title: Cultural feeding practices and child-raising philosophy contribute to iron-deficiency anemia in refugee Hmong children.
abstract: OBJECTIVE
  Iron-deficiency anemia is high in refugee Hmong toddlers attending Special Supplemental Food Program for Women, Infants, and Children (WIC) sites in St. Paul, Minnesota. We investigated social and cultural reasons for feeding practices of Hmong parents that result in excessive milk and inadequate food intake among infants and toddlers contributing to iron-deficiency anemia.
  
  
  METHODS
  In-depth interviews with community members. Focus-group interviews with caregivers. Discussions of results with a professional healthcare group.
  
  
  METHODS
  St. Paul, Minnesota in 1997-1998.
  
  
  METHODS
  Eight Hmong and 7 non-Hmong community members. Thirty-two Hmong parents in focus groups. Thirteen Hmong and 11 non-Hmong healthcare professionals.
  
  
  METHODS
  Qualitative analysis identified themes from community and focus-group interviews. Professional group discussed meaning of results.
  
  
  RESULTS
  To successfully adjust to American lifestyle demands, Hmong refugee families bottle-feed, rather than breast-feed, their infants. In the traditional demand pattern, bottle-feeding can cause infants to be given too much milk at the expense of solid food, and can teach them to prefer milk to food. As these infants become toddlers, caregivers have difficulty weaning them due to a child-raising philosophy of "hlu" that caters to children's desires.
  
  
  CONCLUSIONS
  Hmong caregivers' child-raising philosophy of "hlu" coupled with feeding practices chosen to adjust to American society contribute to the high rate of iron-deficiency anemia in Hmong toddlers.
authors.affiliation: HealthPartners' Institute for Medical Education, Department of Family Practice and Community Health, University of Minnesota, USA. kathiecp@yahoo.com
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Culhane-Pera
authors.forename: Elanah D
authors.initials: ED
authors.lastname: Naftali
authors.forename: Cindy
authors.initials: C
authors.lastname: Jacobson
authors.forename: Zha Blong
authors.initials: ZB
authors.lastname: Xiong
mesh_terms: D000069:Acculturation; D000328:Adult; D018798:Anemia, Iron-Deficiency / Q000208:ethnology*; D001903:Bottle Feeding; D001942:Breast Feeding / Q000208:ethnology; D002668:Child Rearing / Q000208:ethnology*; D003469:Culture; D004435:Eating / Q000941:ethics*; D005260:Female; D017144:Focus Groups; D006801:Humans; D007223:Infant; D007227:Infant Nutritional Physiological Phenomena; D007812:Laos / Q000208:ethnology; D008297:Male; D008910:Minnesota / Q000453:epidemiology