Thai cultural influences on breastfeeding behaviour

Background. Breastfeeding is recognised as a complex behaviour which is influenced by many factors. This creates challengesfor all breastfeeding mothers and health professionals seeking to support women in their breastfeeding journey. Personal,psychosocial, cultural and economic factors create a complicated interplay which affects breastfeeding practices. Maternalmotivation is acknowledged as a determinant of breastfeeding behaviour; however, it is important to recognise that motivationis influenced by the culture and environment in which women live. Understanding how culture influences behaviour offersresearchers insight into breastfeeding practices.Objectives. The aim of this study was to identify the contextual and cultural influences that are communicated throughbreastfeeding instruction within a Thai setting.Methods. Observational data were collected at national, corporate and individual levels using the ARCS educational model (Keller,2008) and Gardenswartzet al’s (2003) cultural model to gain a deeper understanding of key factors influencing breastfeedingeducation and maternal motivation. A total of 75 hours of observation were completed in eight maternity environments. Thedata collected included national data profiles, corporate policies, protocols and everyday practices. Ethical approval was obtainedfrom universities in Northern Ireland and Northern Thailand.Findings. Published national breastfeeding rates were 49.6% for initiation and 15% for duration at six months. Breastfeedingpolicies 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 groupbreastfeeding classes prenatally and postnatally and specific self-efficacy and postnatal discharge classes. The maternity staff tookpride 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 inextricablylinked to individual and national goals. The systematic process of gathering information about the educational and culturalcomponents of breastfeeding behaviour and practices in a Thai setting using a combination of the ARCS model by Keller (2008)and Gardenswartz et al (2003) provided an enriched understanding of the interplay between the individual and societal factorsevident in this unique culture.