WI dietitian hopes educational videos will encourage more Hmong women to breastfeed

When Maomoua Vue was growing up in Laos, breastfeeding was the norm. Women could be seen breastfeeding everywhere and anywhere, she said, and often children would be breastfed into childhood.

But when she immigrated to the United States after the Vietnam War, Vue found breastfeeding was not as publicly visible in her new country. Instead, she said, she and other Hmong women heard of more women choosing formula to feed their infants.

“So most Hmong women assumed that to be independent, to be like American women, to have healthy kids, to have strong kids,” Vue said, “it had to be formula-fed.”

Breastfeeding is the gold standard for nutritional value for infants, according to the American Academy of Pediatrics, but breastfeeding rates in the United States are lower than in other developed countries, with many moms choosing formula, which is seen as a good but less nutritious alternative.

Studies show that a lack of support from employers and communities contributes to parents turning away from breastfeeding, which especially affects nonwhite mothers, creating a racial disparity regarding which moms breastfeed.

While the Wisconsin Department of Health Services doesn’t break down statistics on breastfeeding among the state’s large Hmong population specifically, its data shows that in 2022, about 5% of Asian women and 10% of white women receiving nutritional assistance and education from the Women, Infants and Children program were breastfeeding.

Vue, a registered dietitian nutritionist for the WIC program with the La Crosse County Health Department, is trying to change this trend by making educational videos on breastfeeding in the Hmong language. She hopes the videos will encourage more Hmong women to breastfeed, while also having a greater cultural impact on future Hmong generations.

The idea sparked after Vue helped develop and implement the state’s first bilingual breastfeeding peer counselor training program for Hmong and Hispanic WIC employees, when she realized more needed to be done.

“We have so many mothers out there that could use breastfeeding support,” she said.

Having more culturally appropriate health care information and education in the language spoken by members of a community can make a big difference, Vue said, because it helps them trust in the information more.

“For any culture, if the information comes from a person of that culture, I think it will have more impact,” she said. “We could say the same thing, but in a culture, it will have a bigger impact if it comes from a person of that culture.”

So far Vue has created three videos, which were produced with the help of Gundersen Health Systems. One of the videos helps mothers prepare to breastfeed, promoting available resources such as peer counselors, lactation consultants and classes, and lists questions they can ask their doctor. The second video highlights the benefits of breastfeeding for both the baby and the mother, and the benefits of long-term breastfeeding in particular.

In the third video, Vue details how to navigate breastfeeding when returning to work. Vue said that a lot of Hmong women in the La Crosse community work on assembly lines and struggle to find time to pump breast milk when they return to work, which often forces them to give up breastfeeding.

Vue gives information on operating a breast pump in the video and highlights laws and policies that protect a woman’s right to pump while at work. In Wisconsin, a 2009 law protects a mother’s right to breastfeed in public, but there are no state laws about pumping while at work. Workers in the state are protected by the federal PUMP for Nursing Mothers Act, signed into law in 2022 by President Joe Biden, which mandates that employees have a right to breaks and a private space to pump while at work.

Creating these educational videos in the Hmong language is also important because in the Hmong culture, raising children is a multigenerational effort, Vue said. Often, grandparents who speak Hmong take care of the children when the parents go back to work, and the whole family is involved in caring for the child, including in sticking to plans to breastfeed.

In her own family, Vue has helped support her daughter-in-law, who breastfed all three of her children. “It’s hard work. It takes a whole family. My husband and I and my son, all of us, we have to work together to help my daughter-in-law so she can be successful,” Vue said.

There are very few Hmong dietitians in the United States, according to Viterbo University, where Vue received her degree. It’s becoming harder and harder to find health care professionals with an understanding of the Hmong culture, Vue said, because younger generations of Hmong residents were born in the United States and may not be fully immersed in the culture. She worries that that cultural competency will be lost as older generations age out of the workforce and health care industry, but she hopes the videos can be a way of preserving it.

She also hopes that showing herself in her role might encourage more Hmong women to see themselves in different career paths.

“I hope that with those videos out there, that it will prompt other Hmong young girls to think about, Oh, what is she doing? She is a registered dietitian, she is a breastfeeding educator, let’s look into what kind of field, what kind of career that is. And I hope that it will promote them to think about the dietetics program, to think about becoming breastfeeding educators and to help mothers,” Vue said.

Correction 3/29: Updated to reflect that the bilingual breastfeeding peer counselor training program was the first in the state, not just the first in the county.