Magic Hands at a Price
Zheng Xinyi was due to give birth to her second child any day, but at what should have been a time of bliss for her, as it was for the rest of her family, she was instead focused on whether she would be able to breastfeed her child, after experiencing difficulties when her first baby was born.
On January 20, 2016, the 26-year-old gave birth to her first child at Xixi Hospital in Hangzhou, Zhejiang Province. Shortly after the delivery, she was in pain from clogged milk ducts, unable to lactate freely.
She learned that breast massage could help women in her condition, but when she asked her doctors for help, she was told the hospital did not provide the service.
Back then a masseuse promoting specialized breast massage service to help new mothers walked around the wards every day. Being anxious, Zheng readily accepted the service.
“I was clutching at straws,” she told Newschina. The masseuse told Zheng she had three years of massage experience and charged her 300 yuan (US$50) per hour.
Despite the pain, Zheng underwent three rounds of massage, and this eventually helped her lactate. But a week later, she was astonished to find there was a lump in her right breast. She asked the masseuse for help but was told it was better to go to hospital to get a diagnosis. Doctors there told Zheng her breasts were seriously infected, and she should stop feeding her child until after she had treatment.
Wang Wenhua has been working for the breast surgery department at a major hospital in Beijing for more than 30 years. After she retired, she opened her own clinic, providing specialized breastfeeding services for new mothers. In recent years, Wang has often had to fix the problems caused when women have been given improper breast massage. “The market is in great chaos,” she told our reporter.
According to Guo Chunming, director of the training center under the Chinese Association of Maternal and Child Health Care, nearly 20 million babies are born in China annually, and it is common for young mothers to encounter problems when breastfeeding their offspring.
“The rising demand has created a huge market. But many new moms find it hard to tell the good service from the bad,” he told Newschina. “When mothers suffer from problems when they breastfeed, massage can solve the problem quickly, but the end result is usually contrary to their anticipation.”
Zhao Peng, a doctor at the breast surgery department of the Maternal and Child Hospital of Lanzhou, in West China's Gansu Province, told Newschina that his hospital has over the years treated a growing number of breastfeeding mothers whose breasts were injured by masseuses. He said a mother who had been diagnosed with breast cancer even sought help from a masseuse rather than going to hospital, and the disease was eventually incurable.
Zhao has been working in the sector for 17 years, and when he started his practice, it was rare for mothers to have breastfeeding problems. Now there are problems that stem from commercial pressure – to use paid-for services – and social factors such as growing work pressure, diet and changes in attitude.
Since the 1970s, many new mothers abandoned breastfeeding in favor of infant formula, which they had been persuaded was healthier for the baby than breast milk. According to a survey by the National Health Commission in 2001 in five Chinese provinces, only 45.3 percent of new mothers exclusively breastfed in the first four months after birth. In Beijing, the figure was only 39 percent.
In 2008, when a tainted infant formula scandal hit China, in which melamine was added to powder, sickening thousands of babies and causing the deaths of six, mothers started becoming increasingly reluctant to give their babies domestic milk powder, returning to breastfeeding as they understood the importance of it for their children's health. Zhao said that many young mothers do not have up-to-date medical knowledge,
including a basic understanding of how to breastfeed.
Wang Wenhua also found that many young mothers learned about breastfeeding from overseas textbooks, but many materials are inappropriate for Chinese mothers because of the difference in body shape. Zhao added that most young Chinese mothers received breastfeeding education from hospitals, postpartum care service providers, or online platforms, but the advice given is either too technical or too simple.
Guo Chunming and his team recently undertook a survey on the ways in which mothers learn about breastfeeding, which found that 90 percent learned from online resources. “But online information is not comprehensive enough,” he said.
New mother Zhang Xiaomeng gave birth three months ago. Shortly afterward, she also suffered from fluid buildup in her milk ducts, and after several masseuses could not help her, she came to a hospital in Beijing. The hospital cured her acute mastitis, but still recommended massage for the blocked ducts. Zheng Xinyi also sought advice from Xixi Hospital in Hangzhou over her clogged and sore breasts, but was told the hospital could not help.
Zhao Peng told our reporter that specialized maternal and child hospitals do pay attention to breastfeeding and offer advice and training services, but some obstetrics and gynecology departments at general hospitals will not usually provide these services. “Doctors tend to have the perception that patients need treatment only when they are ill,” Zhao said.
Wang Wenhua explained that in recent years, there have been more breastfeeding problems because research has failed to keep up. “It's become a problem – neither the obstetrics and gynecology departments, nor pediatrics and surgical wards have paid attention to it, and it's become a social issue,” Wang said. Because of the negligence of hospitals, private massage businesses are thriving, she said.
Newschina recently visited several masseuse training companies in Beijing. Huahaoyueyuan, founded in 2014 in Beijing, identifies itself as one of China's top postpartum care service providers. A staff member told our reporter that around 2008, breastfeeding masseuses began to gain popularity in Beijing. The employee claimed that “around 80 percent of breastfeeding mothers suffer problems, and the demand for masseuses is huge.”
Most masseuse training classes are divided into two parts: theory and practice. Trainees have to study traditional Chinese medicine and the structure of the breasts. The staff member at Huahaoyueyuan said on condition of anonymity that breast masseuses are not real professionals and currently there are no standardized training classes in the industry that stipulate what set of skills a masseuse should learn and how to respond to various situations.
Many training institutions do not have any threshold for education level and age when recruiting trainees. Our reporter found at several training institutions that most trainees are aged over 40 with no medical background or higher education. Trainees learn everything in just 10 days and then receive massage certificates issued by training institu- tions. In Beijing, some experienced masseuses work independently, but most self-employed masseuses have to distribute business cards to expectant mothers in hospitals once they finish their training.
Guo Chunming said that lactation through massage is considered a medical procedure, and it is highly likely to bring harm to new mothers if done by someone who is not a qualified doctor.
A veteran breastfeeding massage trainer at Huahaoyueyuan, who has been working there for 10 years, said more people are learning massage skills amid the growing market, and many institutions that provide massage services cooperate with hospitals which will directly recommend masseuses to new mothers.
“In major Chinese cities like Beijing, patients and young mothers trust doctors most,” she said, adding that training institutions have to pay doctors and hospitals for the introductions.
Zhao Peng does not suggest young mothers hire masseuses to help stimulate milk flow. He added that clogged ducts can be relieved with massage, but the problem could persist if the root cause fails to be solved. He did admit, however, that masseuses in some sense can solve problems. “The profession exists for a good reason,” he said, adding it is urgent to raise the bar of the profession and regulate the market.
There is currently no proper qualification for a breastfeeding masseuse, so anyone can claim to be one. China's Ministry of Human Resources and Social Security once offered courses and certificates, but all programs ended in March 2018 thanks to a government reshuffle, according to a report by the Xinhua News Agency.
Guo Chunming told our reporter that the Chinese Association of Maternal and Child Health Care has been working to regulate the market. Starting in 2014, the association launched training programs on breastfeeding, mainly open to medical staff at hospitals. He said the association has invited newborn nursery specialists, maternity experts and breast doctors to establish internal standards and it is expected to be expanded to the entire industry.
A breastfeeding masseuse helps a new mother to lactate