The individual focus of nursing research in breastfeeding: Perpetuating a neoliberal perspective

Abstract

In this paper, I argue for the need to shift the focus of nursing research regarding breastfeeding from that of individual responsibility to include a more system‐focused, population health approach. In the 2011, “Call to Action to Support Breastfeeding,” the U.S. Surgeon General called attention to the pervasive disparities in breastfeeding outcomes in the United States. A plethora of nursing research exists aimed at addressing these disparities; however, this research leans toward a neoliberal perspective, mainly focusing on individual factors and failing to address the systemic inequities contributing to these disparities. A shift in nursing science that focuses research at a population level would more effectively support addressing disparities in breastfeeding outcomes and embrace a commitment to social justice. In focusing at a population level, specific inequities that must be addressed include the negative history of breastfeeding in the Black population, systemic racism, and gender inequality. Critical research methodologies are proposed as useful approaches to address these inequities. By engaging in this level of research and using a critical lens, nurse scientists broaden their scope of care to include the entire population, motivate needed social and policy change, facilitate the choice to breastfeed, and ultimately eliminate breastfeeding disparities.

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Breastfeeding Disparities During the COVID-19 Pandemic: Race/Ethnicity, Age, Education, and Insurance Payor

“…The present analyses focus almost exclusively on identifying disparities on individual-level demographics. Although these findings may be used to offer insights into the disparate health outcomes experienced by different individuals, these disparities are not driven by individual-level differences, but by systemic processes (Kett, 2020); the lack of system-level variables in the present study limits our assessment of the direct mechanisms of these disparities. Thus, future research should continue to consider factors including hospital practices and education (Hemingway et al, 2021), local poverty rate, community norms (Hinson et al, 2018), and employment policies (Petit et al, 2021).…”

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“…Patients are subsequently held responsible for their choices and encouraged to constantly monitor and invest in their bodies (Rasooly et al). Breastfeeding is one example of how nurses have perpetuated neoliberalism thorough focusing on individual responsibility of each breastfeeding person instead of the gender and systemic inequalities that contribute more to decisions about breastfeeding (Kett, 2020). These narratives fail to account for racism, discrimination, mistreatment, and other “racism-related risk factors” (Scott et al, p. 109), and detract from that the larger, system-wide care delivery services may contribute to adverse outcomes for Black pregnant women including a lack of diversity among the nursing workforce (McLemore, 2018).…”