Breastfeeding: how privileged women make privileged choices normative

mother feeding her baby in nature outdoors in the park

Lactivism, like natural childbirth and attachment parenting, is a philosophy of privilege.

Specifically, privileged women shame the less privileged — women of lower socio-economic class and women of color — by insisting that their personal preferences are not merely normative, but actually morally superior.

Lactivism, in other words, is like driving a Volvo.

Sociologist Orit Avishai explores this issue in the chapter Managing the Lactating Body: The Breastfeeding Project in the Age of Anxiety. Avishai immediately gets to the heart of the matter:

Public health campaigns [to promote breastfeeding] are based on two premises: ‘the breast is best’ and breastfeeding as ‘natural’… [T]hese premises are flawed. Like other parenting, reproductive, health and lifestyle choices, breastfeeding is an option framed by access to resources, corporate interests, public policy, competing ideas about science, motherhood and standards of infant care. Drawing on interviews with class-privileged American mothers, this chapter sheds light on how breastfeeding is shaped at the crossroads of moralised motherhood, public health campaigns and grass-roots activism, economic disparities and the commercialised, medicalised and professionalised contexts that characterise contemporary parenting. Specifically, I demonstrate that this group of women constructs the lactating body as a carefully managed site and breastfeeding as a mothering project – a task to be researched, planned, implemented and assessed, with reliance on expert knowledge, professional advice and consumption. The construction of breastfeeding as a maternal project sheds light on breastfeeding disparities (‘successful’ breastfeeders tend to be white, educated, older and heterosexually partnered mothers) and on the fallacy of the ‘breast is best’ and ‘breastfeeding is natural’ slogans.

That goes a long way toward explaining why breastfeeding has been aggressively promoted in public health campaigns despite the fact that it has only trivial benefits. These campaigns have been motivated in large part by privileged white women inscribing and reinforcing their privilege by declaring their personal preferences morally superior to those of poor women and women of color.

It is well established that breastfeeding rates differ markedly by race and class. As Avishai notes:

… [B]reastfeeding has become even more stratified… [I]n Western nations breastfeeding has become a marker of privileged motherhood, where white, middle-class, educated, heterosexually partnered and older mothers are more likely to initiate breastfeeding, continue breastfeeding beyond the first few days and upon return to paid employment and breastfeed exclusively…

These disparities are also a product of racialised and sexualised public discourses. Blum argues that the ‘breast is best’ frame creates a standard of good mothering that faults mothers who cannot comply with this standard or do not wish to comply with it. These mothers are usually poor, uneducated and minority women, some of whom resist what they see as imposition of white, middle class mothering standards.

The heart of Avishai’s argument is that, contrary to the claims of lactivists, breastfeeding as practiced in contemporary America is not natural. Indeed:

…[T]he lactating body [is] a carefully managed site and breastfeeding [is] a ‘project’ – a task to be researched, planned, implemented and assessed. Analysis of the breastfeeding project demonstrates that breastfeeding is far from a natural practice.

Breastsfeeding as a project is promoted in part because of the commercialization of breastfeeding:

… [A] new profession – lactation consulting – emerged in the mid-1980s as an alternative to the free breastfeeding advice offered by La Leche League. Working within a clinical frame, this profession boasts formal training and certification procedures, a vibrant professional association, the International Lactation Consultant Association, and a peer reviewed journal. Breastfeeding is additionally supported by a vast market of goods and services, including lactation classes and books, nursing clothes, bras, pillows, chairs and breast pumps and related paraphernalia. Numerous websites also provide breastfeeding advice, support and merchandise.

What does managing the lactating body involve? Avishai conducted in depth interviews with first-time, educated, workforce- experienced and class-privileged mothers in the San Francisco Bay Area and created this list based on what she learned.

  • Consulting books and asking experts
  • Setting goals and assessing the product
  • Managing the uncooperative lactating body
  • Investing in production facilities

Each stage is mediated by privilege, and most require money. In contrast to the claims of lactivists, breastfeeding is no longer free.

Though most of the women in this study suggested that breast milk is produced by their bodies ‘free of charge’, and contrasted breastfeeding’s ‘simplicity’ with the ‘bagfuls of paraphernalia’ associated with bottle-feeding, many of them were immersed in breastfeeding-related consumption, reflecting broader consumption trends that characterise privileged parenthood. Since the physiology of lactation assumes proper levels of nourishment and rest as well as maternal health – all stratified in the United States – the very construction of breast milk as ‘free’ by mothers and lactation experts masks social inequalities. In addition, … participants in my study embraced the expanding market of nursing gear, gadgets and accessories. They invested in nursing bras (∼ $40), nursing pads, breast pumps and related kits ($200–400), nursing pillows (∼ $40) and nursing chairs (∼$200). Some purchased herbal supplements to enhance their milk supply
or acquired breastfeeding outfits.

Avishai concludes:

Analysis of the mothering project sheds light on the obstacles encountered by women who cannot mobilise such resources, which are no longer considered optional. Viewed in this light, the twin constructs of ‘the breast is best’ and ‘breastfeeding is natural’ are impoverished slogans that do not capture the extent to which both the science and the imagery of breastfeeding are shaped by normative assumptions and middle-class experiences.

Although Avishai describes contemporary lactivism through the lens of sociology, her analysis is nearly indistinguishable from what I have been writing for years:

The benefits of breastfeeding in industrialized countries, while real, are trivial.
The public health campaigns that currently exist are not justified by the empirical benefits of breastfeeding.
Lactivism is the attempt by privileged white women to inscribe and reinforce their privilege by shaming women who are not like them.
Efforts to ban formula gift bags, lock up formula, and make women sign breastfeeding contracts are further signs of privilege and attempts at shaming.
Breastfeeding is NOT best for all mother and babies.

Or to put is in a slightly different way, breastfeeding is equivalent of driving a Volvo. It’s a mark of race and class that provides marginal benefits but serves as a visible sign of privileged status.