Is Breastfeeding Fair? Tensions in Feminist Perspectives on Breastfeeding and the Family

Objective: Breast-feeding rates reflect sociodemographic discrepancies. In Mexico, exclusive breast-feeding under 6 months of age has deteriorated among the poor, rural and indigenous populations from 1999 to 2012. Our objective of the present study was to identify the main social obstacles to breast-feeding in a low-income population in Tijuana, Mexico. Design: Qualitative study using a socio-ecological framework for data collection. Setting: Low-income communities in Tijuana, Mexico. Subjects: Mothers (n 66), fathers (n 11), grandparents (n 27) and key informants (n 25). Results: One hundred and twenty-nine individuals participated in the study: six focus groups (n 53) and fifty-one interviews among mothers, fathers and grandparents; and twenty-five interviews among key informants. Seven social themes were identified: (i) embarrassment to breast-feed in public; (ii) migrant experience; (iii) women's role in society; (iv) association of formula with higher social status; (v) marketing by the infant food industry; (vi) perception of a nonbreast-feeding culture; and (vii) lack of breast-feeding social programmes. Conclusions: Socio-structural factors influence infant feeding practices in lowincome communities in Tijuana. We hypothesize that messages emphasizing Mexican traditions along with modern healthy practices could help to re-establish and normalize a breast-feeding culture in this population. The target audience for these messages should not be limited to mothers but also include family, healthcare providers, the work environment and society as a whole. Keywords Breast-feedingObstacles Low income Socio-ecological framework Breast-feeding practices have improved in the last decades in most of Latin America (1)(2)(3) . Exclusive breast-feeding (EBF) under 6 months of age has increased greatly in Brazil, Colombia and Peru. However in other countries, such as Mexico and the Dominican Republic, prevalence of EBF under 6 months of age has decreased (3,4) . Despite improvements, only in five of nineteen Latin American countries with nationally representative data on trends in EBF over a 10-20 year period do >50 % of mothers exclusively breast-fed babies under 6 months of age (1) . Table 1 depicts rates of EBF under 6 months from Latin America including Tijuana.In the last decades, changes in breast-feeding prevalence in Latin America have shown less improvement in population subgroups whose children are most at risk for mortality and increased morbidity from not being breast-fed, such as poorly educated women with little access to health care (5,6) . In Mexico, EBF under 6 months deteriorated among the poor (33·5 % to 16·6 %), rural (32·7 % to 18·5 %) and indigenous (46 % to 27·5 %) populations from 1999 to 2012 (7,8) . Breast-feeding rates in Mexico are one of the lowest of Latin America with 14·4 % of EBF under 6 months of age (1) . Particularly in North Mexico, there is a lower prevalence of EBF under 6 months of age (10·6 %) than the national average in 2012 (4,9) . There are no data with EBF rates in...

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“…'The practice of breast-feeding must be seen as a right and a true choice for all women, not a privilege (66) '.…”

Section: Discussionmentioning

confidence: 99%

‘Life does not make it easy to breast-feed’: using the socio-ecological framework to determine social breast-feeding obstacles in a low-income population in Tijuana, Mexico

Bueno-Gutierrez

Chantry

2015

Public Health Nutr.

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“…While others argue that mothers breastfeed because it is their role and it is an expected practice from the family and society [33,36]. Nonetheless, other authors suggest breastfeeding as an oppressive practice to women [37].…”

Section: Exploring Perceptions and Practices Of Biomedical Norms Durimentioning

confidence: 99%

Exploring Perceptions and Practices of Biomedical Norms during Exclusive Breastfeeding among HIV-Positive Lactating Mothers in Mozambique

Cuinhane

Coene²,

Roelens

et al. 2017

J AIDS Clin Res

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Introduction: To prevent passing infection to their infants, Mozambican mothers with HIV are advised to follow biomedical norms during breastfeeding. However, little is yet known about how HIV-positive mothers perceive biomedical norms during the breastfeeding period.Objective: To analyse lactating mothers' perceptions and compliance with biomedical norms recommended for reducing the risk of mother-to-child transmission of HIV via breastfeeding. Method:A qualitative study was carried out consisting of in-depth interviews with 59 HIV-positive lactating mothers. This involved 5 focus group discussions, direct observation and 6 semi-structured interviews with nurses. We used Bourdieu's theory of practice as a guiding framework for data analysis.Results: Findings revealed participants had mixed perceptions and inadequate knowledge about breast milk and exclusive breastfeeding. As well, participants struggled to comply with some biomedical norms. Approximately half of the participants breastfed immediately after childbirth. Most participants do breastfeed on demand and all participants complied with prescription regarding antiretroviral therapy for their infants. Of the 59 participants, 53 complied with prescription of antiretroviral therapy for themselves.A total of 56 participants did not comply with exclusive breastfeeding to the sixth month. This was due to a lack of knowledge about exclusive breastfeeding, the perception that both breast milk and formula were not enough to feed the baby up to the age of six months. Other factors included returning to school or work, illness of the mother and child, lack of disclosure of HIV status of the mother as well as social norms. Conclusion:The study results suggest participants' perceptions, incorporated learned experiences and the social environment they inhabit seem to influence compliance to biomedical norms. These norms seem new, and participants are still processing its incorporation. Health education on exclusive breastfeeding and prevention of mother-to-child HIV transmission should take into account the participant's perceptions and their social environment.

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“…Related to these constructions is a moral dichotomy between breast milk which is represented as 'good' and formula milk represented as 'bad' (Bartlett, 2003;2005;Murphy, 2000). In addition, contradictions have been discussed surrounding the public/private dichotomy in terms of the difficulties posed for women returning to work while breastfeeding (Bartlett, 2005;Dykes, 2005;McCarter-Spaulding, 2008) and the frequent taboo on breastfeeding in public places (Stearns, 1999).…”

Section: Introductionmentioning

confidence: 99%

“…A feminist approach to analysis involves going beyond the surface content of women's accounts and explicitly exploring the social processes which can make breastfeeding oppressive (Carter, 1995;McCarter-Spaulding, 2008). Generally feminist approaches highlight the problematic nature of focusing on infant feeding 'decisions' as if they are individual, autonomous choices; instead, they suggest that practices adopted are about balancing different sets of demands and finding solutions which help women to assert some control (Bartlett, 2003;Carter, 1995;Murphy, 2000).…”

Section: Introductionmentioning

confidence: 99%

“…Expressing within this context has been conceptualised as a form of 'control' placed upon breastfeeding in that it is a way of managing future expectations about returning to 'normal', usually economically productive, activities (Dykes, 2005). Additionally, the use of breast pumps in particular has been theorised as contributing to the medicalisation and mechanisation of breastfeeding, in that breast milk is seen as a product rather than breastfeeding as a process, which can lead to disembodiment because it values technical-physical aspects of breastfeeding over interpersonal and intrapersonal ones (Blum, 1993;Dykes, 2006;McCarter-Spaulding, 2008;Van Esterik, 1996). However, it has also been noted that the practice of expressing breast milk has the potential to be empowering, in that it can allow for shared parenting and a 'door to freedom' (Dykes, 2006;Morse & Bottorff, 1992) both of which increase options for women (Van Esterik, 1996).…”

Section: Introductionmentioning

confidence: 99%

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Expressing yourself: A feminist analysis of talk around expressing breast milk

Johnson

Williamson

Lyttle

et al. 2009

Social Science & Medicine

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Recent feminist analyses, particularly from those working within a poststructuralist framework, have highlighted a number of historically located and contradictory socio-cultural constructions and practices which women are faced with when negotiating infant feeding, especially breastfeeding, within contemporary western contexts. However, there has been little explicit analysis of the practice of expressing breast milk. The aim of this article is to explore the embodied practice of expressing breast milk. This is done by analysing, from a feminist poststructuralist perspective, discourse surrounding expressing breast milk in sixteen first time mothers' accounts of early infant feeding. Participants were recruited from a hospital in the South Midlands of England. The data are drawn from the first phase of a larger longitudinal study, during which mothers kept an audio diary about their breastfeeding experiences for seven days following discharge from hospital, and then took part in a follow-up interview. Key themes identified are expressing breast milk as (i) a way of managing pain whilst still feeding breast milk; (ii) a solution to the inefficiencies of the maternal body; (iii) enhancing or disrupting the 'bonding process'; (iv) a way of managing feeding in public; and (v) a way to negotiate some independence and manage the demands of breastfeeding. Links between these and broader historical and socio-cultural constructions and practices are discussed. This analysis expands current feminist theorising around how women actively create the 'good maternal 2 body'. As constructed by the participants, expressing breast milk appears to be largely a way of aligning subjectivity with cultural ideologies of motherhood.Moreover, breastfeeding discourses and practices available to mothers are not limitless and processes of power restrict the possibilities for women in relation to infant feeding.

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Is Breastfeeding Fair? Tensions in Feminist Perspectives on Breastfeeding and the Family

Cited by 49 publications

References 26 publications

‘Life does not make it easy to breast-feed’: using the socio-ecological framework to determine social breast-feeding obstacles in a low-income population in Tijuana, Mexico

‘Life does not make it easy to breast-feed’: using the socio-ecological framework to determine social breast-feeding obstacles in a low-income population in Tijuana, Mexico

Exploring Perceptions and Practices of Biomedical Norms during Exclusive Breastfeeding among HIV-Positive Lactating Mothers in Mozambique

Expressing yourself: A feminist analysis of talk around expressing breast milk

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