it doesn’t actually smell that bad. Besides the advantage of about 6 months of sweet smelling diapers, you’ve got to wonder about what is really hidden in formula after you smell all of the crap that comes out of your baby… literally!
Sorry for my english, I am not a native speaker.
We had our baby born at the Red Cross Hospital at Hiroo. It is considered as a hospital that promotes breast feeding and constantly encouraging the mother to breast feed rather than using those formulas.
I cant say about the smell of a breast fed baby’s dirty diaper vs a non-breast fed baby’s dirty diaper – But I can certainly say that little Dan looks very genki and fit in compare to some of our friend’s babies that looks like a little Sumo Wrestlers (they are not being breast fed – that I know).
you’ve hit the nail on the head. What is it with those hospitals who insiste on fattening up babies before they go home? every baby will learn to breast feed at its own pace and different babies regain their birth weight at different times. Except in very extreme cases, there is no way that a doctor could honestly advise that a baby is having growth issues and must be fattened up during the short (generally 1 week in Japan) stay after birth. Any web search will tell you not to panic if your baby is only growing slowly at the begining (moshi moshi! half of all babies grow slower than the average!)
Japanese hospitals seem to be obsessed with weight gain targets. It’s enough to drive you stir crazy… Think of the pressure that it puts on the Mum to hit these irrelevant targets.
Who decides the weight that a baby must be when it leaves the hospital? And how do they calculate it?
The other problem is that a lot of these numbers are based on average baby weights but with the huge % of Japanese babies on formula or ‘a mix’ the average baby weight statistics are skewed to the upside. It sounds like you chose a good hopsital OrenM!
It is always interesting reading your stories. As I have mentioned before, I am a few months behind you in the processes so it is very educational.
However, my experience has been very different to yours. I can’t comment on how the overall system compares to Australia as I haven’t had a birth in Australia but I know that there were similar claims of stealth marketing (I admit I have no idea if anything was done to prevent it in future). Even with my wife using the magazines as her main source of information she (and I) were convinced that breast feeding was best. We attended the courses organised by the local kuyakusho as well as going to the sanfujinka. On all occasions we were told that breast feeding was best. During the start of breastfeeding my wife was told that it is often difficult / takes time at first but was given advice and encouragement by the clinic staff. FYI, this clinic is not on the list of places certified for breastfeeding that is linked to in your previous article but a typical, if respected, Japanese clinic.
The staff at the local kuyakusho health advice centre have also been helpful in providing advice on breastfeeding and during the follow up classes there almost all of the mothers have breastfed and I haven’t heard any real complaints of degawarui.
I am also a bit mystified by your comment “I’ve heard of some very unsettling stories in Japanese hospitals that have even resorted to giving formula to babies within the first few days of their lives.” Your tone seems to almost equate this issues such as with murder or female circumcision. I am probably reading your comment incorrectly but I read it as you are horrified that it happens. While babies may be able to live without receiving milk for the first few days as you say this may not be the best for them. As our baby was on the small side, I am grateful for the “boost” they gave during the initial stage until milk production started as I believe it helped prevent weakening of him during this period.
As can be seen from my experience above (and talking to other friends having babies here) it has been very different to what you have written. Also condemning the Japanese system based on marketing practices of the formula companies may not be correct, as I have seen similar claims in other countries. Should those countries systems (including my own) be condemned as well?
in our case, our baby was taken away and given milk on the first night in order to give the mum a rest. it made sense to me at the time because my wife was looking pretty tired. it seemed to be the norm at that hospital. it sounds like majimeaussie went to a similar place. i wonder which is better…
Robin Barker here, author of Baby Love, with a quick comment. Nice work Daddy-San, spot on. The comment I want to make is that over the time I worked at the Bondi Beach Early Childhood Centre in Australia (10 years lactation consultant and 25 years child and family health nurse) I saw many Japanese women – either permament residents or visiting – and they all breastfed very successfully for at least the first six months. This was so much the case that it was something I noticed. As well they all (‘all’ is no exaggeration – I do not recall one Japanese mother using formula as the main milk) had a bountiful supply, their babies thrived. For more on infant formula especially following the baby milk tragedy in China go to http://www.realdirt.com.au – follow the links using my name. The formula manufacturers’ marketing, especially in developing countries such as China and India where there are enormous profits awaiting and in countries like North America, and it would seem Japan, where there are very few government controls is clever and subtle, designed to undermine womens’ confidence and to make formula feeding the ‘norm’. I cannot say it too often – breastfeeding is the normal way to feed babies. If it didn’t work the human race would have perished.
it sounds like the “system” served you well – which is great – but it falls apart with couples like us who didn’t want our baby to have any formula. We have had two children already before coming to Japan. Both were raised entirely on the breast so we know all about the fact that it takes a little while for milk to come through and it isn’t that easy for baby and mother in the first week or two. Because we had seen our first two children grow up to be healthy children we were very keen for our third (born in Japan) to be purely breast. The problem was that out hospital wouldn’t have a word of it. Their rules stated that the mother had to sleep at night in a separate room to the baby and that the baby would be given formula during the night so that the mother could sleep. We protested fiercly and made it very clear (in fluent Japanese) that we wanted to breast feed and that we didn’t want them to give our child any formula at all but didn’t get anywhere. Surely that is taking it too far? I didn’t know about the WHO guidelines until I read this article but you would think a Dr would.
I have sympathy for your situation and believe that you should have been able to bring up your baby how you wanted to (provided it is nothing that will harm the baby – and not using formula would not have). However, I understood the article to be about whether clinics promote breastfeeding or not and in your case it seems they probably still have promoted breastfeeding but not to the total exclusion of formula. To me it seems more like it was the common problem in Japan of “these are the rules / procedures and we will not change them”.
Anyway I hope everything is going well for your third baby.
Part #3 of the series is up:
My take on traveling with a young child.
We traveled half way around the world several times with our newborn son and didn’t have a problem – so don’t let anyone tell you otherwise!
Okay, well here is an interesting spin on the same story for you. As I mentioned in your other article on pregnancy, my wife gave birth to our first child – a beautiful little girl – last week. Our hospital was supposed to be “the place to go” to give birth in the area (we live in north Osaka). Well they clearly didn’t read this article because the first day of little baby’s life is deemed a rest day for the Mum. I understand the concept and yes, I do like the idea of giving the Mum a rest after a hard pregnancy. The problem is that this “rest” includes feeding. In fact all of the Mother’s are told that “breast feeding does not start until day two!” (huh?) The nurses looked after our little girl for the first day (ie. they filled her up with formula without consulting us). They didn’t tell us about the colostrum thing you mention in this article. After reading this article I had a look around the hospital and low and behold they had those ads you were talking about from infant formula companies all over the place. damn. I feel like my daughter has been sold to the devil and she is only 8 days old!
Actually, now I think about it, my wife’s “trusted” doctor was telling her a few weeks before the birth that for XYZ reasons she was quite likely to not be able to produce as much milk as other mothers so shouldn’t be worried if she had to add milk. Man – how does that doctor sleep at night.
thanks for the great articles! I enjoy reading them a lot and totally agree with your well-researched comments. I’m a gaijin mom of a 2-year-old and a strong lactivist 🙂 My personal encounter with the medical advices on breastfeeding and that of many friends around is similar to what you write. “No, your baby doesn’t grow all right, you should supplement.” The second or third day postpartum the nurse in my (very carefully selected to be as natural birth and breastfeeding-friendly as possible) hospital told me, as if she was doing me a favour, that if I go to the hospital shop and write down my name and address they’ll give me a free formula. Sure I went and thanked them for the gift. Guess which? Meiji’s Hohoemi. At that time I was a new and very scared just-born mum and the fact that my baby wasn’t growing well enough was terrifying. Few months later I went with a pregnant friend to a free pregnancy and birth seminar organized in one big department store. There were lectures, mom yoga and all sort of interesting things. And free samples of Hohoemi and baby bottles for everyone.
There is just one important detail I want to add to the picture. This situation is not typical for Japan (unfortunately). It is the case for the majority of countries and US is not exception, neither Europe where I come from.
Actually most of my Japanese friends are breasfeeding and many foreign mums I know are exclusively bottle-feeding. The consept breast is the best is slowly taking stand, but so far it’s more of a grass-root movement rather than officially supported and facilitated policy, in most countries.
I’ve heard the phrase “You don’t have enough milk” in so many languages so often. And yet I just recently heard it again – from a friend back home who just recently had a baby. A doctor, a surgeon. Saying his wife didn’t have enough milk and they’re supplementing with formula. “She’s only producing 30 ml of breastmilk and the baby should be recieving 50ml, so we top up with 20ml of formula. No, I don’t worry, after all there hasn’t been a proven difference in the long-term health status of breastfed and bottle fed infants.” I was speachless. Who has sponsored the study he’s referring to, was the question in my mind. Has he ever opened a WHO site or at least a American Association of Pediatricians? This is only to show you that most medical professionals DO NOT get any training on brestfeeding, which is only reasonable – medicine is a science of human pathologies. Breastfeeding does not fall in this category. So all the information medical professionals recieve on the topic of infant nutrition comes from – you guessed it – formula manufacturers. Worldwide.
So I guess the cultural shock here is not between countries perspectives but between educated and illiterate.
P.S. my favourite books on the topic is Martha and William Sears The Breatfeeding Book and La Leche league’s The womanly art of Breastfeeding, available in Japanese だれでもできる母乳育児.
P.P.S. And an idea for the author – I’m very interested to hear your opinion on the topic of where does the baby sleep. I’m sure you must have had this discussion 🙂 My personal opinion is that we on the west have totally lost it here. I’d never leave my baby sleep alone in a cage in a different room. And what industry have we made out of it! It is dangerous for the baby to sleep with its parents??? And most of the “civilised” world buys on this nonsense!
really interesting! i think it’s such a shame that women are being misled in this way, and i strongly support breastfeeding. i have a kiwi friend who recently gave birth in japan, and surprisingly she was praised highly by the doctors and nurses for adamantly and patiently, not to mention succesfully, breastfeeding her baby. she thought she’d get more pressure to use formula, but she didn’t. everyone just seemed amazed that she was so commited.
another pregnancy issue (that’s coming up with another foreign, pregnant friend of mine in japan) is having the doctor tell you that you’re fat and you shouldn’t gain hardly any weight when you’re pregnant. she’s a very normal size. it’s crazy for a doctor to tell a perfectly healthy woman who already feels insecure about the changes in her body, thanks to a first pregnancy, that she’s fat and shouldn’t eat too much.
Damn Meiji milk and their RakuRaku cubes. Haha. Actually our baby wasn’t breastfed for the first two days after birth either because the hospital was insistant on the meiji milk.
I had a terrible terrible experience when I had my first child in Japan. I wasn’t allowed to see him at all after the birth for that night and all of the next day. Only from day number 2 I got to see my baby (but not in my room) and he was a perfectly healthy baby boy too. But the nurses said that as I didn’t speak much Japanese my MIL had asked them to wait for her to arrive. And my MIL would constantly remark how fat I was during my pregnancy telling me that Japanese women do not get heavier than 60 kg maximum in their final month of pregnancy. Which made no sense to me seeing that she’s barely over 4 feet and I’m 5’8.
Your article is spot-on and such a relief to read.
I am a gaijin new mom (just gave birth 7 weeks ago) and married to a Japanese guy.
My experience at the small maternity hospital I went to in Tokyo was very good, except for the immense pressure I was under to supplement with formula.
I was very sure I wanted to breastfeed exclusively and the midwives supported my decision. But when the nurses took over (from day 2), they kept insisting I should supplement immediately because my son was losing weight. I was pretty surprised they should use that against us because I was well aware that babies will lose some water weight when they are born and should be back to their birth weight about 7-10 days after birth. The midwife who delivered my baby was also aware of this and told me this right at birth. By day 4, my son was a bit over his birth weight.
I refused to supplement with formula and managed to hold them off, but it was not easy and I broke down in tears a few times. They would take my son away for a weigh each time I fed, telling me he was only drinking 18ml, when he should be drinking 30ml etc – so therefore ‘I was not making enough milk’. I felt so alone and constantly worried that I was starving my newborn.
(Note: babies need to drink less breastmilk than formula because it digests better and there is less waste)
It didn’t help that my well-meaning mother-in-law and husband were ignorant about the benefits of breastfeeding exclusively and although they didn’t force me into supplementing, the worry was very apparent – and voiced. The nurses would talk in Japanese to my mother-in-law and husband to let them know that the hospital strongly recommends supplementing, and so MIL and hubby would worry even more and try to talk reason to me.
The hospital made me go back after a week to weigh my son to make sure he was OK, since his crazy mother refused to supplement. Thankfully, his weight gain was in the ‘normal range’.
However, at the one month check-up they said his weight gain was below the ‘normal range’ and told me again that I needed to supplement. With this, I almost succumbed to supplementing but my instinct told me that something wasn’t right. I bought a baby scale with the intention of monitoring his weight myself before jumping into formula. Lo and behold, they had miscalculated his weight and my son was way above the weight they had measured!
I am very glad that I didn’t cave in. I know that formula is not the worst thing that can happen to my baby and that it is not exactly harmful but breast exclusively is definitely better. I also think that the doctors and nurses mean well and aren’t maliciously trying to harm my son but I do wish there was more support for breastfeeding.
I am not ruling out formula for my son forever but if and when I choose to add formula to his diet, I would like to do so on my own terms and with all the facts.
The pressure to supplement was (still is) immense for me and it is taking all my resolve to continue to breastfeed exclusively. The issue is that the pressure is not just put on me, but also on my husband and so he in turn worries and this adds more pressure on me.
Also, breastmilk production works on a supply & demand system in accordance with how much your baby needs. The more the baby drinks, the more the mother produces. By supplementing with formula, you are actually decreasing your supply of milk.
So a note to all new mothers and fathers – Be strong! Try to read as much as you can to stay informed and educated. Make up your own mind based on your research.
It also helped me to talk to other gaijin moms here to get some support. It can be very difficult and emotionally draining not to cave in to pressure when you feel all alone in the battle.
And it shouldn’t be a battle but sometimes it sure feels like it!
I had two children in two different hospitals in Japan and breastfed them both. I read a lot about breastfeeding before I gave birth and thank goodness I did or else I am not sure I would have been successful. With my first child, I was of course a first-time mum and less sure of myself, so I didn`t push for what I wanted during the birth and especially afterwards with the compulsory 24 hour rest period. Being separated from my daughter like that will be something I regret forever more. I did have her with me for a couple of hours during the afternoon (she was born just before 10am), so I breastfed her then, alone, with about three books spread open to the latching pages. The nurses were very discouraging and were stressing me out. At 24 weeks, during my “nipple inspection” I was told my nipples weren`t optimal (they were flat) and that I would likely find it difficult. After the birth I asked to breastfeed immediately but the nurses were desperate to whisk her away to the nursery and they gave me less than 5 mins, just placed her mouth to my breast and did nothing to help. I was weak from the labour (and vomiting) and didn`t have the energy at that point to fight them and I “let” them take her away.
I refused formula and was ridiculed. I told them not to feed her anything, even sugar water. I can only hope they complied with my wishes… At night on day 2 when my baby was screaming, I was told “that`s what happens when you refuse formula!” All I really needed was a bit of encouragement… Instead though, it gave me more determination to grit my teeth and carry on and show them all.
The following day my milk came in. The nurses were amazed (a little annoyed?). They started obsessing about weighing her before and after feeds. They kept suggesting formula. A formula rep came to my room and gave me a personalized spiel on how “great” formula is nowadays and even has immunity like beast milk(!!!). I threw away the samples and refused to fill in their form, suspecting a barrage of advertising would follow…
Unsurprisingly as a result of my self-taught nursing attempt I ended up with severe nipple pain, bruising and even bleeding. I visited three different hospitals for advice and cream. Eventually a private midwife helped me by massaging my breasts and unclogging some of the ducts. My daughter started feeding better after around 8 days and by 3 weeks I could latch her on without stamping my foot from the pain. Things got better and better after that.
With my second daughter I decided to change hospitals. As soon as I hit the second trimester I asked to speak to the head midwife and went through a detailed birth plan, most of which is run of the mill in the UK, but here needed my doctor`s special permission. I know I came across as the awkward foreigner, but I don`t care. I had the birth I wanted and my baby stayed by my side constantly after she was born. I refused to let her go in the nursery. I allowed them to keep her there for her 20 minute hearing test on the second day and I allowed them to give her a bath at some point. She didn`t have a drop of anything other than breast milk. My milk again came in more quickly than they seemed to be used to and they were amazed at how much weight she gained. It`s truly incredible that medical professionals can be so oblivious to something that should be so important to them: the supply and demand nature of the breastfeeding relationship.
I really want to somehow be able to help other woman who are struggling with hospitals like these, which discourage them and help lead them to believe there is something wrong with their ability to produce milk, when in fact it is the advice they are being given which is likely causing the problems. Breast milk isn`t simply best: it is the biological norm.
Wow, this is really surprising and really bad. Evidence-based post-partum care for babies and mothers is now leaning toward rooming in (having mom and baby in the same room immediately following delivery and for the entirety of the hospital stay), immediate skin-to-skin contact (putting baby on mom’s chest/stomach right after delivery), and allowing unlimited nursing right from the start (allowing baby to latch and nurse as soon as it is delivered).
This is the standard of care I recently received in America — and the nurses at the hospital were VERY well-trained along these lines. Not once was my request to not offer formula or sugar water questioned. There was also a lactation consultant on-call who came to the room to help with latch and give advice and support. They knew very well that my daughter would lose a significant amount of weight (less than 10% on average, but that’s still a lot), so they didn’t push for supplementation. I’m floored that Japan is so different — I have always admired the medical system in Japan and received excellent care (not OB-related) when I was there.
All that said, even here in America the common fear of nursing moms is that they are not making enough milk. Many mothers I met in my lactation support group (offered for free by the hospital) were obsessed with whether or not the baby was “getting enough” and would do things like buy baby scales to weigh after each feeding or “top off” with formula “just to make sure”. I think a lot of it stems from, as you mention, the lack of familial support many new moms face, a lack of education, and, let’s face it, the CRAZY behavior of newborns. Seriously, if I hadn’t been well-educated as to the benefits of a “virgin gut” and 100% breastfeeding, I would have DEFINITELY given formula — the way newborns act, it’s so easy to think they are tremendously hungry and unsatisfied on breastmilk alone. In reality, the cluster feeding stimulates milk production (so it’s a good thing they nurse a lot); their tendency to wake up easily when they are breastfed protects them from SIDS (so it’s better than the long stretches of sleep from formula feeding); and the fussing helps you identify issues (like foremilk-hindmilk imbalance or food sensitivities). It’s a shame that you practically have to go through it with a child before you realize that it’s totally normal for babies to act like this. But it’s best to remember what some posters above said: if 100% breastmilk wasn’t enough, the human race would be extinct!
I also recommend the Womanly Art of Breastfeeding, Baby Love, and all of the Dr. Sears books — great books!
First let me take this opportunity to commend you for being a GREAT father and HUSBAND in your family… it takes a lot of support and perseverance to overcome all the lack of Breastfeeding support anyone faces in their country..
That said, I am a Breastfeeding Peer-Counselor in Kuwait.. Advocating for well a “Breastfeeding Revolution” 😉 Through my outreach program I meet and help a lot of women from different backgrounds.. Let me assure you that this BATTLE is being fought everywhere.. USA, UK, CANADA, Europe, Middle East….etc.
What’s worse here, is that even though the Ministry of Health has commissioned a Breastfeeding Promotion Committee, it contradicts this wonderful action, by approving the subsidizing of Formula in Food rations to EVERY Kuwaiti citizen up to 3 years of the baby’s life through the Ministry of Commerce!!!!!!!! >:(
Like Japan, all private hospitals here are sponsored by the evil Formula companies, in addition to every new baby receiving it’s very first drink as Formula the new mom gets a goody diaper bag upon her discharge which has the company’s LOGO in large print, and inside not only FREE samples of their “Golden Liquid” educational brochures on why their formula IS the best and a list of their products!
Again like Japan, very few Pediatricians support Breastfeeding and almost always recommend supplementing to a 1st time mom 🙁 One of the ladies we helped, came bawling to us that her baby’s doctor bullied her by telling her how bad of a mother she was for “starving her baby” or how she allowed her baby to become so “unhealthy” when checked and compared to their 1- formula fed baby’s growth chart, 2- a chart that is based to begin with on the standard USA baby (no offence) but that’s not the norm!!! Each ethnic group has a different growth rate and bone structure ……etc!!!!!!!!! Since it was difficult to erase all the bad accusations/name calling, the “Doctor” had the liberty of calling her we recommended that she cluster feeds her baby and if needed top-off her baby with expressed breast milk for 3-5 days and then go back to the same doctor who then admired the change in the baby’s growth pattern and said with confidence I told you, that IS best for your baby!!! She looked him straight in the face, told him off.. how WRONG he was, she never supplemented with FORMULA she just expressed more.. She told then told him and the hospital director that she was never going to step foot in that hospital as long as he is working there.. HE now no longer does 😉
I am just always stumped why we Breastfeeding advocates always end up finding ourselves “defending” Breastfeeding or constantly trying to “sell” the concept, the benefits…etc when IT should be the other way around!
The GOOD thing though, is that the global trend for “organic” and “Eco-friendly” is having a lot of women/families come around and back to basics.. HUMAN NATURE, Breatfeeding (which we have also noticed in Kuwait)
Thank you for sharing what Breastfeeding is like in Japan.. (this is an old post almost 3 years ago, i’m curious to how much -if any, change has occurred towards Breastfeeding since???)
Unfortunately nothing has changed.
My sister in-law gave birth a little over a month ago. My wife was in town so was thankfully there for the birth but she had to fight with the nurse to allow the mother to hold her child after the birth and the whole concept of colestrum or kangaroo care seemed lost on the nurse. After a verbal battle (in front of the poor, tired mother) they eventually gave up and let the mother hold her baby for a minute or so. Then the mother was whisked off to her private bedroom (no place for baby of course) because she had to rest up. Why? Well if she wanted to start breast feeding tomorrow then she would have to get at least 24 hours of rest first! The nurse calmly explained to her that there was no point trying to breast feed any earlier because she wouldn’t have any milk anyway.
The nurses verbally attacked my wife (asking her if she was a nurse and what credentials she had to question their methods.)
I went to visit the day after the baby was born and when I asked where the baby was the mother calmly told me that “oh, the nurses are just giving her some water” as if that was the most logical thing in the world.
To be fair, there are a handful of BFHs in this country but the gap between those that get it and those that don’t is just so large that you can’t bridge it through discussing your preferred birth plans. Worse yet is that the BFHs are a very, very small minority.
I just gave up this time.