Lactivist philosophy is maternalist; my philosophy of breastfeeding is holistic

Hand is writing Holistic approach in the note.

A new paper in Sociological Forum, Making Milk and Money: Contemporary Mothers’ Orientations to Breastfeeding and Work, is helping me clarify my thoughts about breastfeeding. Although typically presented as a medical issue, breastfeeding mandates are actually a philosophical issue.

The author explores the different philosophies through the medium of women’s paid employment. She starts by noting that, just as expectations around women and paid employment have changed in industrialized nations, expectations around breastfeeding have also changed.

[C]ontemporary mothering expectations have increasingly expanded and intensified. One such expectation is that breast milk is (once again) considered the best source of infant nutrition; thus, “good” mothers breastfeed their babies. Indeed, the “breast is best” public health mantra has become ubiquitous…

Contrary to the claims of lactivists — who assume good motherhood means the same thing in every time, place and culture — this reflects a reframing of good motherhood in our culture. Not surprisingly, there are women resisting the dominant cultural model.

There are two partners in the breastfeeding dyad and BOTH have needs.

The dominant model in contemporary industrialized societies is maternalist. This is the model promoted by La Leche League.

This model celebrates women’s ability to nourish, nurture, and bond with their child, and reclaims breastfeeding as part of women’s embodied and intuitive knowledge about reproduction… The maternalist perspective also has connections to “attachment” parenting and “natural” mothering, emphasizing children’s need to develop a safe and secure base through extensive physical and emotional connection with a primary caregiver—typically a mother.

Maternalist philosophy is a philosophy of obligation. Mothers who believe it are sure that women “owe” breastfeeding to their babies.

A subset of the maternalist philosophy is medicalized:

The medical model prioritizes the product of breast milk over the relational process of breastfeeding. From this perspective, as long as women produce milk for their infants, their physical presence is not necessary.

This is not a new philosophy. It undergirds the practice of wetnursing, a practice that has existed for millennia.

This both emerged from and perpetuates the paradigm of “scientific motherhood,” whereby women rely on “expert guidance” for childrearing. While expert guidance in the 1930s strongly promoted formula as the safest, most modern food, later professional opinions consistently emphasized breast milk. In the twenty-first century, major health organizations recognize breastfeeding as optimal for infant nutrition. If the primary rationale for breastfeeding is infant health, then it does not matter how breast milk is produced or consumed as long as women follow expert recommendations.

There are a number of ironies here. First is the irony that lactivists simultaneously demonize the doctors of the 1930’s who “wrongly” promoted formula, but are completely credulous regarding doctors of the 2010’s who promote breastfeeding. In my view, the present day promotion of breastfeeding as “best” is every bit as misguided as the 1930’s promotion of formula as best. There is no one-size-fits-all feeding recommendation. Recommendations should be tailored to the individual infant’s needs and circumstances.

The second irony is that the contemporary promotion of breastfeeding as the natural obligation of all mothers ignores the fact that there was ALWAYS a significant portion of women who opted out of breastfeeding, farming out their babies (often literally) to other women.

My philosophy of breastfeeding, in contrast, is holistic — encompassing the mother’s needs and desires as well as her obligations.

…[A] more recent public discourse on infant feeding has been ushered in with the “fed is best” campaign. While most directly connected to the nonprofit foundation of the same name, this has turned into a new mantra to critique the cultural hegemony of exclusive breastfeeding at all costs, and the perceived vilification of mothers who use any formula. This emerging discourse appears more women-centric, recognizing that the push for exclusive breastfeeding may create unrealistic and harmful expectations.

Fed is best, explicitly recognizes that their are two partners in the breastfeeding dyad and both have needs and desires that must be addressed:

The baby needs to be fed. Even those most hostile to me and to the Fed Is Best Foundation recognize that, sneering that “fed is minimal.” But that’s the point! If you aren’t adequately nourishing a baby by breastfeeding, you haven’t even met its most fundamental need. Fully fed with formula is BETTER than underfed with breastmilk.

The baby needs physical contact with the primary parent, but breastfeeding is not a necessary part of that contact. Throughout the millennia, those who hired, forced or enslaved a wetnurse were never worried that the baby would bond to the wetnurse instead of the mother.

The mother has needs, too. In contrast to the maternalist/medicalized philosophy of breastfeeding that explicitly ignores the mother’s needs, the holistic philosophy respects them. My mantra — her baby, her body, her breasts, her choice — reflects that.

As the author of the paper notes:

Women’s orientations to breastfeeding are shaped by differing, historically situated cultural models and discourses. While women do hold themselves accountable to these, there is no universal set of expectations because of the coexistence of different ideas about infant feeding and mothering.

This is a critical point. Like the founders of the Fed Is Best Foundation, I don’t “hate” breastfeeding. Why would I or they hate it when we nourished our children through breastfeeding and enjoyed it?

And I don’t hate the maternalism/medicalization philosophy of obligation, the belief that the mother’s needs pale into insignificance next to her “obligation” to breastfeed her baby. To an extent, I shared it. The term “attachment parenting” didn’t exist when my children were small, but that’s the kind of parenting I practiced because I thought it was best for my children and for me.

My professional philosophy, in contrast, is holistic. Other women have different needs — including the need to earn money, the need to have a profession, and the need for time away from children — and those needs should be respected.

But the fundamental difference between the maternalism/medicalization philosophy and my philosophy is this: I recognize that I am not the model to which all other women should aspire. My ego is not threatened if you feed your babies a different way than I fed mine. Unfortunately, lactivists appear to feel otherwise.

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  • Dr. Ann Dally, a British psychiatrist, wrote about this decades ago, in “Inventing Motherhood: the Consequences of an Ideal” [ https://www.amazon.com/Inventing-Motherhood-Consequences-Ann-Dally-ebook/dp/B07TXKSSRV/ref=sr_1_5?keywords=ann+dally&qid=1573118178&s=books&sr=1-5 ] in which she noted that [among other interesting things] the concept of the biological mother being the “only” suitable 24/7 childraiser emerged after WWI, when it became imperative to get the women out of the factories and back into the house, so demobbed soldiers could get their jobs back. The “new science” of psychology was enlisted to encourage this: working mothers meant neurotic children! The insistence on being physically available to breastfeed to exaggerated ages is simply an extension of this.

    • EmbraceYourInnerCrone

      I think that time period was also when the idea that “refrigerator mothers ” were to blame for children being autistic…because everything must be the fault of the mother

  • Cartman36

    there are “two partners in the breastfeeding dyad”. Thank you! I don’t understand why it is so hard for people to understand that Moms needs matter just as much as baby’s. Yes, I have a unique responsibility to provide for my children’s health, well-being, nourishment, education, housing, etc but that doesn’t mean that I have to disavow my own needs and wants.

    • Not only that. The insistence on a mother-infant “dyad” keeps Father at a distance, and actually devalues him.

      • Cartman36

        Very true! And the other children and extended family members.

      • EmbraceYourInnerCrone

        BIngo! I had the beginnings of Postpartum depression and NOT breastfeeding probably kept it from being worse than it could have been. My husband took two weeks daddy leave, my parents came out for a couple of weeks after that , and my in-laws for a couple of weeks after that. Since I was not breastfeeding this meant someone else could feed her the night feedings and let me sleep and it also meant if I wanted to take a short walk alone, there was someone to watch the baby. My husband is better with fussy babies than I am.

      • FormerPhysicist

        My children are very securely attached to their father, but I do notice that my brother, who formula-fed his daughters jointly with my SIL, is more attuned to responding to their needs. Maybe it’s just different personalities, but there was definitely a different dynamic set up in infancy.

    • Sarah

      I understand exactly why it’s so hard for certain people to acknowledge it!