I’m currently working on a paper about mother’s milk as a source of contamination and how it is dealt with in the cross-over between local and medical ideas about risk. Although comparative anthropological work on breastfeeding has (thankfully) blossomed and advanced since the turn of the century, I wanted to take a few moments to summarise why Vanessa Maher’s 1992 edited volume The Anthropology of Breast-feeding: Natural Law or Social Construct remains my go-to text for thinking critically about global health and child rearing practices. If you wish to move beyond the recent evangelism on breastfeeding as the panacea to all inequality and question whether policy has changed tack at all, this volume is a good place to start (and a great warm-up read to the 2015 volume of Ethnographies of Breastfeeding).
First published in 1992 this edited collection remains as relevant, if not even more so today. The critiques developed in this volume, predominantly a) little is known about the cultural practices of BF in the western world; b) that universalised global health policy is often framed within the idealism of BF in the developing world – which is generally born out of economic and social restraints and bears no resemblance to the expected lives of women in industrialised and post-industrialised countries; c) the cultural and social dimension of our understanding of BF casts doubt on the accepted medical wisdom of many international organisations active in the field of healthcare.
The latter is what concerns me most in my current writing and thinking today. The most recent research and inclusion in the sustainability agenda surrounding improvements in BF is highly situated within a medical discourse. In an effort to highlight the disconnect between the value of human milk as a substance and its substitution, a paper in the recent Lancet series on BF argued: The fact that the reproductive cycle includes breastfeeding and pregnancy has been largely neglected by medical practice, leading to the assumption that breastmilk can be replaced with artificial products without detrimental consequences (Victora et al 2016:485). Whilst this may be the case, the current push to situate breastfeeding within a discourse of nutrition, maternal and infant morbidity and mortality, and human intelligence is no more helpful. Anthropology has done much work over the years on the impact of pathologizing pregnancy and childbirth – there is much we can learn from this in how we understand breastfeeding once it is captured under the medical gaze.
In the introductory chapter to the collection Maher positions a critical anthropological analysis of breastfeeding via the interrogations. These categories provide a framework for a cross-cultural examination of breastfeeding practices without falling into the trap of universalising meaning:
Breast Vs Bottle – an oversimplification
- An infants’ survival will depend on many factors but certainly not only on having been breastfed – economic status, education of the mother, housing, access to medical care, social controls on women’s sexualities and reproductive capacities, caregiving practices. Ethnographic research in urban areas of the Philippines and Tanzania for example, has shown that the mode of feeding in the populations’ most healthy infants appears to be insignificant (:4).
- ‘Nutritional uses’ of breastfeeding are culturally determined and this must be taken into account.
Whose milk is it anyway?
- In many societies, the rules regarding breastfeeding are laid down by men and tend to support male-dominated institutions.
- That younger women’s practices are often enforced by older women does not necessarily mean that ideas behind such practices originated with women.
- Breast milk is a female resource whose cultural and institutional importance is such that men and women content for its control. Cross-cultural accounts of the meanings behind human milk as a bonding substance and feeding as symbolic connections between humans evoke gendered ownership which transcends that of the mother-child unit.
Breastfeeding and Political Order
- Associating breastfeeding with intimacy and privacy in industrialised societies has resulted in the exclusion of nurturing practices in public spaces – That a woman should breastfeed at work or in public is a violation of cultural categories which sustain a power structure.
- Societal rules about gender and segregation and cultural beliefs about spoiling milk impact on space and duration of feeding. Notions of pollution are apparent in all aspects of how, why and where women can breastfeed in various cultures.
Patriarchy and the Mother-Child Relationship
- How much responsibility does a society place at the breast of the mother for emotional development and why?
Patriarchal Institutions and the Interruption of Breastfeeding
- Patriarchy means that the relationship between mother and child is defined or even controlled by the cultural emphasis or social institutionalisation accorded to relationships involving adult men in dominant positions (:23).