Breastfeeding

Breastfeeding as a Socially Constructed Practice

The World Health Organization (WHO) recommends that infants be exclusively breastfed without any supplementary foods (including breast milk alternatives) during their first 6 months, followed by a combination of breastfeeding and complementary foods (excluding breast milk alternatives) up to age 2. The recommendations of national medical associations, such as the American Academy of Pediatrics, and international breastfeeding advocacy organizations, such as the World Alliance for Breastfeeding Advocacy (WABA), echo these guidelines. Breastfeeding advocacy rests on the premises that the “breast is best” and that breastfeeding is natural. Social scientists demonstrate that far from being “natural,” breastfeeding decisions, practices, and experiences are shaped by historical, cultural, and social norms and customs. These norms and customs govern feeding decisions for infants: breast milk or breast milk alternatives; who may feed the child at the breast, the mother, a paid wet nurse, or another mother involved in a network of mutual child care; where breastfeeding is to occur, in public, at the workplace, in the presence of family members, or in the privacy of one's home; how often breastfeeding should occur, according to a fixed schedule or “on demand,” in response to infant cues; how long breastfeeding should last, through early infancy or well into toddlerhood; how breastfeeding is to be learned, within the mother's informal kin and social networks or through specialized professionals; and how breastfeeding is experienced, as pleasurable and empowering or as a burden.

Breastfeeding Trends

When breast milk alternatives were first introduced in the late 1800s, results were disastrous. High mortality and morbidity rates of infants whose diets were supplemented in the early weeks of life spurred breastfeeding campaigns in the United States and in Britain. These campaigns encouraged women to breastfeed longer and to avoid unsafe supplements and alternatives.

When safer alternatives became widely available in the 1920s, breastfeeding rates began to decline worldwide, and by the 1930s, infant feeding methods were viewed as a matter of choice in Western nations. Promoted as more convenient and later as more nutritious than human milk, formula was perceived as an equivalent alternative to breast milk, sometimes even touted as a superior alternative. As part of the process that brought reproduction and parenting under the purview of experts, infant feeding came under scrutiny in the 1950s. Rima Apple, in Mothers and Medicine, informs that during this period, American physicians and public health officials began to promote formula as the modern, responsible, scientific, and “American” method to feed one's child. Pam Carter makes a similar observation in the British context. Combined with practices that interfered with lactation mechanisms, such as maternal-infant separation in hospitals following childbirth and the promotion of strict infant feeding schedules (as opposed to breastfeeding infants on demand), many mothers were diagnosed with insufficient milk syndrome and subsequently advised to discontinue breastfeeding. Amidst this culture of scientific motherhood, a group of women in Chicago founded a breastfeeding advocacy and support organization in the 1950s, La Leche League.

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