Breastfeeding: A Māori World View October 2018

1. Breastfeeding: A Māori World ViewOctober 2018

2. Māori Leadership “I used to talk to them about breastfeeding their babies. I’d say that God has given women breast to use, to provide her babies with food. If they went on using the bottle, as they were doing for convenience, then when these babies grew up they’d still be looking for a bottle. Only this time it would be a brown one.” ūkaipō Dame Whina Cooper

3. Learning Outcomes • Identify concepts in traditional Māori society that supported successful breastfeeding and ensured its protection • Identify how colonisation impacted on Māori breastfeeding rates. • Identify the significance of the Treaty of Waitangi in the provision of culturally appropriate breastfeeding services. • Identify the role of Baby Friendly Initiatives in protecting, promoting and supporting breastfeeding for Māori whānau.

4. Te Ao Kohatu“The Ancient World” This relates to traditional breastfeeding practices that were part of early Māori communities. The survival of whānau, hapū and iwi was reliant on effective child rearing practices. All Māori babies were sustained on breastmilk. Without sustenance the whakapapa lines would be lost and extinct, like the Huia bird.

5. Traditional Māori Society Protection of WhakapapaTraditional childrearing practices were integral in ensuring the survival of whānau, hapū and iwiWhakawhānaungatangaRelationships - interaction within whānau, hapū and iwi ensured pregnant and breastfeeding women were cared for by the collective. All her needs were taken care. Mana WahineMāori women have particular rights and obligations within each whānau, hapū and iwi, and the exercising of such matters could be described as Mana Wahine.

6. Ūkaipo – the place of nurturing Ūkaipo refers to the nurturing of a person, literally to the place where a person is suckled. The word ūkaipo is supposed to be an abbreviated form of the extended phrase: kai waiū i te po or “suckling milk at mother’s breast”. Te Rōpu Rangahau Hauora Māori o Ngai Tahu (1998). “Our concept of ūkaipo, literally to feed is not just the physical nurturing but also the spiritual and emotional nurturing which serves to eventually make the adult.” Minister Tariana Turia

7. “Ko te whenua te wai-ū mo nga uri whakatipu” • Wai ūLiterally this means milk from the breast. The whakatauki (proverb) compares sustenance from the land to milk from the woman’s breast and demonstrates the importance of women in nurturing the iwi. • Whangai ūBreastfeeding was such a valued practice its benefits were recognised in the social acceptance of wet nursing.

8. Tapu/Noa • Tapu literally means sacred, under restriction. • Tapu enabled the social life of the community to be maintained, it was the basis of law and order and its respect ensured the survival of the community • Noa is the opposite of tapu and literally means free from tapu. It provides a balance to ensure freedom to participate in other aspects of every day living.

9. Traditional Practices • Whangai uWet nursing played an important role in the nurturing of infants. • Waenga – bondingTime at the breast enhanced the bonding process and was an important time to recite whakapapa, karakia and waiata • Kiri ki te kiri Placing pepi Skin to skin • Mirimiri – massageMāori practiced mirimiri an ancient Māori form of massaging the pepi for healing and relaxation that helped with breastfeeding as well • Te Whare KohangaA temporary, purpose built construction for the birthing mother which allowed time away from the collective to establish breastfeeding.

10. Makereti: The Old Time Māori “Her u (breasts) which had received special attention during the months of her pregnancy would have the waiu (milk) flowing easily, and so the child fed from the breast soon after it is born. In the old days the u were mirimiri (massaged), and also the matamata (nipples), and a Māori mother never had the difficulty of the women who had come into contact with civilisation. When a woman became hapū, her breasts were attended from three months after right up to the birth of the child.” Maggie Papakura

11. Te Ao Hurihuri“The Everchanging World” Māori women now have the lowest breastfeeding rates in the country. This explores the impact of colonisation on traditional childrearing practices and looks at other issues that are a barrier to Māori women breastfeeding.

12. This infamous statement was made not long after the signing of the Treaty of Waitangi and indicates the health status of Māori at that time. “A barbarous and coloured race must inevitably die out by mere contact with the civilised white, our business therefore, and all we can do is to smooth the pillow of the dying Māori race...” Dr Isaac Featherston, 1846

13. Colonisation Colonisation of Māori by European law and culture continues to disconnect Māori from their land, language, culture and roots right up to this day. Moana Jackson 2003 • Introduction of tobacco and alcohol • High infant mortality rates • Significant decline in Māori population

14. Alienation Loss of land greatly effected whānau, hapū and iwi not only through the loss of their economic base but led to the fragmentation of Māori society, flow of people to cities to look for work Alienation from land, culture, language, traditional society

15. Assimilation Most aspects of Crown policy were directed at the assimilation of Māori into colonial society • Loss of language • Loss of mana • Loss of traditional practices • Nuclear families

16. Legislation Native Health Act 1909. Matters commonly attributed to this act are adoption/ whāngai and breast feeding by Māori women. There was legislation passed in 1909 preventing whāngai, and in 1908 restricting retaining an infant in care for the purpose of nursing. Adoption of Children by Natives, ss 161-170 of the Native Land Act 1909 puts an end to adoption “in accordance with Native custom” and sets out the conditions under which Native adoptions can occur. These provisions continued in variations of the Native Land Act until repealed by the Adoption Act 1955. Infants Act 1908 has restrictions on retaining an infant in care for the purpose of nursing for more than seven consecutive days unless licensed as a foster-parent These provisions did not extend only to “Native” women.

17. Te Ao Marama“The World of Enlightment” A world where all babies are nurtured at the breast and breastfeeding is reclaimed as a traditional child rearing practice. Lets identify the changes that must be made to ensure all Māori babies are breastfed exclusively in a supportive whānau environment. “Ma te titiro whakamuri, ka kite i te huarahi haere whakamua”You need to look back to see the pathway forward

18. Māori population growth are driven by their high rate of birth and natural increase (births minus deaths). During 2012–14, the total fertility rate was 2.5 births per woman, compared with the overall New Zealand total fertility rate of 2.0 births per woman. Ethnic intermarriage (parents with different ethnicities) also makes an important contribution to Māori population growth – about one-quarter of Māori births (ie where the child is identified as Māori) have a non-Māori mother and a Māori father. Stats NZ http://archive.stats.govt.nz/browse_for_stats/population/estimates_and_projections/projections-overview/nat-Māori-proj.asp

19. The Treaty of Waitangi The New Zealand Breastfeeding Alliance is committed to the principles of the Treaty of Waitangi and will work with the principles through: Partnership, by working with whānau, hapū and iwi to develop appropriate policies and procedures that will improve breastfeeding rates and services in New Zealand Participation, by involving Māori in decision making, planning, development and implementation of the Baby Friendly initiatives. Protection, by working in a manner that will protect and preserve Māori traditional breastfeeding practices

20. Protection The Crown will actively protect things precious to Māori • Breastfeeding is a taonga and protected under the principles of the Treaty of Waitangi • Kuia/Koroua are repositories of knowledge, tikanga and cultural values “Improving breastfeeding rates for Māori by respecting Māori cultural concepts and values”.

21. Participation Whānau, hapū and iwi have the right to organise their own affairs and resources • Māori for Māori services • Culturally effective service provision “Increasing Māori participation in decision making and encouraging active participation in the service.”

22. Partnership • Based on good faith • Working with whānau, hapū and iwi • Māori workforce development • Bi-cultural models Involving iwi and Māori communities in all aspects of service provision to improve outcomes for Māori accessing the service

23. Māori World Realities • Live as part of an extended whānau • Socially challenged • Doing the best they can with the available resources • Searching for identity “The mother who opts not to breastfeed or does not do so as long as she planned is doing the best that she can with the resources at hand”

24. Responding to the Challenges • Perceptions • Access to traditional knowledge • Lack of education • Fragmentation of services • Break down in the family unit “He aroha whaea rere, he potiki ūkaipō”A mother’s love for her offspring, a breastfeeding child

25. Te Kitenga Roa • Encourage and facilitate breastfeeding utilising ancestral knowledge • Workforce development • Reduce perceived barriers to breastfeeding in Māori communities • Reorientation of health services • Promotion and education “E Hoki ki Te ūkaipō”

26. “Whānau Tinorangatira” • Partners, mothers and sisters play an important role in supporting decisions to breastfeed and in overcoming barriers to breastfeed • Infant feeding comes up for discussion around ordinary home life and meetings during one on one conversations • Health promotion and maternity services should not overlook the whānau as a primary source of information and support.

27. Take Care of Our Children

28. Kia u, Kia mau, Kia ita The New Zealand Breastfeeding Alliance is committed to Māori responsiveness by embedding the principles of Te Tiriti ō Waitangi through everything we do including the New Zealand Baby Friendly Documents, audit tools, auditor training, education tools, employment of staff, meeting process and reporting mechanisms. We look forward to sharing results of major research into breastfeeding for Māori; the update of the New Zealand Baby Friendly Documents in alignment with the revised “Ten Steps to Successful Breastfeeding” and the update of the Ministry of Health’s Breastfeeding Strategy. As part of this process, we will review this resource in 2019 and continue to develop other resources to support, protect and promote Māori rights to breastfeed. October 2018 www.babyfriendly.org.nz info@nzba.co.nz

29. References Boast, Richard. Sited on http://www.TeAra.govt.nz/en/te-tango-whenua-Māori-land-alienation Bryder, L. (2001) New Zealand’s Infant Welfare Services and Māori, 1907-60. Health and History. Durie, M. (1998). Whaiora: Māori Health Development. 2nd edition. Oxford University Press, Melbourne, Australia Glover, M. Waldon, J. Manaena-Biddle, H. (2008) Te Whangai UU – Te Reo Aratika Māori Women and Breastfeeding. University of Auckland, Auckland and Massey University, Palmerston North. Māori SIDS. (1994). Infant Care Practices: a Qualitative Study of the Practices of Auckland. Department of Māori and Pacific Health, University of Auckland, Auckland. Ministry of Health. (2002). He Korowai Oranga: Māori Health Strategy. Ministry of Health Wellington Papakura, Maggie. (1986 ). The Old Time Māori. New Zealand Women’s Press, Auckland Pomare, M. (1909). Nga Kohungahunga Me Nga Kai Ma Ratou. Te Aute Society Te Rōpu Rangahau Hauora Māori o Ngai Tahu. (1998). ūkaipō: The Place of Nurturing. Māori Women and Childbirth. University of Otago. Dunedin. Turia, T. (2006). Good Health Starts at the Breast. Māori Party speech at the launch of Wai Uu Wai Oara, Hauora Whanui.