Posted On: Nov. 11, 2017
BREASTFEEDING –Nature’s benevolent act of nurturing life Introduction Breast feeding is the nature’s blessing which nurtures a neonate to life. It is a psychologically and physiologically a novel experience for the mother by which she provides immunity to a new-born to fight the disease causing microbes in the milieu around it. The nutrients in the first milk or colostrums are like ‘manna’ for a new-born providing it a mixture of antibodies and nutritious anabolic proteins. Breast feeding is an act which lets a mother feel complete and gratified of her motherhood. Breastfeeding is generally conceived as a private act where a nurturing mother is in intimate connection with the infant. The act is envisioned to be occurring in a tranquil background within the privacy of one’s own bedroom or in the baby’s nursery in a house with the participants as the sole witnesses. The moment as soon as the breastfeeding mother travels with her baby in an aeroplane, sits up with her baby into a car seat or enters a multiplex theatre or a shopping mall leaving the protected vicinity of the bedroom, breastfeeding no more remains a private, personal and intimate act. The hunger cries of a baby in a shopping mall, in a religious ceremony of a church, at a public swimming pool, a music concert or while the mother is at office, breastfeeding transforms into a public act, which may involve multiple players few with authority, become involved. They may include police officers, who may enforce public obscenity laws; private security officials in a store may be worried about the sensitivity of other customers, employers who may be requested to accommodate an employee’s call to nurse an infant in official duration; and passersby unacquainted to witness breastfeeding in public. The above implications have thus transformed breastfeeding in public a matter of public policy debate. The breastfeeding mothers are seeking protection to their rights to breastfeeding rights in public places by lawfully bespeaking public officials to alter the public policy. These mothers are likely to move in public places—for example as a consumer in a shopping centre or as a bank employee in the workplace—they are into active quest for safeguarding the parenting decisions, including breastfeeding, which are frequently considered as private actions. Subsequently, looking for support for these private practices through public means, such as legislation, is satirical. It is argued upon by several advocates that one of the benefits of breastfeeding is the nurturing and the humane touch it provides. Breastfeeding for these people means that the child nurses at the mother’s breast during the entire period. Therefore, breastfeeding does not involve the expressing of breast milk by hand or a mechanical pump or suction pumps to be bottle-fed to the child later. Paediatricians on the other hand coined a term exclusive breastfeeding, which means that if the child feeds upon only breast milk—irrespective of whether it is fed via the breast or the bottle—but not on the supplemental formula, cow’s milk, tea, semi-solid substituent foods, or water-mixed substituents. Human breast milk provides the infants a plethora of health benefits, as reported in the medical literature. The breast milk has immunoglobulin G and A which the nursing mother passes on to their infants via breast milk. (1) Thus, a breastfed infant is provided a immune response towards all the infectious disease contracted by the mother during her life. These involve all the diseases contracted by her during the duration of breastfeeding, as well as the diseases against which she has been immunized. As a result, as compared to a child fed on substituent milk, a breastfed baby stands a better chance of survival against a serious disease due to a immune cover. THE HISTORY OF BREAST FEEDING The evolutionary history provides an important basis for claiming a right to breastfeed. According to Patricia Stuart-Macadam, breastfeeding, as has pointed out that for more than 99 percent of our history as a species, infants were primarily breastfed. During that long evolutionary history, a reciprocal physiological relationship has developed between mothers and infants, with each depending on the other for optimal health. In that context, the cultural alteration of ancient evolutionary patterns of breastfeeding “can have profound implications for the physiology, growth and development, and health of human infants and children as well as for the physiology and health of women.” (1) Despite differences in practical arrangements, human breast milk remained the primary way that civilizing humans fed babies. That holds true for the cultural traditions of Western Europe that most directly inform the historical continuity of breastfeeding practices in the United States; breastfeeding remained the dominant method of infant feeding throughout the course of the Medieval era in preindustrial Europe.(2) As Valerie Fildes puts it, the question remained much the same as it had throughout human history, not “ ‘Was an infant breastfed?’ but, ‘Was an infant breastfed by its own mother or a relative, friend, or wet nurse?’ ”(3) Wet nursing had become a norm for upper-class European women throughout the Medieval era, “while in poorer families the mother nursed her own child.”(4) Later on, breastfeeding continued to be the dominant form of infant feeding, though certain regions are notable for not breastfeeding their infants. In those areas, such as “parts of Germany, Bohemia, Northern Italy, the Austrian Tyrol, Finland, Sweden, Iceland, and Russia,” children were fed with differing combinations of animal milk and cereal paps.(5) Though the colder climates in these areas were more hospitable to storing milk products, the infant mortality rates in these areas appear to have been substantially higher than in the remainder of Europe where breastfeeding was the norm.(6) BREASTFEEDING IN COLONIAL AMERICA As one would expect, breastfeeding practices in the American colonies largely mirrored dominant European practices, particularly those inherited from England. Breastfeeding one’s own children continued to be the norm in the colonies throughout the seventeenth and eighteenth centuries.(7) Certainly, some members of the upper classes followed the European fashion of using wet nurses, but most American mothers, given relatively low rural population densities and the lack of financial wherewithal, did not have this option. Tracking breastfeeding practices in the colonies from the sixteenth to the early parts of the eighteenth century, one can see the way breastfeeding practices are entwined with larger notions of women’s roles as mother and wife. Far from being matters of social indifference, these roles, in turn, are often subsumed under broader notions of the common good and the unique role that women played in operative notions of what constituted that good. Women’s roles, then as now, are often dictated by authorities and experts, typically male, who are determined to govern women’s sexual and reproductive activities. The Puritans, for example, emerged as one of the primary advocates for maternal breastfeeding. Puritan theologians and ministers saw breastfeeding one’s child as part of a mother’s Christian duty to populate the flock for future generations. Those women who avoided breastfeeding were counted, according to Cotton Mather, among those “Careless Women, Living at Ease” who “are Dead while they Live.”(8) These programmatic assertions by social and religious experts remind us that decisions about breastfeeding never occur in a social vacuum. Rather, they tend to emerge within broader narratives about what is proper for women, children, and society as a whole. Presaging the increasing role that medical and scientific expertise have come to play in determining breastfeeding norms, seventeenth century colonial mothers were warned not to breastfeed their children for several days after birth. At the time, many physicians believed that colostrum (the light yellow fluid secreted by mothers before and after birth as a precursor to the production of breast milk) was harmful, perhaps even fatal, for infants. Today, we know that colostrum provides nutrients and antiallergens that protect newborns from disease and infection.(9) It is difficult to know with any precision the degree to which this repeated public advice was heeded by nursing mothers, but, at the very least, this advice suggests that expert, scientific advice, despite its importance, and despite its elevated position in modern societies, is necessarily partial and runs the risk of peremptorily denying the importance of practices developed by women and children themselves in their actual feeding practices. This observation is not meant, in any way, to discredit a scientific approach to breastfeeding. In fact, contemporary breastfeeding advocacy is largely based on the now undeniable avalanche of scientific evidence about the health benefits of breastfeeding for both mother and child, but it does remind us that modern society’s faith in science can be marshaled in ways that deny women their autonomy and which prevent them from making the best feeding choices for their child and themselves. Even during a time where mothers can have greater confidence about an advanced scientific consensus about breastfeeding, that perspective can preclude other dimensions that rational mothers might consider in deciding not to breastfeed. The expectation that colonial wives should be available for their husbands’ sexual gratification often conflicted with their duties to care for their children. On the one hand, this tension can help explain the practice of wet nursing among the economic classes who could afford it. It also gives us some insight into how breastfeeding operated as a form of birth control, delaying the onset of ovulation between 8 to 12 months, thus allowing women a modicum of control over the size of their families. Furthermore, it was the belief of many during this time period that sex during the breastfeeding period was detrimental to the health of the child. From the early colonial period throughout the nineteenth century, the experience of mothering always occurred under the threatening shadow of infant and childhood mortality.(10) Nancy Schrom Dye and Daniel Blake Smith, however, note a change in the way women responded to this ever present threat in the nineteenth century. Early Americans, they claim, expressed “a more passive attitude of Christian resignation,” but, by “the early decades of the nineteenth century, except among evangelical families, Divine Providence was giving way to exalted motherhood in the care and protection of children.”(11) As the modern sensibility that humans could use their reason to successfully respond to the problems of their experience began to take hold in modern cultures, and as the advances of modern medicine began to be felt across society, mothers would increasingly see infant mortality as a problem to which they could successfully respond in this world. THE BREAST AS A SEXUAL OBJECT The historical record also reminds us that women’s decisions to breastfeed are further complicated by their relationships to men. It is worth pausing here to consider the ways in which the breast occupies a fascinating, charged place within our culture. Utilized by Karl Linnaeus in the nineteenth century to demarcate mammals from the rest of the animal kingdom within his taxonomic system, the breast marks that familiar yet unsettling intersection of the human and the animal, the maternal and the sexual. As Londa Schiebinger summarizes its broad range of cultural meanings: Long before Linnaeus, the female breast has been a powerful icon within Western cultures, representing both the sublime and bestial in human nature. The grotesque, withered breasts on witches and devils represented temptations of wanton lust, sins of the flesh, and humanity fallen from paradise. The firm spherical breasts of Aphrodite, the Greek ideal, represented an otherworldly beauty and virginity. In the French Revolution, the bared female breast— embodied in the strident Marianne—became a resilient symbol of freedom. From the multibreasted Diana of Ephesus to the fecund bosomed Nature, the breast symbolized generation, regeneration, and renewal.(12) It is not entirely clear that the erotic role that the breast plays in Western cultures necessarily reflects an intrinsic biological norm. Katherine A. Dettwyler points to studies by C. S. Ford and F. A. Beach that found “only 13 out of 190 cultures report that men view women’s breasts as being related to sexual attractiveness, and only 13 out of 190 cultures report male manipulation Within Western societies, Marilyn Yalom has traced what she sees as a shift from the sacred breast, celebrated in both prehistoric and Christian medieval cultures, to increasingly prevalent representations of an erotic breast beginning in the Renaissance, frankly depicted as the desired object of the male sexual gaze.(15) The idea that the breast can mean different things, or, at the least, that different dimensions of its meaning can be accentuated, during different historical eras seems to reinforce this emphasis on the culturally determined, rather than the biologically based, meaning of the breast. Nonetheless, the tension in which the breast is situated, oscillating in the Western imagination between the maternal and erotic, may not be entirely a matter of shifting cultural attitudes about women and their roles as mothers and sexual objects. Freudian psychoanalysis points to the breast as the original infant fixation, the erogenous focus of the first stage of the child’s sexual development, which eventually progresses toward a fascination with the genitals.(16) Melanie Klein would depart from this Freudian orthodoxy, developing an “object relations theory” that makes the breast the central fixture of the developing psyche.(17)Regardless of the ultimate accuracy of these theories, their general assertion that a child’s original desire for the nourishing breast remains an unconscious tenance of the family.”(22) This valorization of the mother in the United States may shine some light on the different social structure in which nineteenthcentury women faced decisions about how to feed their infant children. Even as urbanization began to bring women closer together, the lack of a firmly estab lished aristocratic class made wet nursing a less common practice than in Europe.23 Furthermore, as Linda Blum suggests, maternal breastfeeding “became almost an emblem of new democratic ideal, as images of ‘nature’ were linked with equality, the rejection of decadent, aristocratic ‘culture,’ and the rising health and wealth of the middle class of the young nation.”24 At the same time, this emerging norm of the good mother who sought to breastfeed her baby was part of a broader effort to police distinctions between the middle class and the lower class of European immigrants who were seen as dirty and whose milk was, therefore, less pure.25 In the South, despite concern about the fitness of black slave women’s milk, up to 20 percent of plantation families used slaves to wet nurse their children.26 The irony, of course, is that black slave women were often denied the ability to nurse and care for their own children.27 That evolving sensibility of the cult of domesticity created a space in which women could realize their agency within the limits of the domestic sphere, but it also entailed a responsibility for the children entrusted in their care.28 In fact, even as the increasing valorization of women reinforced extant norms of mothers breastfeeding their own children, the rise of a scientific world view and the belief that mothers should use the best means possible to optimize the health of their children began to create the antecedents for the precipitous decline of breastfeeding rates in the twentieth century. Spurred by concerns about the ability of mothers to deliver wholesome milk to their infants, by suspicions about the purity of milk from immigrant and slave women available for wet nursing, and by the higher rates of infant mortality associated with cow’s milk and other human milk substitutes, physicians and scientists began experimenting with finding formula substitutes for human breast milk.29 The effects of the industrial and scientific revolutions had an increasing impact on all aspects of mothering during this period, and those changing material realities began to profoundly affect breastfeeding practices in a variety of ways. The organization of economic production around time schedules in the 1800s, for example, introduced a logic of efficiency and mobility that eventually began to colonize child rearing practices.(30) The idea that infants should be fed on a more regular, more efficient schedule worked against practices of feeding on demand, which is requisite for successful breastfeeding. Because breastfeeding is demand driven, feeding according to a schedule “is a particularly efficient way to diminish milk supply,”(31) and it is not surprising that the change to scheduled feedings led to increasing reports that women were having difficulty producing sufficient quantities of milk for the nursing infants.(32,26) Breastfeeding Rights in the United States Riding the wave of momentum created by the women’s suffrage and the settlement house movements during the progressive era,33 the last decades of the nineteenth century and the early decades of the twentieth century witnessed the emergence of women’s voices as a public, political force capable of casting attention on the problem of infant mortality, and middle- and upper-class women began to mother their children in a more openly caring way.34 This new public presence put pressure on the State and the medical community to effectively respond to the infant mortality problem.35 That response, in the early part of the new century, entailed a public health campaign that urged women to breastfeed, but that same campaign also hints about how the increasing medicalization of infant feeding points to alternative feeding methods. We see a fusion here of a norm of good mothering attached to class status coming into contact with the logic of medicalization. As these factors coalesced over the course of the twentieth century, and as they eventually hooked up with women’s entrance into the work force in the latter part of the century and with the increasing commercialization of the erotic breast during the same time period, they had the overall effect of driving down breastfeeding rates in the United States. In fact, breastfeeding rates in the United States have been relatively low over most of the last century,36 fluctuating because of a variety of cultural and economic reasons manifested in the changing nature of expert discourses about mothering and infant feeding. At the beginning of the century, from about 1900 to 1930, it appears that between 85 and 90 percent of mothers breastfed their babies at birth.37 However, feeding cow’s milk or other supplements to infants was considered a major cause of infant mortality and a public health crisis by 1900.38 With the medicalization of pregnancy and childbirth, infant feeding practices also came under medical supervision. As understanding of human nutrition increased and supplies of clean water and pasteurized cow’s milk became abundant, formula feeding increasingly replaced breastfeeding. Consequently, American breastfeeding rates fell, and reached their nadir approximately in the 1970s.39The late part of the nineteenth and early part of the twentieth centuries witnessed an increasing medicalization of childbirth and child rearing practices that have directly impacted norms of infant feeding. For many, this process of medicalization, which saw the male dominated medical profession assume power over decisions about childbirth and child rearing practices, is a fundamental cause of the steady decline of breastfeeding rates throughout most of the twentieth century. As Penny Van Esterik defines this term: Medicalization of infant feeding refers to the expropriation by health professionals of the power of mothers and other caretakers to determine the best feeding patterns of infants for maintaining maximum health. There follows from this definition no judgment as to how medicalization of infant feeding relates to infant morbidity—only an argument that what was in the past largely the concern of mothers and women is increasingly part of the medical domain.40 Van Esterik’s definition captures the reaction against the disempowering, denaturalizing effects on breastfeeding mothers, but, as she points out, it may oversimplify the case on at least two fronts. First, during the early part of the twentieth century, the scientific and medical communities actually advocated breastfeeding in reaction to the number of infant deaths associated with diarrhea caused by unpasteurized and unsanitized cow’s milk.41 As a poster used in this campaign clearly states, “To lessen baby deaths let us have more mother fed babies. You can’t improve on God’s plan. For your baby’s sake—nurse it!”42 Second, the medicalization of childbirth and child rearing began to gain predominance within the ideology and practices of childbirth and child rearing because of its increasingly apparent effectiveness. The fear of infant mortality ceased to be the primary shaping force of mother’s self-understanding by 1920.43 The passage of the Federal Food and Drugs Act in 1906, which gave the Bureau of Chemistry (which later became the Food and Drug Administration) the responsibility of regulating consumable substances,44 and the invention of antibiotics in 1928 were among the achievements and practices that began to change women’s self-understanding of their burden as mothers. These accomplishments in health care were a crucial “post-material” fact that contributed in important ways to the acceptance in the rise of artificial feeding methods through the 1950s and 1960s. The scientific revolution that had led to miraculous achievements in many areas of health care and medicine made a convincing case that women should heed health care professionals’ infant feeding advice. To assert that women’s increasing acceptance of bottle feeding meant that they were being duped would overstate the case. It may be that this consensus was reinforced by the development of vaccination, and medical and sanitation advances, which improved infant mortality rates and, thus, masked the benefits of breastfeeding (including the further reduction of infant mortality at the margins). The increasing medicalization of infant feeding and care was reinforced by the United States’ capitalist economy. On the one hand, women’s increasing participation in the work force (only 19% of women were in the labor force in 1900, while over half of mothers with children under age three were in the labor force by 2002)45 has, over the course of the twentieth century, created a new incentive for women to seek greater flexibility in their feeding options. The greater prosperity enjoyed by many families and women during the twentieth century also gave women the option of being able to afford formula and, thus, made breastfeeding less of an economic necessity. In this context, the discourse of liberal feminism, which seeks to downplay the differences between men and women and to maximize women’s ability to choose public and professional careers, reinforced the attractiveness of bottle feeding. On the other hand, infant feeding research and its application was increasingly funded by formula companies, and by the 1950s, those companies were aggressively promoting their product with aggressive marketing campaigns that courted physicians with junkets and other perks.46 The interrelationship of medicalization and capitalism has tended to normalize our understandings and expectations of what constitutes natural feeding practices, leading to a severe decline in breastfeeding rates, and continues to shape feeding practices even as an increasing understanding of the health benefits of breastfeeding has piled up over the last 30 years.47 LA LECHE LEAGUE AND ITS HEIRS: THE REVOLT AGAINST SCIENTIFIC MOTHERING AND THE RISE OF THE NATURAL MOTHER Against this backdrop of an increasing medicalization of infant feeding practices and its emphasis on formula feeding, some women began to resist the kind of disembodied mothering that these approaches entailed.48 Though this resistance had been simmering throughout the rise of medicalization, it began to gain momentum in 1957. That year, seven Catholic women came together to offer an alternative to the increasingly dominant paradigm of “scientific motherhood.”49 Searching for a name that reflected their philosophical commitment to breastfeeding the group called itself La Leche League after a shrine in St. Augustine, Florida, Nuestra Senora de la Leche y Buen Parto, or “Our Lady of Milk and Good Delivery.”50 From its modest beginnings, La Leche League, now known as La Leche League International (LLLI), has grown into a major international organization that, by the beginning of 2001, was serving 200,000 people every month in 66 countries and responding to breastfeeding questions from an estimated 750,000 American mothers every year.51 LLLI’s publication The Womanly Art of Breastfeeding now boasts a circulation of more than 2.5 million copies and has been published in eight languages and in Braille.52 On its Web page, La Leche League summarizes its core philosophy with the following statements: • Mothering through breastfeeding is the most natural and effective way of understanding and satisfying the needs of the baby. Mother and baby need to be together early and often to establish a satisfying relationship and an adequate milk supply. • In the early years the baby has an intense need to be with his mother which is as basic as his need for food. • Breast milk is the superior infant food. • For the healthy, full-term baby, breast milk is the only food necessary until the baby shows signs of needing solids, about the middle of the fi rst year after birth. • Ideally the breastfeeding relationship will continue until the baby outgrows the need. • Alert and active participation by the mother in childbirth is a help in getting breastfeeding off to a good start. • Breastfeeding is enhanced and the nursing couple sustained by the loving support, help, and companionship of the baby’s father. A father’s unique relationship with his baby is an important element in the child’s development from early infancy. • Good nutrition means eating a well-balanced and varied diet of foods in as close to their natural state as possible. • From infancy on, children need loving guidance which reflects acceptance of their capabilities and sensitivity to their feelings.53 As these statements make clear, the position and activity of pro-breastfeeding groups, such as La Leche League, go beyond the health benefits of breast milk to include a valorization of the bonding contact between the mother and infant, which itself is warmly nested in the nurturing love of the attentive husband and father. By focusing on the bonding effects of the mother–child dyad, this discourse has been able to extol the psychological and emotional benefits that accrue to both the child and the mother. For mothers, this bonding effect can take the form of a renewed appreciation of their own bodies. In fact, many women reported that La Leche League’s celebration of the embodied act of breastfeeding helped them recognize alternatives to the predominant cultural scripts that had previously contoured their understandings of their bodies. One small-breasted La Leche League leader, for example, talked about how this emphasis helped her overcome the denigrating view of her body imposed by male expectations: “I did not feel so good about my body before nursing. I feel my breasts have a use now and I have much more confidence in my body. My breasts are not just there for men!”54 Another mother, Nicole Strickler, enthused, “Overall, I think the nursing relationship has enhanced my sexuality in the sense of making me feel more comfortable and that my body is more valuable and beautiful in a way that I had not realized before.”55 An important dimension of the La Leche League ideology rests on how it connects the practice of breastfeeding to an ethos, to a total way of life, which addresses important questions of meaning and purpose for many of its adherents.56 As Julie DeJager Ward points out, this ideology was crafted, both consciously and unconsciously, by drawing on ideas made current by modern science, the Second Wave of feminism, and the traditions of the Roman Catholic Church.57 As Ward notes, La Leche League, in resisting the medicalization of infant feeding practices, did not reject science. On the contrary, they recognized that “many women who wished to breast-feed did not achieve that wish because they had received poor information from the medical community.”58 One might say that the organization sought to use science and sound medical advice from professionals to save infant feeding patterns from the misguided consensus of the mainstream medical community of the time. Though feminists often criticize La Leche League for its complicity with traditional and, from many feminists’ perspectives, stifling notions about women’s proper role as the good mother, League adherents shared the feminist belief that women need to share information with one another in order to liberate themselves from the misinformation disseminated by a male-dominated culture.59 And though it may be true that La Leche League’s religiously inherited picture of a good mother suggests a traditionalist strain of its ideology, it is also the case that its immense success can be attributed to the way in which it integrates the practice of breastfeeding into a larger philosophy of life emerging across different sites in American culture during the late 1950s and early 1960s. In fact, the amazing success of La Leche League cannot be understood apart from feminist, women-centered celebrations of natural ways of being that began to emerge in the 1960s, and the commitments of La Leche League are undoubtedly part of the broader foci of the natural mothering movements and attachment parenting movements.60 It is not uncommon, in fact, for La Leche League followers to count themselves as adherents of these philosophies, and there is clearly some overlap between “natural mothering” and “attached parenting.” Chris Bobel, in fact, describes “natural mothering” as a way of mothering that emerges at the intersection of the lifestyle choices of the voluntary simplicity, attachment parenting, and cultural, or difference, feminist movements.61 Natural mothers, according to this description, eschew the fast-paced consumerism typifying modern life, seeking instead the voluntary simplicity of living “frugally, rejecting material preoccupations and opting for recycling, bartering, and trading in place of traditional market exchange.”62 In doing so, adherents seek to actively recognize that “individual well-being is entangled with the well-being of society at large.” The respect for the natural world that this mode of living entails spills over into a belief, drawn from the ethos and insights of difference feminism, that women occupy an important, biologically distinct role, that positions them “as nurturing, intuitive, and relationship oriented, regardless of class or race.”63 Often, those traits are assumed to be natural, or essential, though it is not impossible to accentuate those womanly virtues without such an essentializing move. Even if those qualities are culturally and historically conditioned, it could be reasonably argued that they are worth preserving. As advanced by William and Martha Sears, whom Bobel credits with coining the term, attachment parenting entails much that sounds common sensical, such as connecting closely to one’s baby in a way that allows the parent to recognize the child’s needs, but it challenges many norms of mainstream twentieth-century parenting by asking parents to keep their baby wedded to their body in a baby sling and to sleep with their baby. Of course, it also mandates that mothers should breastfeed their babies.64 Moreover, the ultimate success of La Leche League and these corollary movements is grounded in the increasing scientific consensus about the importance of breastfeeding. As Ward points out, for La Leche League founders, “it was the solidity of their scientific knowledge base that grounded the other elements of their philosophy.”65 By the first decade of the twenty-first century, the proclamations of the scientific mainstream have given increasing ballast to advocates’ long-held assertion that “breast is best.” The American Academy of Pediatrics, for example, now states flatly, Human milk is uniquely superior for infant feeding and is species-specific; all substitute feeding options differ markedly from it. The breastfed infant is the reference or normative model against which all alternative feeding methods must be measured with regard to growth, health, development, and all other short- and long-term outcomes.66 The American Dietetic Association takes the position “that exclusive breastfeeding provides optimal nutrition and health protection for the first 6 months of life, and breastfeeding with complementary foods for at least 12 months is the ideal feeding for infants.”67 The strategic plan of the United States Breastfeeding Committee of the Department of Human Health and Services, referencing Healthy People 2010, has set goals for 2010 of 75 percent rate of initiation, 50 percent at 6 months, and 25 percent at 1 year. This enthusiasm for breastfeeding as the optimal form of infant feeding is echoed by the position of the American Medical Association. As these and similar position statements from groups ranging from the Centers for Disease Control and Prevention, to National Organization for Women, to the March of Dimes suggest, La Leche League’s general mission to promote breastfeeding finds ample support from the scientific, medical, and advocacy communities.68 ORGANIZATIONS SUPPORTING BREASTFEEDING WORLD OVER There are many active groups which are active all over the world to protect the rights of the mother and the child or are actively campaigning for education of masses and promotion of breastfeeding. They also serve as monitoring bodies to protest against any product (genetically modified baby food) which has a direct influence over the health of the baby. Baby Feeding Law Group – This group is an alliance of UK organizations functioning for the accomplishment of the International Code of Marketing of Breastmilk Substitutes into UK legislation. It has a member’s listing, information on their actions, and a resource section. Baby Milk Action – This is UK based organization (member of IBFAN) which actively campaigns against inappropriate newborn feeding and negligent marketing. It includes information about their actions, policies, and relevant news articles. Breast Feeding Committee for Canada – This organization is committed to protection, promotion and supporting of breastfeeding as the normal feeding methodology for infants. They are actively involved in the implementation of the Baby-Friendly™ Initiative. The website bears current information about their activities, membership, news-letters and released articles. Breastfeeding Promotion Network of India (BPNI) –This is a national network in India which promotes mother and child healthcare by promoting breastfeeding. The website bears the information, educative training programs, promotions, social draft, and monitoring conformity with legislation. Geneva Infant Feeding Association (GIFA) – This group maintains a citations centre for, and is responsible for coordinating IBFAN groups in Europe; it also is a representative of IBFAN network to government delegation at the United Nations. The website maintains information about their activities and publications. Innocenti Declaration on the Protection, Promotion and Support of Breastfeeding – It is a text of a declaration created and adopted by participants at the WHO/UNICEF policymakers' meeting held at the Spedale degli Innocenti, Florence, Italy, on 30 July-1 August 1990. INFACT Canada – This organization is responsible for protection, support and promotion of breast-feeding in Canada.The website offers information about national actions and international demonstration issues, a news bulletin, press-releases, and resources. International Baby Food Action Network (IBFAN) – This is a world-wide network of organizations working towards the reduction of infant child mortality; promoting breast-feeding and campaigning against negligent and precarious corporate practices. The web-resource includes background on the issue, news, "Code-Watch", resources, and a listing of members. New Zealand Breast Feeding Authority - An alliance of groups working to launch the Baby Friendly Hospital Initiative, and for breastfeeding to become the cultural norm; includes information on their programs, activities, and membership. NAFIA –This is a brief outline of the Nordic Work Group for International Breastfeeding Issues and their activities. Nataional Alliance for Breast-Feeding Advocacy (NABA) – This group is located in the US and is dedicated towards the protection, promotion and support of breastfeeding. The web-URL carries information about their activities, legal issues, news and alerts, and their publications. Third World Network (TWN) - A group with a website report exposing the pressures exerted by multinational corporations on governments in Africa, Asia and S America to undermine the International Code of Marketing of Breastmilk Substitutes. Ted Greiner's Breastfeeding Website - An anthology of Ted Greiner’s papers on different aspects of breastfeeding promotion which also include health and nutritional aspects, the impact of HIV , breastfeeding in developing countries, and the international code for the marketing of breast milk substitutes is present on this URL. World Alliance for Breastfeeding Action (WABA) – Created in 1991 as a global set of connections of organizations and individuals to protect, encourage and support the mothers and childrens’ right to breastfeeding as per the Innocenti Declaration. The website has information about their programs, actions, associates and resources. Monitoring Compliance with the International Code of Marketing of Breastmilk Substitutes in West Africa - A comparative study monitoring compliance with the International Code of Marketing of Breastmilk Substitutes in Togo (with no legislation on the subject) and Burkina Faso (with legislation); published in the British Medical Journal (BMJ). (January 18, 2003) References 1. Patricia Stuart-Macadam, “Biocultural Perspectives on Breastfeeding,” in Breastfeeding:Biocultural Perspectives, ed. Patricia Stuart-Macadam and Katherine A. Dettwyler (New York: Aldine De Gruyter, 1995), 7. 2. Valerie Fildes, “The Culture and Biology of Breastfeeding: An Historical Review of Western Europe,” in Breastfeeding: Biocultural Perspectives, 101–2. 3. Fildes, “The Culture and Biology,” 102. 4. Fildes, “The Culture and Biology,” 102. 5. Fildes, “The Culture and Biology,” 104. 6. Fildes, “The Culture and Biology,” 104. 7. Paula A. Treckel, “Breastfeeding and Maternal Sexuality in Colonial America,” Journal of Interdisciplinary History 20 (1989): 25–51. 8. Treckel, “Breastfeeding,” 32–33. 9. Treckel, “Breastfeeding,” 27. 10. Nancy Schrom Dye and Daniel Blake Smith, “Mother Love and Infant Death, 1750– 1920,” The Journal of American History 73 (1986): 329–53. 11. Dye and Smith, “Mother Love,” 343. 12. Londa Schiebinger, Nature’s Body: Gender in the Making of Modern Science (Boston: Beacon Press, 1993), 53. 13. Katherine A. Dettwyler, “Beauty and the Breast: The Cultural Context of Breastfeeding in the United States,” in Breastfeeding: Biocultural Perspectives, 181. 14. Dettwyler, “Beauty and the Breast,” 171. 15. Marilyn Yalom, A History of the Breast (New York: Ballantine Books, 1997). 16. Yalom, A History, 147–58. 17. Carolyn Latteier, Breasts: The Women’s Perspective on an American Obsession (Binghamton, NY: The Haworth Press, 1998), 61–73. 18. As cited in Rebecca Kukla, “Ethics and Ideology in Breastfeeding Advocacy Campaigns,” Hypatia 21 (2006): 166–67. 19. Kukla, “Ethics and Ideology,” 167. See also Yalom, A History, 254–55, and Latteier, Breasts, 75. 20. Kukla, “Ethics and Ideology.” 21. Lauri Umansky, “Breastfeeding in the 1990s: The Karen Carter Case and the Politics of Maternal Sexuality,” in Bad Mothers: The Politics of Blame in Twentieth Century America, ed. Molly Ladd-Taylor and Lauri Umansky (New York: New York University Press, 1998). 299–309. 22. Rima Apple, Mothers and Medicine: A Social History of Infant Feeding, 1890–1950 (Madison: The University of Wisconsin Press, 1987), 5. 23. Linda Blum, At the Breast, Ideologies of Breastfeeding and Motherhood in the Contemporary United States (Boston: Beacon Press, 1999), 21. 24. Blum, At the Breast, 21. 25. Blum, At the Breast, 21–22. 26. Blum, At the Breast, 22. 27. Blum, in fact, hypothesizes that lower rates of breastfeeding by contemporary black women reflects the indirect effect of this history in which they did not have ownership of their own bodies. This does not, in her view, mean that these women find themselves “deficient.” Rather, she found that “some used humor or irony to criticize the moralism of the ‘natural’ and few used the term positively. After such a long history of oppression justified by their closeness to nature, their primitive, subhuman being, it makes sense that they would wary of such ideologies.”Blum, At the Breast, 13–14. 28. Apple, Mothers and Medicine, 5–6. 29. Apple, Mothers and Medicine, 7. 30. Jacqueline H. Wolfe, “What Feminists Can Do for Breastfeeding and What Breastfeeding Can Do for Feminists,” Signs: Journal of Women in Culture and Society 31 (2006): 397–424. 31. Wolfe, “What Feminists,” 404–5. 32. Wolfe, “What Feminists, 404. 33. For a detailed discussion of the emergent women’s movement during this period, see Barbara Ryan, Feminism and the Women’s Movement: Dynamics of Change in Social Movement Ideology and Activism (New York: Routledge, 1992), 21–38. 34. Ryan, Feminism and the Women’s Movement, 337. 35. Ryan, Feminism and the Women’s Movement, 347. 36. For a discussion see Naomi Baumslag and Dia L. Michels, Milk, Money and Madness: The Culture and Politics of Breastfeeding (Westport, CT: Bergin and Garvey, 1995). 37. Blum, At the Breast, 28. 38. Jacqueline Wolfe, “Low Breastfeeding Rates and Public Health in the United States,” American Journal of Public Health 93 (2003): 2,000–2,010. 39. Gerry E. Hendershoot, “Trends in Breast-Feeding,” Pediatrics 74 (Suppl., 1984): 591–602. 40. Penny Van Esterik, Beyond the Breast—Bottle Controversy (New Brunswick, NJ: Rutgers University Press, 1989), 112. 41. Wolfe, “Low Breastfeeding Rates.” 42. As quoted in Wolfe, “Low Breastfeeding Rates,” 2,000. 43. Dye and Smith, “Mother Love and Infant Death,” 353. 44. John P. Swann, “A History of the FDA,” http://www.fda.gov/oc/history/historoffda/fulltext.html (accessed August 16, 2009). 45. Barbara Downs, “Fertility of American Women: June 2002,” United States Census Bureau, Current Population Survey, http://www.census.gov/prod/2003pubs/p20–548.pdf (accessed August 16, 2009). 46. Wolfe, “What Feminists,” 407. 47. Bernice L. Hausman, Mother’s Milk: Breastfeeding Controversies in American Culture (New York: Routledge, 2003). 48. The notion of the disembodied mother is taken from Blum, At the Breast, 53. 49. Lynn Y. Weiner, “Reconstructing Motherhood: The La Leche League in Postwar America,”The Journal of American History 80 (1994): 1357–81. 50. Wiener, “Reconstructing Motherhood.” See also Christina G. Bobel, “Bounded Liberation: A Focused Study of La Leche League International,” Gender and Society 15 (2001): 130–50. 51. Bobel, “Bounded Liberation,” 131. 52. Bobel, “Bounded Liberation,” 131. 53. La Leche League International, “Our Philosophy,” http://www.lalecheleague.org/ (accessed June 16, 2007). These statements are taken verbatim from LLLI’s Web page. 54. Blum, At the Breast, 72. 55. Blum, At the Breast, 72. 56. Julie DeJager Ward, La Leche League: At the Crossroads of Medicine, Feminism, and Religion (Chapel Hill: The University of North Carolina Press, 2000). 57. Ward, La Leche League, 3. 58. Ward, La Leche League, 3. 59. Ward, La Leche League, 4. 60. See Robert Karen, Becoming Attached: Unfolding the Mystery of the Infant-Mother Bond and Its Impact on Later Life (New York: Warner Books, 1994). 61. Chris Bobel, The Paradox of Natural Mothering (Philadelphia: Temple University Press, 2002), 48–72. 62. Bobel, The Paradox, 49. 63. Bobel, The Paradox, 67. 64. Bobel, The Paradox, 61–62. 65. Ward, La Leche League, 3. 66. American Academy of Pediatrics Work Group on Breastfeeding, “Breastfeeding and the Use of Human Milk,” Pediatrics 100, no. 6 (December 1997): 1035. 67. American Dietetic Association, “Promoting and Supporting Breastfeeding,” http://www. eatright.org/cps/rde/xchag/ada/hs.xsl/advocacy_1728_ENU_HTML.html 68. Katherine R. Shealy and others, The CDC Guide to Breastfeeding Interventions (Atlanta, GA: Centers for Disease Control and Prevention, 2005); American Medical Association, “H-245.982 AMA Support for Breastfeeding,” http://www.anassn.org/apps/pf_new/pf_online?; U.S. Breastfeeding Committee, Breastfeeding in the United States, A National Agenda (Atlanta: U.S. Department of Health and Human Services Centers for Disease Control, 2001); Elizabeth Toledo and Jan Erickson, “NOW Demands Greater Acceptance and Access for Breastfeeding Mothers,” http://www.now.org/nnt/05–98/breastfd.html (accessed 2009-08-19; and March of Dimes, “Breastfeeding,” http://www.marchofdimes.com/pnhec/298_ 1061.asp (accessed August 15, 2009). 69. For a classic statement of the environmental justice ethos, see Robert Bullard, Dumping in Dixie: Race, Class, and Environmental Quality (Boulder: Westview Press, 2000). 70. For a discussion of this tension, see Maia Boswell-Penc, Tainted Milk: Breastmilk, Feminisms,and the Politics of Environmental Degradation (Albany: State University Press of New York, 2006), 6–7. 71. Edith White, Breastfeeding and HIV/AIDS: The Research, the Politics, the Women’s Responses (Jefferson, NC: McFarland and Company, 1999).