2016 - Issue Four

The Sustaining Gaze: Mother’s Milk

Mary Shivanandan Download Article

Palmer, Gabrielle, The Politics of Breastfeeding (London, UK: Pandora Press, 1993).

Martucci, Jessica, Back to the Breast: Natural Motherhood and Breastfeeding in America (Chicago: University of Chicago Press, 2015).

Kippley, Sheila M., Breastfeeding and Catholic Motherhood: God’s Plan for You and Your Baby (Manchester, NH: Sophia Institute Press, 2005).

Breastfeeding and the Environment

Both Pope Benedict XVI and Pope Francis have made strong statements on the threat to the environment as well as to human society from a consumerist mentality, from the politics of waste to the degradation of the human condition. Both refer to a “human ecology” which is a necessary counterpoint to concern for the natural environment. So Pope Francis affirms: “If everything is related, then the health of a society’s institutions has consequences for the environment and the quality of human life” (Laudato Si’, 142). For as Pope Benedict says, quoted by Pope Francis, “man too has a nature that he must respect and cannot manipulate” (LS, 155). This nature is expressed in our bodies. “Learning to accept our body, to care for it and to respect its full meaning is an essential element of a genuine human ecology” (LS, 155). In Caritas in veritate, Pope Benedict refers especially to issues of conception, gestation and birth.

The book of nature is one and indivisible: it takes in not only the environment but also life, sexuality, marriage, the family, social relations, in a word integral human development. Our duties towards the environment are linked to our duties towards the human person, considered in himself and in relation to others. (CV, 51)

What is surprising, then, is that neither in Caritas in veritate nor in Laudato Si’ is there mention of breastfeeding with its contributions on the material level to the prevention of waste from plastic bottles, and on the human level to the bonding of mother and child at the heart of the family.

Fortunately, there are voices who address this lacuna. They are the recent The Politics of Breastfeeding by Gabrielle Palmer,[1] Back to the Breast: Natural Motherhood and Breastfeeding in America by Jessica Martucci, and the classic Breastfeeding and Catholic Motherhood: God’s Plan for You and Your Baby by Sheila M. Kippley.

Gabrielle Palmer

Palmer ends her book on a pessimistic note:

The hardest thing about writing this book has been coping with my own despair as I confront the facts of human ‘progress.’ It is not simply breastfeeding that is destroyed before it has even begun to flow, but oxygen-giving, climate-maintaining forests, the food abundant sea and the fertile earth. All the wealth, beauty and resilience that nature has provided for so long is being damaged irretrievably. (302)

What is Palmer’s evidence for this state of affairs? She asserts that 3,000 babies die daily from bottle feeding. From the mid-19th century when milk substitutes were discovered, bottle feeding gradually came into its own. It was fueled by the industrial revolution, which saw many rural families migrate to the cities to work in factories. It was also advanced by technological innovation, which created a surplus of cow’s milk and its pasteurization. The wealthier classes had always resorted to wet nurses, but this was the first time breast milk even of wet nurses became unnecessary. Palmer devotes a section to profits from bottle feeding. In 1991, it was estimated that “US $7 billion worth of baby milk is sold each year, which is around US $19 million or 380,000 tins a day” (24). That was expected to reach US $20.2 billion by 2010. Four hundred and fifty million tins of formula are needed to feed 3 million babies bottled formula, resulting in 70,000 tons of metal, which are not adequately recycled in developing countries. While commercial entities are the main beneficiaries of the profits, Palmer charges that doctors and nutritionists are also investors. “A baby milk market was created in the late nineteenth and early twentieth century, and was conceived through the mutual attraction of the manufacturers and the doctors” (199). It followed the move from home to hospital births. As we shall see in reviewing Martucci’s book, bottle feeding provides nurses, doctors and hospitals much more control.

Palmer gives the case for breastfeeding forcefully. Not only does breastfeeding, which provides a period of amenorrhea after birth,

prevent more births worldwide than all other forms of contraception . . . what is clear is that the West’s export and promotion of artificial baby foods, together with the grosser errors in infant feeding techniques disseminated by health workers, have had a serious effect on birth spacing, which is a key factor in both demographic trends and in the well-being of individual women. (106)

Breastmilk, furthermore, provides all the nutrients necessary for infant growth and health. It contains anti-infective properties and changes according to the needs of the infant. In fact, no supplemental foods are necessary for six months. Breastfeeding also provides psychological and emotional benefits. It is the act of breastfeeding not the breast milk per se that provides the closeness between mother and baby.

Why then did women give up what was best for both mother and child? With the advent of bottle feeding and the medicalization of birth, women lost confidence in their own bodies. Palmer views such abandonment as not truly serving women’s freedom and links it to relations between men and women. Men have been known to forbid their wives to breastfeed. Palmer writes that “A lot of honest men admit they are jealous of breastfeeding babies and their mothers; it is something that men cannot do and it makes them feel excluded” (84). At the same time, work became separated from the home with industrialization and women reacted to this apartheid. Palmer calls this separation “abnormal” and points out that it has not always been so in the West and neither is it in much of the developing world.

Palmer’s book touches on many of the vital links between breastfeeding and a human ecology: the waste of a valuable resource, the pollution of the environment when plastic bottles and tins are not adequately recycled, the reduction of the mother-child bond, the loss of women’s confidence in their bodies, the separation of work and motherhood and the aggravation of demographic issues by the loss of amenorrhea due to breastfeeding. It remains for Jessica Martucci to show how the compromise that has been reached in the United States—that is, a return to breastfeeding and, at the same time, widespread resort to breast pumping—is not truly a human ecology. This is because breastfeeding (vs. pumping) is holistic and a split between the material aspect of breast milk and bonding is no real solution.

Jessica Martucci

Right at the beginning, Jessica Martucci lays out her perspective: “The history behind breastfeeding’s return reveals the important intersection between the experiential knowledge of mothers and the scientific expertise of professionals in the medical and human sciences” (3). She then refers to an “ideology” of natural motherhood which is constructed around “a new understanding of nature, one built around a science of instinct, evolutionary principles and a revolving consciousness of the relationship between the natural world and that of humans, particularly women” (3). In other words we are talking about an Enlightenment anthropology, in which nature is malleable and not the creation of a loving God ordered to communion. Martucci, who subscribes to this anthropology, notes that this “ideology” of motherhood is linked with the burgeoning environmentalist and feminist movements (including its lesbian strains). She recalls the return to breastfeeding as both the path to female pride and its Achilles’ heel since the rise in breastfeeding coincided with a conservative critique of women’s place outside the home. The breast pump was promoted to working women so that “‘I’m breastfeeding’ came to mean ‘I’m breast pumping’” (5). In fact, she charges that “feminist ambivalence over how to deal with breastfeeding ironically helped entrench natural motherhood with conservative arguments in favor of ‘traditional’ family values” (8).

In the late 1930s and 1940s bottle feeding was the norm. It was only in 1956 that a group of middle class Catholic mothers in a suburb of Chicago founded La Leche League in support of breastfeeding. In the 1970s, breastfeeding caught the attention of feminists and the “ideology” of “natural motherhood” was born. The next chapter title refers to “The Death of the Moral Mother and the Rise of the Biological ‘Mom’” (17). As Martucci chronicles, natural biological motherhood is in direct conflict with feminist ideals such as promoting women’s work outside the home, childcare and reproductive rights. Postwar research by Bowlby underscored the importance of having a loving consistent female caregiver, preferably the mother, looking after the child. There was much discussion of maternal deprivation, not just in orphanages. The initiation of breastfeeding rose from 22% in the 1970s to 60% in 1984. Women found they enjoyed breastfeeding. In fact, research by Niles Newton showed that the same pleasure is activated in breastfeeding as in conjugal intercourse. Added to this was the growing interest in ecology; although the disputed charge of contamination of breast milk from toxins in the environment favored homogenized cow’s milk that harbored fewer toxins. Yet “Despite its faltering start, “[B]reastfeeding would emerge again as a central, if not highly contested, component of maternal identity by the turn of the century” (138‒39).

The return to breastfeeding meant that power relations within the family were affected. Breastfeeding encouraged a particular kind of family. Although it was traditional with the mother at home, husbands were called upon to help out. In the postwar U.S., Martucci notes, the husband/wife relation gradually came to have an overemphasis on conjugal intercourse such that the breast was eroticized more than in other eras. Putting the baby to the breast upset this postwar order.

An important part of Martucci’s book is her discussion of the emergence of “scientific motherhood” which began to flourish at the mid-point of the last century. Martucci describes “scientific motherhood” as encompassing “an interventionist, medical and technology driven model of maternal and childcare that rested upon the expertise of scientifically trained professionals as authorities and guides” (59). In that context, doctors who favored breastfeeding were up against the reality that it required individualized care, which scientific medicine was ill-equipped to provide. Pediatricians and general practitioners were more comfortable with the control bottle feeding provided; mixing formulas was considered a science while breastfeeding was an art requiring “tactile knowledge and the cultivation of bodily intuition” (80). The La Leche League had a major goal of winning over the medical and nursing profession. The League actively campaigned to overcome the resistance of doctors and especially nurses, whose routine was interrupted by the nursing mother. Eventually many nurses, who had breastfed their own children, tried to influence their own profession by encouraging rooming-in practices in hospitals.

Personal experience was an important factor in affecting how nurses responded to the breastfeeding mother. Indeed, as Martucci notes, “breastfeeding offered nurses the opportunity for greater professional authority” (128), this could be, for example, by becoming a lactation consultant. This new authority, however, eventually came at the expense of the mother-baby bond. By the 1980s, the new profession of lactation consultant relied heavily on breast pumps. Lactation consultants formed their own organization, the International Lactation Consultant Association (ILCA). At first relations between this new group and the older La Leche League  were friendly and cooperative, but “territorialism quickly acted to distance ILCA’s professionals from LLLI’s lay people” (190), who thought that “‘the baby is the very best ‘pump’”(188). The ILCA rejected the “traditional motherhood” philosophy of LLLI, which they considered “rigid,” opting instead for “cultural motherhood.” Eventually the lactation consultant came to view the breast pump as “the most natural alternative to breastfeeding” (195). This created a new market for breast pumps. The lactation consultant became identified with breast pump technology.

In 1984 the US Surgeon General C. Everett Koop promoted research on the benefits of breastfeeding, which drew in the American Association of Pediatrics and other medical associations. Since that time, breastfeeding has become increasingly acceptable among both mothers and members of the medical profession. However, coupled with “scientific motherhood,” this new acceptance was focused almost exclusively on the nutritional benefits of breastfeeding and not the bonding benefits. As one commentator, who remarked on the plethora of articles on lactation appearing in professional journals, noted: “If one categorizes these articles by topic, it is clear that the larger group focuses on breastmilk as a product” (196‒97). Palmer “overtly linked the use of breastfeeding technologies with a process of medicalization and ‘the destruction of knowledge that was common to all’” (197). This brings us to the book by Sheila Kippley, Breastfeeding and Catholic Motherhood: God’s Plan for You and Your Baby.

Sheila Kippley

In the introduction of her book, Sheila Kippley says that it is addressed to Catholics and that she hopes “to show how breastfeeding is an integral part of the vocation of Christian motherhood” (xi). She goes on: “the mother makes a covenant with, or unspoken commitment to her baby through the devoted task of breastfeeding him over a period of time” (xii). The book begins with the emphasis on the health benefits of breastfeeding for both mother and baby following from three key principles: on-demand, exclusive breastfeeding for six months, ecological breastfeeding for at least one year, and mother’s consistent loving care. Kippley notes that this requires a mother to be at home, which in Western industrialized nations is practically “heroic,” as John Paul II had said. But, she insists, it is during these early years that a child develops the capacity to trust. Chapter Four shows how breastfeeding is a continuation of pregnancy and in Chapter Five, Kippley compares physical and psychological aspects of breastfeeding to the marriage act: “The woman offers her body to her husband in the marriage act and to her baby in the breastfeeding act” (47). Following John Paul II, she finds in both the union of two orders, the order of nature and the order of the person. In both acts the woman is making a gift of self. Chapter Six links what she calls ecological breastfeeding (i.e., exclusive breastfeeding for the first six months) to natural conception regulation. (Kippley distinguishes between cultural breastfeeding, exclusive and ecological. Only ecological breastfeeding provides amenorrhea beyond six months.) Together with her husband John, Sheila has been a pioneer in the sympto-thermal method of natural family planning. Since ecological breastfeeding provides a period of amenorrhea, they classify it as one of the two methods of birth spacing, with breastfeeding being the primary method.

Concluding Thoughts

This brings us to final thoughts on the comparison between the acceptance by the medical profession of both breastfeeding and natural conception regulation. It would seem from Jessica Martucci’s book that a compromise was reached endorsing breastmilk as a product which could be delivered in a technological way via breast pump, thus allowing control by the medical profession, including nurses and the new profession of lactation consultants. This compromise also solves the problem of mothers with infants who work outside the home. In contrast, the largely lay, experiential La Leche League, founded originally by Catholic mothers, favors what is seen in the secular world as an “ideology” of natural motherhood. This half-way return to breastfeeding, as outlined by Martucci, was rightly rejected by the La Leche League, which understood that breastmilk alone wasn’t sufficient for infant or maternal well-being; rather, the bonding arising uniquely from breastfeeding and natural mothering was crucial to the well-being of both mother and child.

Many of the same issues spoken of here can be seen in the practice of natural family planning (NFP). In fact, as Martucci points out, the breastfeeding mother upends the modern focus on the conjugal relation. By becoming a producer not a consumer, the breastfeeding mother also gains more salience in the family. In responsible parenthood—which involves the practice of NFP, the focus also changes so that a real partnership can develop between husband and wife, with the woman affirmed as a person by her husband’s willingness to forego intercourse temporarily for the good of his wife and children. Ultimately, both NFP and breastfeeding are ordered to communion. But these psychological and even spiritual benefits cannot be brought about by a strictly medical approach. If natural family planning is valued simply for being a form of family planning without drugs or devices, it is in danger of becoming a “product” with the additional use of drugs or devices during the period of abstinence. In other words it loses its value as a family and community building method.

All three books show the benefits and challenges of breastfeeding for a true human ecology, which society as well as the Church have yet to take fully into account.

[1] Pages in this article are referenced from the second edition, published by Pandora Press (London, UK) in 1993. A newer revised edition was published by Pinter and Martin (London, UK: 2009) as The Politics of Breastfeeding: When Breasts are Bad for Business. This revised edition gives credit to those who are seeking to remedy the situation, particularly through various declarations and documents of support.

Mary Shivanandan has retired as Professor of Theology at the Pontifical John Paul II Institute for Studies on Marriage and Family, and is the author of Crossing the Threshold of Love: A New Vision of Marriage in the Light of John Paul II’s Anthropology (Catholic University Press).