Who Takes Decisions about Breast Feeding?

Originally breasts evolved for the production of milk. Lactation was a prerequisite for successful reproduction. For thousands of years there was no realistic alternative, although milk was available from domesticated animals.

Just over 50 years ago the necessary technology began to become available to those who could afford it. Before this time women of the higher social classes who did not want to breast feed, or who could not breast feed, might hire a lactating woman of a lower social class, often an unmarried mother who had ruined her chances of supporting herself through getting married. Women of lower classes who for some reason were unable to breast feed faced a serious problem indeed.

During the interval between the two world wars, the bottle-and-teat technology and the necessary infrastructure improved in the West, and became available to more and more women, but it was not until the 1940's that the decline in breast feeding really gained momentum. Today there are European countries where breast feeding is almost non-existent. For a period of time more and more women were bottle feeding their babies, giving a variety of different reasons for it.

Female Culture

One of the most likely reasons for the decline in breast feeding seems to have been the loss of the traditional female culture, with increasing urbanisation and modernisation. In the traditional female culture, support and advice on breast feeding were offered to any inexperienced mother.

Our modern culture has never developed any replacement for the women's culture. The health service has done its best to teach young and inexperienced mothers what they need to know about child care, generally basing their educational efforts on the attitude that women are ignorant about this scientific subject.

The producers of all kinds of articles for "modern childcare" have for years been assisting the health services with informative brochures and samples for mothers. Industry has hitherto been dominated by men who themselves cannot breast feed and who have no understanding or sympathy for the traditional women's culture. It has been far easier to obtain information on how to correctly prepare a bottle-feed than about how to increase one's own milk production.

Labour Force

In theory the decline of breast feeding enables women to do work which may be needed to keep society functioning - usually low-paid unskilled work. But in periods when the labour of women is not regarded as vital to society, it becomes important to emphasise her role as mother and homemaker. Naturally things are not put as crudely as this.

The emphasis is on the femininity of women, and this ideology is successfully communicated, especially by the growing communications industry. The image of woman presented is that of a passive, elegant, sexy object, with large, firm breasts. This emphasis on the beautiful breasts makes it important that she should not ruin their shape. It has erroneously been believed that lactation causes sagging of the breasts. The most important aspect of the breasts is no longer their glandular function but their importance as a source of erotic stimulation.

And at work, even though in some countries the law provides for this, women have no facilities or social encouragement to breast feed. The day nursery, if it exists at all, is probably too far from the workplace to make breast feeding realistic.

Self-confidence

Consequently the market was sound for the development of a commercial/industrial product to substitute the breast milk. Until the late 1950's the content in the bottles had been diluted cows milk with sugar. Today there are many baby foods producers who with great conviction and much money market "the best milk that money can buy".

The results of research clearly show that it is impossible to produce a food which can replace breast milk with regard to composition of nutrients, ability to protect against infection, avoidance of allergies and freedom from contamination. But research does not have the same money at its disposal for publicising its findings.

Gradually the self-confidence of women and their faith in their own abilities and values, have been successfully undermined.

The disruption of the extended family and traditional agriculture, increased urbanisation, adoption of Westernized lifestyles, the impossibility of finding work for a woman who is breast feeding - all these factors make an autonomous decision about breast feeding almost impossible.

The decline in breast feeding is caused by socioeconomic developments in society and is not the result of autonomous decisions by women themselves.

Only when women can begin to define their own needs, only when they refuse to accept these needs as belonging simply to "the private sector", will some fundamental change be possible.

Adapted from an article by Brita Brandtzaeg, M.Sc., Elisabet Helsing (nutritionist) and Marit Kromberg, MD, DTM & H, Norway, 1975.

The Real Sucker

At the beginning of this booklet, the FAO was quoted as saying "Early weaning under the conditions which prevail in developing countries can be singled out as the main cause of malnutrition in the infant."

This statement seems to indicate that it is poverty that makes bottle feeding dangerous. For poor people this makes bottle feeding a status symbol (implies wealth). Yet it has been shown (page 11 ) that, on the contrary, bottle feeding involves a risk even in rich communities.

Therefore the infant formula marketing case raises fundamental questions for us in the West, more especially for women. It is women who are the "victims" of consumerism, of these values evoked by rich and powerful manufacturers, to be more sexy, more cool, more wifely, more beautiful, with slimmer hips and more beautiful breasts, - status symbols for our men. As Lucy Komisar writes:

"Advertising is an insidious propaganda machine for a male supremacist society. It spews out images of women as sex mates, housekeepers, mothers and menial workers - images that perhaps reflect the true status of most women in society, but which also make it increasingly difficult for women to break out of the sexist stereotypes that imprison them."    (Women in Sexist Society, Signet, USA 1972)

Whether we are talking about middle America or the Kenyan outback, women who want to be mothers as well are no longer part of the public sector - their contribution is in the home, in the "private sector".

Somewhere along the line women have been sucked into the status-symbol game, and have forfeited the capacity to choose, and have lost some basic rights for themselves and for their children.

Jane Cottingham and Marit Kromberg

Let me tell a typical story: A Swedish baby-food producing firm every year has a one-day symposium for pediatricians, and in 1973 the theme for the meeting was "human milk and breastfeeding". Among other things, the question of why modern mothers did not breastfeed was raised.

One after the other, the venerable persons gave their contributions to the explanation of the mysterious question: "Why do 'they' not breastfeed?" Nobody had actually hit upon the idea to ask one of "them" - the mothers - to offer an explanation.

When I entered the rostrum, I was the very first woman to talk about the subject, and, as a matter of fact, I had to invite myself to the symposium, and to ask for permission to speak.

In this field, as in most fields that are regarded as interesting, women are most conveniently "forgotten".

Let me mention one very distasteful example: in medical journals you may all have seen an advertisement for a drug that inhibits lactation. There is a picture of a beautiful lady, who lovingly looks at her little baby-bundle, all lace, make-up and glamour. And it is triumphantly stated in the advertisement, with big letters: SHE IS INHIBITED - AND DOESN'T KNOW IT.

The message is double: a lovely woman-doll of course wouldn't care less; for she is inhibited in her life situation (as these ugly women libbers claim) and she doesn't question what her doctor does to her. The fact that no milk comes to her breasts does not even make her wonder. She must be the perfect woman-doll-patient.

Are we that silly? Sometimes I wonder. When, for example, a mother has asked for breastfeeding advice from both her grandmother, who has breastfed five children, and her doctor who has breastfed none, she tends to disregard what her grandmother says in favour of the advice from the doctor. Even if doctors say wrong things about breastfeeding, grandmothers have to give in.

The woman's "reproduction culture" - our foremothers' knowledge and tradition in connection with birth and breastfeeding, are by many sociologists not regarded as any culture at all, and have very scarcely been studied. Thus the knowledge and tradition in connection with this event have been largely ignored.

And when the ties with the big family and traditional society are severed, for instance when a young couple moves to town in search of a "new" life, the knowledge in connection with breastfeeding disappears. The young mother has few to ask for advice if her nipples hurt, if her baby is a poor sucker, or when her milk supply dwindles. Instead, she is exposed to "knowledge" about bottle-feeding - or at least to the image that bottle-feeding is easy to do and will secure her baby's health.

One main misconception about breastfeeding is that the knowledge about "how to do it" is inherent in any woman. This is not so. Whether we have a "motherly instinct" or not may be discussed. Ideally, when a couple have a baby, they assume a "parent responsibility". But practical knowledge about what to do is not inherent in the breastfeeding mother. So when problems arise, which they unavoidably do to a varying degree among three-fourths of the women giving birth - she has to get advice. And this has to be advice based upon knowledge about the function of the breasts - not theories about how the bottle should be given.

The female biological functions often have a slightly ridiculous ring. When I talk about breastfeeding, which I quite often do, I have had to tolerate a lot of condescending laughter from my fellow men, which I usually meet by starting to talk about women's liberation in order to make them nervous.

From "Women's Liberation and Breastfeeding", Elisabet Helsing, in Environmental Child Health, October 1975, pp. 290-292. This whole issue is entitled " Symposium on Breastfeeding" containing many interesting articles on all aspects of breastfeeding.