" (Canadian Minister of Health, 1997) it is related that imported formula is not affordable or not readily available therefore, breastfeeding is "simply the norm." (Canadian Minister of Health, 1997) This work relates that when no supplement formula is available that breast milk "is commonly supplemented with prechewed rice paste or rice and sugar porridge." (Canadian Minister of Health, 1997) at six months of age the child's diet begins to include "a thin gruel of boiled rice flour (bot) followed by porridges." (Canadian Minister of Health, 1997) it is related that infants in urban areas of Vietnam nd Cambodia "are more likely to be formula-fed." (Canadian Minister of Health, 1997) The work of Serdula, Cairns, Williamson and Brown (1991) states that 93% of children from Southeast Asia were breastfed "in their country of origin" while of those born in the U.S. only 10% were breastfed with a similar trend reported among Hmong refugees. Among Hmong women living in Thailand refugee camps it is reported that 88% had plans to breastfeed their infants until the next child was born however, "following immigration breastfeeding initiation rates appeared to fall off sharply." (Serdula, Cairns, Williamson and Brown, 1991) it is related that this patterns "appears to reflect the Canadian experiences as well." (Serdula, Cairns, Williamson and Brown, 1991) it is related that the reason primarily stated for switching the infant from breast milk to formula is generally "the perception of insufficient milk supply." (Serdula, Cairns, Williamson and Brown, 1991) it is embarrassing for Vietnamese women to breastfeed in public and furthermore, it is stated by Leininger (1987) to be "potentially dangerous, particularly in the workplace" and additionally breastfeeding is generally stopped when the mother returns to school or work. Many times, the mother will employ a wet-nurse to continue breastfeeding the infant if they are able to afford it. The view of Indochinese women is quite different from that of women in the United States in that Indochinese women "feel that breastfeeding may make them too skinny and drain their energy" while women in the United States are glad that weight loss accompanies breastfeeding." (Serdula, Cairns, Williamson and Brown, 1991)

Sri Lankan Tamil Culture

It is reported that in Sri Lanka, the norm is breastfeeding of infants however, most recently formula and cow's milk has been used by women who must return to work quickly and those who are not able to breastfeed. For women who do not work outside the home breastfeeding takes place for longer period than for those employed. Tamil women in Canada do still breastfeed and switch to formula at the time the infant is four months old or sooner if they must return to work. The Tamil culture requires the mother and the new baby to remain confined to home for the first thirty days following childbirth. The mother limits water intake and is allowed to consume no fruits, vegetables or juices however after the first five days, the mother is allowed fresh fish and chicken followed by certain vegetables. The chosen foods are believed by the Tamil culture to increase and improve breast milk as well as the strength of the mother.

Chinese and Taiwan Culture Examined

Infants in rural areas of mainland China and Taiwan are "typically breastfed since formula is not readily available and very expensive." (Canadian Minister of Health, 1997) in more urban areas such as Hong Kong the predominant method of feeding infants is formula feeding. China stated indications that most of caregivers believe that breastfeeding infants is best practice and in fact 73% of caregivers agree. It is related that thirty-two percent of infants are breastfed still by four months postpartum and approximately two-thirds of infants were not breastfed until 24 hours following their birth. It is stated that women from Hong Kong generally have more education of a formal nature and are usually from a higher socioeconomic level and generally more in the know about the benefits associated with breastfeeding "...and are more likely to initiate and continue breastfeeding in Canada." Women from China and Taiwan are found to be "more likely to discontinue within the first two to four weeks" and these findings are "supported by data from two recent studies examining breastfeeding rates among Chinese and Vietnamese families in the City of Toronto. (Canadian Minister of Health, 1997) This work states "In 1993, breastfeeding initiation rates for Hong Kong immigrants were 86% compared to 47% for mothers from mainland China. These rates...

A variety of reasons has been postulated for the low breastfeeding rates among immigrant women from mainland China. Research by Chan-Yip and Kramer (1983) indicated a number of reasons for low rates among Chinese women in Montreal: the women have been told that formula is superior to breast milk; some women are embarrassed to breastfeed in front of others, particularly in crowded living quarters; formula-feeding is more convenient, especially when returning to work; and there exists the perception that breastfeeding is viewed as "old-fashioned." (Canadian Minister of Health, 1997) Focus group findings which involved recent immigrant women from Hong Kong state indications that "all of the women had bottle-fed or planned to bottle-feed their children, notwithstanding the fact that they had all been breastfed themselves." (Canadian Minister of Health, 1997) Reasons stated by the participants included:
1) Greater convenience;

2) Avoidance of embarrassment;

3) More free time;

4) Plans to return to work; and 5) the perception of formula as being modern, more stable and nutritious than their own milk were reasons put forth by the participants for bottle-feeding vs. breastfeeding. The benefits were not clear to the participants in the study. (Canadian Minister of Health, 1997)

Japanese Culture

Japanese culture highly values children and is viewed as the woman having becoming complete. The role of women in the Japanese culture is one in which traditionally involves rearing children and as well nurturing them. It is stated that "within this context, breastfeeding is viewed as very positive and very necessary for the health of children. As such, it is promoted in all segments of society." (Canadian Minister of Health, 1997) the norm in Japan was traditionally prolonged breastfeeding and still today children are often breastfed for long period. The kindergarten application in Japan actually asks the question of "how long was the child breastfed and if the child has been weaned. The work of Riordan notes that more than fifty percent of Japanese mothers are breastfeeding at three months postpartum and that this rate is known to drop to only one-third at six months postpartum." (Canadian Minister of Health, 1997) the work of Chan-Yip and Kramer (1983) states findings that the Chinese women participating in their studies were not aware of support services regarding breastfeeding and as well were unaware of where they could receive "assistance with lactation." (Canadian Minister of Health, 1997) the Canadian Minister of Health states: "Further research is needed regarding infant feeding patterns, both pre- and post-immigration, and on cultural beliefs and practices related to infant feeding in Canada. Research is needed to determine the best ways to support lactation and promote breastfeeding among all cultures." (1997)

The work of Health Canada entitled: "Immigration and Health" states that "Infant care behaviors, such as breastfeeding have a demonstrated relationships to health status." (Health Canada, 2006) it is related that in 1997, Edwards and Boivin made a comparison of the differences "in infant care behaviors between recent immigrants (less than 3 years in Canada) and less recent immigrants (more than 3 years in Canada) using data from participants recruited from five regional hospitals in the Ottawa-Carleton region. Although there were no significant differences in infant care behaviors between the two groups there were differences in maternal variables associated with these behaviors." (Health Canada, 2006) the hypothesis in this reported research is that "the lack of prior experience among primiparas may contribute to diminished self-efficacy, lack of knowledge about health-promoting infant care practices and lack of family support for behaviors such as prolonged breastfeeding." (Health Canada, 2006)

The study states findings that: "data from the NPHS and NLSCY suggested that mothers who identified themselves as immigrants and mothers who spoke a language other than English and/or French were more likely to breastfeed compared to their non-immigrant, English/French-speaking counterparts. Another Ottawa-based study confirmed that women who spoke other languages were more likely to breastfeed than English-speaking mothers. However, since breastfeeding rates in Canada could not be compared with breastfeeding rates in the countries of origin, no…