It takes a village to breastfeed a child, not a lactation consultant

Traditional, tribal hut of Kenyan people

One of the biggest ironies of contemporary breastfeeding promotion is how UNnatural it it.

Sure, breastmilk is promoted as best because its natural, but the elaborate demands and restrictions that characterize the Baby Friendly Hospital Initiative (BFHI) are based not on what happens in nature, but on the contemporary philosophy of neoliberalism. Indeed the entire profession of lactation consultant — an expert paid for assistance — is the epitome of capitalism, not nature.

Isolating a new mother in a room by herself with no one else to care for her or her newborn is an unnatural, capitalist concept.

According to We Need to Talk about Family: Essays on Neoliberalism, the Family and Popular Culture:

Neoliberalism is usually defined as the expansion of economic thinking in all spheres of human activity, including the family …

The individualistic conception of selfhood central to neoliberalism accepts that an individual is both an ideal locus of sovereignty and a site of governmental intervention…

We see its impact in the BFHI that is predicated on individual maternal action and disregards the impact of the family and “the village.” As a result, contemporary breastfeeding promotion is UNnatural, harking back to a past that never existed.

For example, consider the BFHI policy of closing well baby nurseries to force women to room-in with their infants 24/7. There are NO human cultures (no historical cultures, no indigenous cultures, no cultures in developing countries) that leave women alone to care for their infants by themselves from the moment of birth.

According to Traditional postpartum practices and rituals: a qualitative systematic review:

Organized support, usually in the form of family members caring for the new mother and her infant for a specified period of time, is almost universally provided in the early postpartum period by the mother, mother-in-law, other female relatives or husband…

Organized support typically corresponds to a prescribed period of rest, during which the mother is prohibited from performing her usual household chores. In most cultures, the rest period spans between 21 days and 5 weeks, and is considered a period of vulnerability for future illness.

Isolating a new mother in a room by herself with no one else to care for her or her newborn is a modern, unnatural concept. It has nothing to do with nature and everything to do with neoliberalism and capitalism.

Consider the BFHI policy of banning formula supplements. The practice of prelacteal feeding spans time and culture. Odds are high that it reflects the fact that up to 15% of new mothers have insufficient or delayed production of breastmilk. Without supplements, those babies would have died of dehydration.

We’ve ignored these insights about supplementation, ascribing them to ignorance, in favor of our preferred belief that women in indigenous cultures breastfeed early and exclusively. Once again we’ve missed the critical difference between our indigenous foremothers and ourselves. Early supplementation of breastfeeding itself is not harmful; it looks harmful when the only available prelacteal feeds are contaminated with bacteria.

How about pacifiers? They, too, are banned by the BFHI despite the fact that they reduce the incidence of Sudden Infant Death Syndrome (SIDS). Pacifiers have been used for at least the past 12,000 years and probably far longer.

There is evidence that [pacifier] precursors have been used since the Neolithic Period to calm down children. Small balls made of fabric containing food were portrayed in paintings. Other balls made of non-perishable material persisted throughout time…

We’ve ignored the historical evidence of widespread pacifier use because lactation professionals prefer to pretend that women in indigenous cultures used their breasts as pacifiers. That comports with neoliberal fantasies about the mother as an individual actor shorn from her family, her community and the technologies of her time.

What about lactation consultants? There is no such thing as experts for hire in nature. That is an invention of capitalism. Women learned to breastfeed from family members who were invested in the wellbeing of the baby nearly as much as the mother herself. They did not pay money to self-proclaimed experts more concerned with the process of breastfeeding than the outcome of healthy babies.

In truth, supporting breastfeeding does not require banning technology; it requires providing care.

If lactivists really want to increase breastfeeding rates they’d stop trying to recapitulate the absence of technology and concentrate on recapitulating the philosophy of care: it takes a village offering a tremendous amount of help and support — including supplements and pacifiers — to breastfeed a child.

Instead of promoting the Baby Friendly Hospital Initiative, they’d be banning it.

  • demodocus

    I know a certain doctor potential grandma who’d probably not mind at all helping her daughter/daughter-in-laws with their babies. 🙂

    God knows I have had to lean on a few empty nesters I know who didn’t mind keeping my kiddos for an hour now and then.

  • Leading Zero

    It wasn’t that long ago that extended family was able to care for new moms and their babies. When my mother was close to her due date, she went back to her home town to give birth to me so that her mother and MIL could support her afterwards. I was 12 when my youngest sibling was born, and learned how to bottle feed him and change his diapers not long after my mom came back from the hospital. When my oldest was born, though, my primary source of support was the public health nurse’s home visits (standard in my province at the time) and a couple of trips to the LC’s offices. (My husband was working full-time, and had far less experience in infant care than I did. So his ability to help was pretty limited.)

    As new mothers get older (I was 30 when I gave birth) and families get smaller, our collective memory of the way things were is slowly evaporating, replaced by the fairy tale of the mom who always did everything bravely by herself.

  • Queen Khentkawes

    Off topic, but I think you’ll find this article in the New Yorker of interest. https://www.newyorker.com/news/dispatch/a-midwife-in-the-north-country

    • rational thinker

      I just read it. There are a lot of lies and misinformation in that article.

    • Mel

      Turns out that the title “Independent Small Business Owner Can’t Afford Niche Business” just didn’t have the same ring……

    • Daleth

      Quote: “Smith [the CNM] recalled one obstetrician telling her that no one ever sued him for performing a C-section.”

      Yes, that’s because people don’t file OB medical malpractice suits unless the mom or baby gets hurt (or killed). What the OB was saying is that it’s better to do an unnecessary c-section and have mom and baby come out fine, than to fail to perform a necessary c-section and end up with a dead or injured baby as a result.

      Does anyone genuinely disagree with that? Does anyone really think that avoiding unnecessary surgery is more important than avoiding dead or brain-damaged babies?

      We do not have the technology to be 100% certain, in advance, which c-sections are absolutely necessary. All we can do is see when things are starting to get risky. If at that point you’re more concerned about avoiding a c-section than making sure you don’t kill the baby, you’re going to end up with some babies dying when a c-section would’ve saved them.

  • rational thinker

    Usually if you want to work in health care and give medical advice and examine patients you have to go to some sort of medical school first. Why is a lactation consultant allowed to examine a patients breasts and allowed to recommend cutting up a newborns mouth all without having gone to any kind of medical school. I think most new mothers have no idea a LC has not gone to any medical schools either. Just like when a woman chooses homebirth with a midwife and is mislead to believe she hired a CNM when she is really just a CPM.

    • AnnaPDE

      I don’t know how it is where you live, but as far as I know, a nursing or medical degree, or something related, is a prerequisite for the IBCLC certification.

      • alongpursuit

        In Quebec I have met with several IBCLC-certified LCs that had no formal medical education. Just the certification.

    • Sarah

      It does show, fundamentally, that actually on societal levels we don’t really think this stuff is that important. Otherwise it wouldn’t be entrusted to bullshitting hobbyists.