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Oromo Immigrants and Breast Feeding Information for American Health Care Providers

Author(s): Catherine Staunton, MD; Almaz Duressa, Oromo interpreter at HMC
Contributor(s): Jemila Abdi; Fetema Mohammed; Teshame Bayu; Mama Argo

In many ways, breastfeeding is a universal practice, yet there are cultural aspects that vary considerably. Here is a summary of what several Oromo women and men living in Seattle said about breastfeeding in their culture.

In East Africa, practically all infants are breastfed. Breast feeding is initiated in the second or third day of life when the mother's milk comes in. Prior to this, the infant is given fresh butter which "cleanses the gut; newborns are full of dark stool (i.e. meconium) and butter clears this out." Unpasteurized cow milk is often given as well, and is frequently continued past the first few days as a supplement to human milk. Formula is extremely rare for it can only be obtained in large cities and is prohibitively expensive.

The initial breast production of "yellow water" (i.e. colostrum) is viewed as nutritionally useless, "just like water". It is sometimes expressed and discarded, not fed to the infant. In general, Oromo people see water as void of nutrition and do not drink it. They seriously doubt the value of clear fluid diets for infants with gastroenteritis, which the American doctors advise.

Mothers feed infants on demand, rarely going far from the infant and sleeping with them at night. Breast feeding is acceptable in all social situations, even a busy marketplace. However, breastfeeding women often keep their breasts covered when not feeding, fearing the lactating breasts are very susceptible to airborn illness.

Sometimes women breast feed infants who are not their own. This is particularly true when both mother and daughter have infants and are lactating. It is usually done for convenience, for example when one of the women is away from the village on an errand. Occasionally in situations of maternal illness, death, or failed milk supply, a relative or other village women assume breastfeeding responsibility. However, such infants are frequently just sustained on cow's milk.

It is rare for women to be unable to breast feed. Practically all mothers breast feed. It is almost unheard of for there to be significant breastfeeding problems except in the case of very ill mothers.

Infants are breastfed until two or three years of age. Prolonged breast feeding is seen as nutritionally beneficial and recognized as a form of birth control. Solid foods are offered at a young age (around 2 months). If the infant shows interest, small amounts of soft food are continued. If not, solid foods will again intermittently be introduced until the infant appears ready.

Despite this strong breastfeeding background, many, probably the majority, of Oromo women opt to formula-feed once they take up residence in the U.S. Following are frequently cited reasons for formula-feeding:

  • Probably the most heartfelt reason for formula-feeding is an attempt to assimilate. New immigrants observe the majority of American women formula feeding their babies; they don't want to stand out as different. They formula feed in public yet often breast feed at home, especially at night.
  • It is more convenient, especially in public, since there are strong taboos against bare breasts. Also, many social situations (especially work and school) require mothers to be separated from their infants.
  • Infants get used to bottle feeding and then refuse the breast.
  • Formula-fed infants gain weight more readily and mothers see larger as healthier.
  • WIC provides formula for free. If they had to buy formula, women would breast feed more, but formula is readily available.

As one Oromo woman said, "The Oromo community needs education. They don't realize that breastfeeding is socially acceptable and healthier for their infants. They don't know how to juggle the demands of western lifestyle with breastfeeding. With more knowledge, they would choose to breast feed their infants."