Zhao Lili massages a new mother. Photo: Courtesy of Zhao Lili

By Chen Xiaoru

There are people getting paid for touching breasts in the city, and there aren't enough of them to meet demand.

Unlike the practitioners of traditional breast massage, which purports to increase the size of a woman's breast, these masseuses specialize in massaging the breasts of new mothers to help them produce more milk for their infants, and relieve the pain new mothers suffer from swollen breasts.

The job has grown increasingly popular as more mothers turn to breast feeding following the tainted milk scandal of 2008, in which dairy producer Sanlu Group was caught adding the chemical melamine to its infant milk powder, leading to the deaths of at least six infants.

If one runs the Chinese words cuirushi or kainaishi (which loosely translate to "massage therapists for increasing the amount of breast milk a mother produces") through an Internet search engine one will receive links to countless sites for postpartum breast care centers, masseuses and training schools.

According to a report released in May 2009 by the Shanghai Municipal Health Bureau and a maternity heathcare center under the bureau, the percentage of mothers who breast-feed in Shanghai jumped from 30 percent in 2005 to 89 percent in 2009, and about 80 percent of new mothers undergo difficulties when breast-feeding babies. The report cited that the milk scandal as driving the sudden growth.

Masseuses in demand

Zhao Lili took the job as a breast masseuse in 2007 at a time when the job was still a new thing in Shanghai. The year was dubbed as the "Year of the Golden Pig" and was widely considered to be the most auspicious year to give birth to babies in six decades according to traditional Chinese culture.

Still, few people had heard about the service. It was not an easy start for Zhao. To deliver her services to the doors of the mothers, Zhao had to travel all around the city, often covering long distances, sometimes even out of the city. "The farthest client that I saw lived in Nanjing. It took me about six hours by train. I spent longer getting there than I did in the woman's home," Zhao said.

But those days are over thanks to the growing popularity of the service. "If a client lives too far, I will tell her to find another therapist," Zhao said.

While talking to the Global Times, Zhao passed on a client over the phone because the woman lived in Anting, Jiading district, in the northern part of the city. Zhao said the distance was too far to go, especially when many of her clients now come to her. "Once a client's husband drove her and her hungry baby from Zhejiang Province just to see me because the woman was feeling pain in her breasts," she said.

As new mothers might need help at anytime, Zhao must work irregular hours. She sometimes leaves home at 5 am and doesn't return until midnight. "I have received calls in the early morning and late at a night. When new moms start to feel pain in their breasts, it can hurt more than when they give birth. They cannot wait," Zhao said.

The amount of time Zhao spends with each client depends. "It usually takes three hours to massage a new mother. And they will be able to feed their baby without another massage. But if the breast duct is seriously clogged, it may take up to seven hours to finish the massage," she said.

Milk powder scandals in recent years have resulted in an increasing number of new mothers opting to breast-feed. Photo: CFP

Certified to touch breasts

To meet the increasing demand, Zhao has hired four fellow therapists. She was proud to point out that two of them graduated from top Chinese universities, though neither majored in a medical discipline. Not all of Zhao's therapists have a medical background.

Although Zhao said that she had worked at a hospital of traditional Chinese medicine (TCM) before becoming a breast massage therapist, she was vague about the exact position she held and did not give the hospital's name. But she said that she learnt the breast massage from two therapists before starting her practice.

"I learned breast massage from a TCM doctor in Shandong Province and from a therapist from Heilongjiang Province. I read medical books by myself. The therapists in my group gather once a week to share our experiences and talk about the different problems we encounter," Zhao said.

Zhao added that she trained her therapists herself. The trainees spend three weeks learning the theories before practicing on each other. "You know, some therapists are actually maternity matrons or care workers in hospitals. They usually know little about breasts," she said.

A mother surnamed Ju, who is nursing an 8-month-old, told the Global Times that she paid 100 yuan ($15) an hour for hospital workers to massage her breasts a few months ago. "I went there three times. Each time was like a nightmare. The massage really hurt and it did not help me produce milk," she said.

Zhao said the prices can vary. Some charge 100 yuan. The highest I know is 1,400 yuan for one massage. The time the massage can last is also different," she added.

Zhao charges each client 300 yuan a session, which typically lasts three hours. Zhao said that her monthly income is higher than most white-collar workers she knows in Shanghai. The high income has drawn more people to the job, resulting in more training centers for postpartum breast care popping up. But not all of them are accredited.

Beiqin, a breast massage therapist training center, advertised online that they provide training courses which ensure trainees of certificates that are recognized nationwide. Its advanced course costs 8,000 yuan and lasts 15 days. No relevant experience is required to apply for the course.

Trainees can follow the therapists to the homes of new mothers and practice on their clients. A cheaper course costs 1,860 yuan for five days of training and does not give students the opportunity for hands on training, the center's receptionist said over the phone.

The Ministry of Human Resources and Social Security has not recognized postpartum breast massage therapist as a category of job and breast massage therapists don't have to register with the authorities. Instead, some hold massage therapist certificates, the newspaper Morning Express reported in March.

A picture featuring a male massage therapist at work has circulated widely on Sina microblog since March 23. The therapist is massaging a woman's breasts which are covered by a towel. Many Internet users admired the job and referred to it as the best job a man can think of.

However, no male therapists were uncovered by the Global Times and insiders say that the job is temporarily unavailable for men.

Zhai Yixuan, a therapist who has been in the industry for years said that she had not heard of any men entering the industry and doubts whether Chinese husbands would agree to allow male masseurs to touch their wives' breasts.

More professional, please

Zhou Min is a senior doctor at Yueyang Hospital, a prestigious TCM hospital in Shanghai, specializing in treating postpartum mastitis, an infection of the breast that commonly infects women breast-feeding for the first time. She said that many patients have come to see her after they received massages from the breast massage therapists.

"I have two patients who came to me after their breasts were injured. Many centers told their clients who has been mistreated to come to me for help," Zhou said she had been dealing with the aftermath of unsuccessful massages for a while and was really worried about the qualifications of some of the breast massage therapists and the training schools in the market.

"Some therapists applied vegetable leaves and flour to breasts. It may temporarily relieve the pain but their skin will be injured," Zhou said.

In her opinion, many so-called training schools for breast massage therapists in Shanghai do not have qualified teachers, let alone the trainees coming from the centers.

Breast massaging can increase the quantity of mothers' milk. But mothers should not be massaged when their breasts are infected. And each massage should be controlled within 30 minutes to avoid hurting the breast tissue. Pregnant women should not receive a breast massage as it has the danger of stimulating uterine contractions and may lead to premature birth, Zhou said.

Zhou said that urban new moms are more likely to have swollen breasts and have difficulty in breast-feeding because of their lifestyle.

"Irregular feeding time and the stress from work can largely reduce milk production. New moms should not eat too much heavy food. The milk a new mom produces in the first two weeks is called colostrum. Usually it is thick and moms should eat light foods to avoid clogged milk ducts. But Chinese families believe that new moms should eat extra heavy food to make sure that their milk is more nutritious after they give birth," she told the Global Times.

Tainted milk incidents in China

September 2008

Sanlu milk powder was found to be contaminated with the chemical melamine. The company recalled milk powder produced before August, but was unable to stop tainted milk powder from entering the market, resulting in the death of six infants and another 290,000 were hospitalized by the end of 2008, according to a Xinhua News Agency report in March 2009.

March 2009

Chenyuan Dairy in Jinhua, Zhejiang Province, was involved in the "leather milk" scandal. Leather milk uses leather and hair as the main source of protein and can result in heavy metal poisoning.

December 2009

The chemical melamine reappeared in dairy products. Shanghai Panda Dairy and several dairy products companies in Shanxi, Shandong, and Liaoning provinces were reported to be involved.

April 2011

Authorities in Gansu Province confirmed that milk produced by two local dairy farms was tainted with nitrite. Three children were killed and 36 hospitalized.