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Beyond Health, Beyond Choice

Breastfeeding Constraints and Realities

Edited by Paige Hall Smith, Bernice L Hausman, and Miriam Labbok

Publication Year: 2012

Current public health promotion of breastfeeding relies heavily on health messaging and individual behavior change. Women are told that “breast is best” but too little serious attention is given to addressing the many social, economic, and political factors that combine to limit women’s real choice to breastfeed beyond a few days or weeks. The result: women’s, infants’, and public health interests are undermined.  Beyond Health, Beyond Choice examines how feminist perspectives can inform public health support for breastfeeding.


Written by authors from diverse disciplines, perspectives, and countries, this collection of essays is arranged thematically and considers breastfeeding in relation to public health and health care; work and family; embodiment (specifically breastfeeding in public); economic and ethnic factors; guilt; violence; and commercialization. By examining women’s experiences and bringing feminist insights to bear on a public issue, the editors attempt to reframe the discussion to better inform public health approaches and political action. Doing so can help us recognize the value of breastfeeding for the public’s health and the important productive and reproductive contributions women make to the world.

Published by: Rutgers University Press

Series: Critical Issues in Health and Medicine

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Preface and Acknowledgments

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pp. xi-xiv

This collected volume results from presentations at the fifth Breastfeeding and Feminism Symposium held March 20, 2010, at the Weatherspoon Art Gallery on the campus of University of North Carolina at Greensboro (UNCG), cohosted . . .

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Introduction: Breastfeeding Constraints and Realities

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pp. 1-11

Recently there has been an explosion of feminist attention to breastfeeding, in addition to increased activity in public health and medical research. Our collected volume, . . .

Part I: Frames

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Chapter 1 Feminism and Breastfeeding: Rhetoric, Ideology, and the Material Realities of Women’s Lives

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pp. 15-24

The current popular feminist critique of breastfeeding advocacy and promotion is unhelpful at best and destructive at worst. Its overall effect is to anger breastfeeding supporters rather than to encourage them to different . . .

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Chapter 2 Breastfeeding Promotion through Gender Equity: A Theoretical Perspective for Public Health Practice

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pp. 25-35

The connection between gender inequality and women’s breastfeeding practice has been recognized since the early days of the breastfeeding movement. Numerous documents produced or endorsed by the breastfeeding movement . . .

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Chapter 3 Breastfeeding in Public Health: What Is Needed for Policy and Program Action?

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pp. 36-50

Breastfeeding, especially exclusive breastfeeding, has been shown to be the most important infant and child survival intervention in terms of its potential impact on mortality. Increased exclusive breastfeeding could prevent about . . .

Part II: Studying Breastfeeding across Race, Class, and Culture

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Chapter 4 Breastfeeding across Cultures: Dealing with Difference

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pp. 53-63

Feminism refers to theories and actions that reduce (and ultimately eliminate) inequality and discrimination on the basis of gender, race, class, and ethnicity. As with all “isms,” feminisms have histories. In South Asia, local feminism . . .

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Chapter 5 The Dangers of Baring the Breast: Structural Violence and Formula-Feeding among Low-Income Women

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pp. 64-73

Athena is a twenty-six-year-old single mother who lives alone with her five children. After a high-risk pregnancy and premature delivery, she fully breastfed her newborn, Clifford, for four months while attending a community . . .

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Chapter 6 Racism, Race, and Disparities in Breastfeeding

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pp. 74-83

Discussions of racism and race are uncomfortable for most Americans who idealize equality of all peoples, yet individual and institutional racial discrimination abound. It has been called the elephant in the room, in part . . .

Part III: Medical Institutions and Health Education

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Chapter 7 Pediatrics, Obstetrics, and Shrinking Maternal Authority

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pp. 87-97

When physicians do not allow mothers to breastfeed immediately after giving birth, when hospitals house newborns in nurseries apart from their mothers, and when nurses feed breastfed newborns formula without their mothers’ . . .

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Chapter 8 New Professions and Old Practices: Lactation Consulting and the Medicalization of Breastfeeding

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pp. 98-109

Professional breastfeeding knowledge in the United States today is embodied by the lactation consultant.1 Lactation consulting emerged on the global scene in 1985 as a new and highly gendered health care profession specializing in the . . .

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Chapter 9 Preparing Women to Breastfeed: Teaching Breastfeeding in Prenatal Classes in the United Kingdom

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pp. 110-119

The seemingly paradoxical construct of breastfeeding as a “natural skill that needs teaching” has been examined in detail elsewhere and is evident by the plethora of books written by those who have been successful, giving advice to . . .

Part IV: Roles and Realities

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Chapter 10 “Are We There Yet?”: Breastfeeding as a Gauge of Carework by Mothers

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pp. 123-132

On my lifetime Social Security record, there are two gaps filled in with zeroes. They mark the years—three after the birth of each child—when I left the paid labor force to be a full-time mother. During these periods when my official . . .

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Chapter 11 Breastfeeding and the Gendering of Infant Care

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pp. 133-143

Human reproduction is inherently gendered: women, not men, give birth, lactate, and breastfeed.1 Domestic work and child care are also highly gendered activities, but not necessarily inherently so. Among two-parent families with . . .

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Chapter 12 Working out Work: Race, Employment, and Public Policy

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pp. 144-156

It is simple enough—breastfeeding is the biologic norm, and it is good for babies and mothers. On this point, most would agree. However, like many other relationships in women’s lives, maintaining a breastfeeding . . .

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Chapter 13 The Impact of Workplace Practices on Breastfeeding Experiences and Disparities among Women

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pp. 157-166

Since a majority of mothers of infants are in the labor force, work organizations play an important role in facilitating women’s ability to breastfeed.1 In most workplaces ideal worker notions assume male career patterns and treat . . .

Part V: Making and Marketing Mothers’ Milk

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Chapter 14 Marketing Mothers’ Milk: The Markets for Human Milk and Infant Formula

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pp. 169-179

Today, breastfeeding, human milk, and its substitute, infant formula, are commodities. “Mother’s milk” is marketed both literally and figuratively, as a good for sale, a normative behavior, and a cure for a variety of contemporary social and . . .

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Chapter 15 Empowerment or Regulation?: Women’s Perspectives on Expressing Milk

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pp. 180-189

Recent research suggests that expressing breast milk may be an increasingly common practice during early infant feeding, yet relatively little is known about the reasons for this practice.1 Moreover, there is little explicit analysis of . . .

Part VI: Morality and Guilt

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Chapter 16 Feminist Breastfeeding Promotion and the Problem of Guilt

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pp. 193-202

It is difficult to have a conversation about breastfeeding in any setting without raising the specter of guilt. From the point of view of the mother who does not breastfeed and says she resents being made to feel guilty about her feeding . . .

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Chapter 17 Breastfeeding in the Margins: Navigating through the Conflicts of Social and Moral Order

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pp. 203-211

The moral tone implied in breastfeeding knowledge is rooted in power relations that also affect the identity of mothers. We present our arguments with examples of women living in poverty, since this is a population whose . . .

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Chapter 18 Reinstating Pleasure in Reality: Promoting Breastfeeding through Ars Erotica

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pp. 215-225

In 2010 the Department of Health and Aging in Canberra released a ten-point Australian National Breastfeeding Strategy for stakeholders and government agencies. The first point reads, “Monitoring and surveillance” and the last, . . .

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Chapter 19 Breastfeeding in the “Baby Block”: Using Reality Television to Effectively Promote Breastfeeding

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pp. 226-235

The program Bringing Home Baby opens with a typical schedule for the first days after a baby is born. Title slides read: “First 36 hours”; then, “Day 1: Newborn baby,” “Crying,” and “Diapers.” A second set of slides state: “Day 2: . . .

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Chapter 20 Rethinking the Importance of Social Class: How Mass Market Magazines Portray Infant Feeding

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pp. 236-245

Women go through intense role modification when they become pregnant and prepare for motherhood. From a sociological perspective, women typically begin a process of anticipatory socialization, or information-seeking practices, . . .

Part VIII: Sexuality and Women’s Bodies

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Chapter 21 Breastfeeding in Public: Women’s Bodies, Women’s Milk

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pp. 249-258

Breastfeeding takes place within cultural contexts where women receive conflicting messages about their bodies, breastfeeding, and role as mothers. Although the public health message is “breast is best,” cultural associations . . .

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Chapter 22 Sexual or Maternal Breasts?: A Feminist View of the Contested Right to Breastfeed Publicly

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pp. 259-268

Breastfeeding mothers must cope with the dominant notion of the sexual breast that pervades the culture of the United States.1 Even though laws have been passed clarifying the right to breastfeed in public in forty-four states as well as . . .

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Chapter 23 Intersections: Child Sexual Abuse and Breastfeeding

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pp. 269-279

At the 2010 Breastfeeding and Feminism Symposium, I asked the attending feminist scholars, activists, and clinicians, “How many of you practice with the assumption that mothers who were sexually abused as children will be . . .

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Conclusion Beyond Health, Beyond Choice: New Ways Forward in Public Health

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pp. 281-285

The collected chapters in this work make it clear that pushing women to breastfeed for health reasons alone is a weak strategy. Such encouragement does not address the complexity of decision making that is created by the . . .


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pp. 287-326

Notes on Contributors

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pp. 327-332


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pp. 333-338

E-ISBN-13: 9780813553160
E-ISBN-10: 0813553164
Print-ISBN-13: 9780813553030
Print-ISBN-10: 0813553032

Page Count: 356
Publication Year: 2012

Series Title: Critical Issues in Health and Medicine