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Chapter 17 203 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 breastfeeding experiences are rarely addressed in the literature. Building from critical concepts developed by French thinkers Pierre Bourdieu and Michel Foucault, we examine closely how issues of power, morality, and identity are embedded in public health promotion of breastfeeding, and how that promotion might be changed to better address women’s practices and needs. Motherhood and Ritual Medical anthropology demonstrates that the reproductive behaviors of women are heavily controlled through ritual. Reproductive rituals regulate and impose normative behaviors and often restrictive rules on women who are expected to follow them during pregnancy, birth, and the postnatal periods, constituting what French ethnographer Arnold Van Gennep called “rites of passage.”1 As a result, women around the world function under the scrutiny of family and community. Women are expected to comply with specific rules relative to their social, bodily, emotional, nutritional, and spiritual behaviors during their biosocial transition to motherhood. In some cultures, for example, pregnant women are forbidden from attending funerals to avoid jeopardizing the health and survival of their unborn child.2 In Vietnam, tradition dictates that mothers cover specific parts of their bodies to prevent illness in old age.3 While the familial and community knowledge justifying these norms and rules varies according to Breastfeeding in the Margins Navigating through the Conflicts of Social and Moral Order Danielle Groleau and Lindiwe Sibeko cultural context, the aim to protect the mother and infant is fully transcultural. Such cultural knowledge, passed on from one generation to the next, serves to safeguard not only the mother and her child but also the reproduction and survival of a group.4 This cultural pattern may also explain why, even in modern posttraditional societies, strangers commonly feel entitled to offer unsolicited advice to a new mother, to ask personal questions concerning her pregnancy, or even to touch her belly. If mothers follow the prescribed traditional perinatal rules and rituals of their group, they gain what French sociologist Pierre Bourdieu refers to as symbolic capital. Symbolic capital is a form of power that comes with social position, affords prestige, and leads others from the same fields to pay attention to the agent who has such capital.5 Indeed, such mothers will be considered “good mothers” by their group, since they are safeguarding themselves, their infants, and, correspondingly, the reproduction and survival of the family and community. Hence, by following culturally sanctioned infant feeding practices immediately after birth, a mother gains symbolic capital that imparts her with social stature and leads others from the same community to pay attention to and respect her. Conversely, mothers can lose symbolic capital if they fail to follow perinatal cultural norms. Rites of passage imply a moral dimension to motherhood and maternal practices. Rites of passage are also known for the psychological protective and adaptive effect they have on women experiencing vulnerability because of their transition toward a new biosocial status and identity.6 In the context of transition to a new identity, infant feeding decisions and experience—whether corresponding to or deviating from the local infant feeding habitus of their community—are not neutral for mothers, nor for their family or community.7 In fact, when mothers choose to deviate from local cultural norms or the habitus of infant feeding, such a decision often has emotional implications for them in terms of their own identities as mothers, but also for other actors in their family and community. By adopting the traditional cultural rules regulating bodily and behavioral rituals, mothers contribute to the construction of their new maternal identity and gain symbolic capital. Through their actions they also confirm and reproduce the cultural identity of the family and community. For example, in our study examining breastfeeding attitudes and practices of mothers from Cape Town, South Africa, mothers of young infants reported that they adhered to traditional perinatal rituals, with more than half of the mothers using traditional infant herbal preparations despite clinical advice to the contrary.8 Mothers did not disclose these practices to health care practitioners who were perceived to disapprove of these traditional practices. 204 Danielle Groleau and Lindiwe Sibeko The increasingly individualistic family structures in Western settings have meant a change in how families and communities dictate reproductive rituals. As family and community have become...

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