Presentation Transcript

1. The Feminist Politics of Infant Feeding

   Transformations: Gender, Reproduction and Contemporary Society Week 10 Caroline Wright
2. Structure of Lecture Infant Feeding in Headlines Brief History of Infant Feeding Problematizing Choice ‘Breast is Best’ Discourse Some Statistics Breastfeeding Advocacy Women’s Experiences of Breast- and Formula-Feeding Conclusions
3. Infant Feeding Hits the Headlines ‘Researchers to Offer Shopping Vouchers to Mothers Who Breastfeed’ (Guardian, 12 Nov 2013) ‘Breastfeeding Benefits Babies’ Brains’, (Brown University, 6 June 2013) ‘China Executes Two Over Tainted Milk Powder Scandal’ (BBC, 24 Nov 2009) Facebook’s image censorship guidelines: moderators ban images of breastfeeding if nipples exposed (Guardian, 23 October 2013)
4. Brief History: Breast Feeding Israel 2000BC: breastfeeding religious obligation; Ancient Egypt, Greece and Roman Empire women breastfed own children Qur’an recommends breastfeeding to 30 months Breasts develop in females at puberty as milk glands grow and swell Developing placenta stimulates hormonal release and milk ducts increase Alveoli, clusters of grapelike sacs, take nutrients from blood to make breast milk Expulsion of placenta precipitates lactation Colostrum first: high protein, low fat, antibody rich Flow of milk: baby sucking (or crying) stimulates hormonal ‘let down’ reflux Wet-nursing starts among royalty Moche Figure: Peru, 100-800 AD
5. Brief History: Wet Nursing Wet nurse breastfeeds another woman’s baby Practised from 2000BC to 20th century Used when lactation failed or birth mother died (need) Royal women 950 BC were first to prefer to use wet nurses (choice), then elite women In 18th century Europe elite wives and wives of professional men hired wet nurses Wet nursing was well-organised profession, supported through contracts Concern at various points about what else may betransmitted Industrial Revolution sees working class women ‘farming out’ babies to destitute peasant women (need) Development of safer feeding bottle sees demise of wet nursing
6. Brief History: Feeding Bottles Long history but not hygienic method until late 19th century Vessels of clay, wood, ceramic, cow horn used Rags, linen, sponges used as teat Bacterial infection was common Fed: milk from cows (goat, sheep, donkey, camel, pig, horse) Infants in rural areas could suckle directly from animal 1851: glass bottle with cork nipple invented in France 1845: 1st Indian rubber nipple In 19thc estimated that one third of infants fed artificially died in their first year Glass, England 1910 Glass, England 1858 Clay, Roman Ceramic, Germany
7. Brief History: Infant Formula Liquid cow’s milk fortified with carbohydrate, patented 1865 Carbohydrate powder, add milk Evaporated milk patented 1835 Unsweetened condensed milk patented 1885, recommended in 30s and 40s 1883: 27 patented brands, fattening but lacked protein and nutrients, dangerous when milk ‘off’ 1912: Easy to clean rubber nipples, ice-box for milk 1929: first non-milk formula (soy flour) Marketing to physicians 1940s and 1950s: Formula well-known, safe, popular
8. Activity: Which Method and Why? Why Not? Why Breastfeeding?
9. Activity: Which Method and Why? Why Not? Why Formula Feeding?
10. Problematizing Choice Choices are shaped by cultural, social, economic and institutional context Breastfeeding is an embodied ‘choice’ Not a free choice when formula feeding associated with discourse of ‘bad motherhood’? Not a free choice when UK formula manufacturers spending around £20 per baby promoting their products, while government spends 14p per baby promoting breastfeeding?* Not a free choice when marketing plants ‘seeds of conditionality’*? Not a free choice when most women in UK want to breastfeed but face ‘booby traps’: cultural and institutional barriers (Breast for Babes)? * Source: Ecologist, 1 April 2006
11. ‘Breast is Best’ Discourse Best for baby’s health (indisputable) Best for mother’s health (may depend) Best for mother-baby bond (exclusive?) Best for environment (indisputable) Cheapest (but what is included?) Most convenient (but what is compared?)
12. UK Weaver, Lawrence (no date) Feeding babies in the 21st century: Breast is still best, but for new reasons, Available online: http://www.historyandpolicy.org/papers/policy-paper-89.html
13. Why Breastfeeding Declined in UK Medicalized birth separated mother and baby Sedation of mother and baby restricted capacity Baby often given bottle feed first, breastfeeding had to be to strict regimes, not often enough Routine ‘topping up’ with formula Breastfeeding ‘failed’ so switched to formula: seen as cleaner, more efficient, more socially acceptable More women in workplace, not accommodating Discourse of science as providing the ‘best’ Women lost confidence in their ability to breastfeed Loss of intra-generational capacity building
14. Contemporary Rates: UK Only 1% of UK mothers still breastfeeding exclusively (EBF) at 6 months (WHO recommendation) 81% of mothers breastfeed at birth, up from 76% in 2005 UK variation: England rate highest, then Scotland, Wales, NI In England 83% at birth, 24% EBF at 6 weeks, 17% at 3 months, 1% at 6 months Rates including any breastfeeding (ABF) drop more slowly In UK 55% ABF at 6 weeks, 34% at 6 months Baby living in affluent area 4 times more likely to be EBF than baby living in deprived area BF most common in women over 30, in minority ethnic group, who left education after 18, have managerial / professional work, live in least deprived area Source: NHS (2010) Infant Feeding Survey
15. Breastfeeding Advocacy Emerged in 1960s and 1970s in context of declining rates of breastfeeding around the world Particular concern with formula marketing in ‘3rd world’: inappropriate and dangerous method of infant feeding endangering babies (polluted drinking water; poverty; illiteracy) Once mothers ‘hooked’ can’t go back Also concerned with role of physicians, links to infant formula companies, free samples 1974 War on Want publishes The Baby Killer; Third World Action Group Report: Nestle Kills Babies Nestle filed libel charges for $US 5 million against TWAG Found guilty but fine nominal and judge recognised Nestle’s unethical conduct
16. Consumer boycott of Nestle Boycott launched in US in 1974 by INFACT (Infant Formula Action Coalition) 1978 spread to Australia, Canada, New Zealand 1979 WHO/UNICEF host international meeting on infant and young child feeding 1979 International Baby Food Action Network (IFBAN) est. 1980 Nestle boycott starts in UK; work begins on draft code 1981 Sweden and W. Germany boycott; Intl Code adopted 1982-4 France, Finland, Norway join boycott, intense in US 1984 Nestle agrees to implement code, boycott suspended 1988 Boycott resumes amidst evidence of code violations Boycott continues, over 20 countries
17. Marketing Code International Code of Marketing of Breast-milk Substitutes Adopted 21 May 1981: 118 in favour, 1 against, 3 abstained US signed in 1994. Signing doesn’t mean adopt all parts Bans all advertising or promotion of BMS to general public Bans samples and gifts to mothers and health workers Requires information materials to advocate breastfeeding, warn against bottle feeding and not to idealise use of BMS through pictures or text Bans use of healthcare system to promote BMS Bans free or low-cost supplies of BMS Allows health professionals to receive samples, but only for research Demands that product information be factual and scientific Bans sales incentives for BMS and direct contact with mothers Requires labels to inform fully on correct use of formula and risks of misuse Requires labels not to discourage breastfeeding
18. Women’s Breastfeeding Experiences Schmied and Lupton (2001): Minority of women sampled experience breastfeeding as pleasant and intimate, enjoy inter-dependence and sharing body Majority of women experienced ambiguities and tensions, ranging from feeling drained by constant need to be available, to feeling embarrassed, to feeling disgust, pain, alienation, anger, failure Schmied and Lupton highlight extent to which breastfeeding is at odds with discourse of controlled, contained body as superior; ‘success’ requires a lot of emotion-work Britton (1998): Sample of 30 breastfeeding women showed wide variation in experiences of ‘let-down’, from pleasurable sensation, to no sensation, to tingling, to red hot pain Variable responses to leaking: sign of success or embarrassing violation of norms Breast pad marketing akin to that for towels/tampons
19. Women’s Formula Feeding Experiences Lee (2008):1/3 of women in samples who are formula feeding had planned to formula feed Factors: convenience, disliked idea of breastfeeding, had problems breastfeeding first child, wanted to involve others, had other children to look after 2/3 of women in samples who are formula feeding in whole or part intended to mostly or exclusively breast-feed but didn’t go to plan Women feel uncertain (48%), sense of failure (32%), guilty (33%), worried about what health visitor will say (23%), worried about effects on baby’s health (20%) Negative feelings about self highest for women who had wanted to breastfeed but all women formula feeding have to rebut discourse that they are bad mothers
20. Conclusions Infant Feeding is a highly contested issue Breastfeeding by birth mother routine through history, but wet nursing and bottle feeding of animal milk also has long history, latter associated with high infant mortality rates By mid 20thc manufactured formula fed through hygienic bottles established as safe and popular in minority world and breastfeeding rates declined Expansion of formula markets to majority world where costly and may not be safe, leading to consumer boycott of Nestle and campaigning for code to govern formula marketing Advocacy raising breastfeeding rates in UK, but substantial barriers remain, many women have negative experiences and don’t continue, ‘failure’ stigmatized as bad motherhood How can we hold onto importance of breast-feeding without essentializing women and without judging them?
21. Multiple Expressions of Care and Love