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The Work of Breastfeeding

By: Stearns, Cindy A. | Women's Studies Quarterly, Fall 2009 | Article details Save to active project
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The Work of Breastfeeding

Stearns, Cindy A., Women's Studies Quarterly

Breast milk is now the gold standard for infant feeding. The encouragement to breastfeed is consistent in a range of pubUc forums. In the United States, all the major medical and pubUc health organizations are strong promoters of breastfeeding, citing the health benefits to both baby and mother (Kukla 2006) . The American Academy of Pediatrics describes human milk as "uniquely superior for infant feeding" (2005, 1). Recommendations to breastfeed are echoed in popular baby care manuals (Knaak 2005), in a recent Department of Health and Human Services-sponsored advertising campaign (Wolf 2007), and in guideUnes for supplemental government food programs for women and children (USDA 2005) . In line with public health messages about the value of breast milk for babies, breastfeeding is increasingly a symbol and a measure of good mothering in the West (Avishai 2007; Lee 2007). Murphy suggests that by "deciding to formula feed, the woman exposes herself to the charge that she is a 'poor mother' who places her own needs, preferences or convenience over her baby's welfare. By contrast, the 'good mother' is deemed to be one who prioritizes her child's needs even (or perhaps especially) where this entails personal inconvenience or distress" (1999, 187-88). Breastfeeding is thus an integral component of the child-centered and demanding maternal practices inherent in the ideology of intensive mothering (Hays 1996). Lee's recent study of mothers in Great Britain provides clear evidence of this. She describes women's despair when they can't breastfeed and must turn instead to formula and concludes "how good a mother a woman is has come to be measured by whether she breastfeeds" (2007, 1088).

The cultural and medical mandate to breastfeed has important implications for the work of mothering. While often unacknowledged as such, breastfeeding is time- and labor-intensive work and it is work only mothers in families can perform. For example, child care duties such as preparing bottles of infant formula, changing diapers, and doing laundry are activities that can be shared by other members of a household including men and other children. In contrast, producing breast milk is an exclusively maternal body job.1 Some previous work takes note of the maternal effort involved in the doing of breastfeeding (Bartlett 2002; Blum 1999; Kelleher 2006; Shaw 2004; Stearns 1999). However, there has not been a comprehensive exploration of breastfeeding as embodied labor and the impact this may have on women and on the division of labor in families. In a social climate that prioritizes and often valorizes breastfeeding as the gold standard for infant care, the meanings and consequences of the labor of breastfeeding demand closer scrutiny. In this paper I add to our understanding of the embodied dimensions of mothering by exploring breastfeeding as body work through an analysis of in-depth interviews with breastfeeding mothers. The concept of body work refers to "work that individuals undertake on their own bodies and to the paid work performed on the bodies of others" (Gimlin 2007, 365). In recent years, feminists and social scientists have established a growing body of empirical research on both types of body work: the body work of appearance enhancement, including practices such as cosmetic surgery, exercise, and dieting; the body work involved in paid care work of the elderly and infirm; and paid beauty work and aesthetic labor performed by workers in nail and hair salons and retail work (for a review of research in this area, see Gimlin 2007; Wolkowitz 2006). This empirical focus has produced enlightening descriptions of the subjective experience of embodiment and the gendered, racialized, and classed social relations of providing paid services to others' bodies. In the following analysis, I describe both aspects of body work identified above: work on a woman's own breastfeeding body and the unpaid maternal body work of breastfeeding a baby. Furthermore, I explore the potential impact of the body work of breastfeeding on the division of labor in families. METHODS This paper is based on in-depth, open-ended interviews with sixty-six women living in California. The interviews were completed in two stages: fifty-one were interviewed from 1996 to 1998; and in an effort to explore additional issues and verify some findings, fifteen additional women were interviewed from 2005 to 2006. The interviews typically lasted about ninety minutes. A list of topic areas and orienting questions was covered in every interview but the structure of the interview was open and additional topics introduced by the mother were discussed. To ensure a diverse sample in terms of race and class, participants were recruited from various strategic sites, including the federally funded Women, Infants and Children (WIC) program for lowincome mothers, mothers' clubs, a state-funded teen parenting program, breastfeeding support programs, La Leche League, and lactation consultants. A snowball sample was employed, with mothers referring other mothers to the study. The mothers ranged in age from eighteen to fortythree years. Fifty-two percent of the women were first-time mothers. At the time of the interview, 27 percent of the mothers were employed full time, while 29 percent were employed part time, 11 percent were fulltime students, 30 percent were not working, and 3 percent were unable to work because of a disability. The sample is class diverse, as indicated by occupation and household income; it included mothers who were or had been working as physicians, lawyers, teachers, child care providers, retail workers, vineyard workers, bus drivers, and house cleaners and in many other occupations. The sample reflects the primarily Caucasian demographic of the geographic area being studied: 83 percent of the sample self-identified as just white, 11 percent as just Mexican American/

Latina/Spanish/Hispanic and 6 percent as American Indian/Native American/Cherokee and white. Only one interview was not in English (it was conducted in Spanish). Two participants identified as lesbians and three were single mothers. At the time of the interview, 88 percent of the mothers were currendy breastfeeding at least one child and two of these mothers were tandem nursing.The age distribution of the breastfeeding child or child who had most recendy been weaned at the time of the interview is as follows: 9 percent of the children were under the age of 3 months; 32 percent were 3-6 months old; 22 percent were 7-12 months old; 14 percent were 13-18 months old; 12 percent were 19-24 months old; and the remaining 12 percent were over the age of 24 months. In all, the mothers breastfed a total of 108 children, with the youngest child weaned at 1 month and the oldest at 5 years. The women in the sample breastfed longer than the national averages but in line with higher breastfeeding rates in the western United States. Seventy-nine percent of the mothers had breastfeed at least one child for at least six months. All interviews were tape-recorded and transcribed in full. Initial codes were developed through lineby-line open coding of interview transcripts. Key themes (analytic codes) were then identified, developed, and applied to the entire body of interviews. In the following analysis I describe major themes derived from the interview data concerning how mothers describe the physical work involved in breastfeeding, as well as how they feel about that embodied work and its impact on the division of labor in their families. In examining the interview data, I did not find racial or ethnic differences across these themes, which may be due to the preponderance of Caucasians in the study. I also did not find consistent social class differences for any of the dominant themes considered here, although there was substantial class diversity in the sample. There may be racial or ethnic, social class, and other demographic differences, however, and future research with differently constituted groups of participants in other regions may yield different or complementary results.2 BREASTFEEDING AS MATERNAL BODY WORK One dimension of breastfeeding body work is the extent to which women actively engage in body practices related to their work as producers and suppliers of milk. All the mothers in the study report at least a few intentionally altered body practices related to their breastfeeding work. For example, mothers dress differently to be able to breastfeed easily, discreetly, and on demand. Mothers are also mindful of the potential for leaking and manage dieir dress (use of breast pads) and body (timing of breastfeeding) to avoid problems. To produce "quality" milk, mothers continue with prenatal regimens, taking prenatal vitamins and avoiding beverages usually restricted during pregnancy (coffee, wine and other alcoholic drinks) as well as over-thecounter and prescription drugs. In addition, mothers avoid cigarette smoke and "being around chemicals" because they fear that these substances wiU be transferred to the baby through the breast milk. Mothers report that they eat more food while breastfeeding because they require more calories. They increase their fluid intake to remain hydrated and thereby produce more milk. They also eat with greater attention to specific nutritional requirements of the baby. For example, Sylvia, a married, thirty-one-year-old part-time housecleaner and Mexican immigrant describes her dietary work: "I started to eat a lot of peanut butter and I did not like it at all, but I knew that it was for him and for his benefit I would eat it. . . . Now that he is pulling away from breastfeeding, I am starting to eat more vegetables. I love vegetables. I don't like meat. I hardly eat it, but you know I had to eat it for him." In addition, mothers may monitor their diet while breastfeeding because they perceive that their child has a sensitivity to certain foods (e.g., garilc, spices) received through the breast

milk. In sum, in their effort to produce a high-quality, ample, and readily available supply of milk, work on the maternal body is routine for mothers. The other dimension of body work is the work performed on the bodies of others. Although breastfeeding is often described as "natural" in popular discourse, both the mother and the child work at breastfeeding, with the mother often directing the work. Joanie, a white, married, twentyfive -yearold preschool director, describes the complexity of her first efforts to feed: "It was like propping up pillows, sitting up, OK nose, navel, knees; putting her to me; putting it in her mouth; suck, suck, suck. Watching the clock, which you know, you just can't do, I mean, now I know, I don't even look at the clock, she knows when she's done. But before, it was like, OK; oh, it's only been twenty minutes. Have I had milk letdown? Is she dimpilng? Is her bottom lip puiled out? Can she still breathe? Make sure the nose isn't pressed up too much. ... I mean, it was ilke a nightmare." All the mothers in this study reported a learning process at the beginning of breastfeeding their first child and being often surprised that what they beileved was "natural" was in fact a learning project. Early breastfeeding is often marked by smail and large body problems for the mother, including nipple soreness, mastitis, and low milk production (Keileher 2006). Mothers must find ways to persist with the work of breastfeeding while coping with discomfort and pain. They must overcome existing problems or foresee potential problems with each unique child. For example, they learn to place their nipple in the child's mouth and help a child latch on in a manner that produces an effective suck and does no damage to the mother's nipple. Mothers also learn to encourage or delay feedings to ensure maximum production of breast milk and reduce the chances for breast engorgement or leaking. As body workers, mothers must also look for cues in the baby's body for evidence of the success of breastfeeding. Mothers learn to identify a "good," or productive, suck and to observe whether a baby is swailowing while sucking. In the early days mothers count wet diapers or bowel movements as an indication of adequate breastfeeding. In addition, the weight of the baby at medical visits is a measure of the effectiveness of mother's body work. JOYS AND FRUSTRATIONS OF BREASTFEEDING The interviews reveal the emotional challenges and rewards of breastfeeding. Mothers who discover a new "use value" of their breasts as a result of breastfeeding emphasize the satisfaction this provides for them: I enjoy it because it makes me feel good that I can provide for her, you know. It amazes me that my body can actually produce this and support her life. (Betty, age twenty, white, not married or partnered, student) I love the fact that I can look at [kids] and say, you know for the first six months or whatever, that's all they had was breast milk from my body to feed them. That's an amazing thing, it's a miracle, it really is to me. (Nadia, age thirty, Cherokee/white, married, full-time student) Highlighting women's perception of the unfolding abilities of the maternal body, the word "miracle" (above) or "amazing" is employed to describe the ability to use one's body to provide food for a child. This theme of pride and pleasure in the physical production of breast milk is in contrast to research by Dykes (2005) involving mothers of two- to five-day-old infants where she found "the most striking and consistent theme was women's lack of confidence and trust in their ability to produce enough milk or milk of the right quality" (2005, 2287). It may be that the more experienced

breastfeeders in the present study came to value and trust their ability to breastfeed through performing this body work over time. In addition to body appreciation, mothers report that breastfeeding provides a unique emotional connection with a child. It's a closeness. It's something that only I can give her that nobody else, like her dad, or her grandparents, or her aunts and uncles can. Um, it's just something that I just feel that nobody else can give to her but me. (Donna, age forty, white, married, part-time buyer for health food store) I think that it bonds you and the baby a lot closer when you breastfeed because you're a lot closer to the baby. Bottle-fed, you, you know, once they start holding the bottle, you just basically give them the bottle and you're not really there. (Celeste, age forty-one, Mexican American, married, stay-athome mother) Mothers argue that close emotional ties occur through breastfeeding that do not happen through bottle-feeding, especialiy the physical closeness and eye contact with the baby. While mothers point out the joys of breastfeeding (to varying degrees), another prominent theme is the body frustrations involved in breastfeeding. For example, some mothers describe their body work as making them feel like machines, tools or animals: I do like breastfeeding. Sometimes I kind of feel like I'm a machine. (Jackie, age thirty, white, not married/partnered, not working, receiving WIC) Sometimes I feel like a cow. I just feel like a milk machine, but most of the time I realiy enjoy it. (Elien, age thirty-seven, white, married, occasional jobs as house cleaner) Other mothers describe feeling "touched out" by the constant body contact with the child, as in "I have the life sucked out of me," and also a sense of frustration that they can't produce as much milk as required by their alwayshungry baby. Mothers also note the personal restrictions involved in being the sole source of food as weli as the substantial time demands of providing breast milk. It's nice to feel like only I can take care of those specific needs. But it's also much more time consuming than I thought; it's much more tiresome than I ever anticipated. (Joanie, age twenty-five, white, married, preschool director) When you think about this life, this little life that depends on you and only you. I mean it's an amazing responsibility. Particularly when you have a child like mine who was so colicky. ... A lot of people would be flattered that oh, she's such a mommy's girl, but it's like, it's a lot of pressure too - to know that for twenty-four hours a day nobody else can meet her needs. It's mind-blowing when you think about it. (Bella, age thirty-three, white, married, full-time hairdresser) For Bella, the exclusive responsibility of breastfeeding is "wonderful" and a "lot of pressure."The individual responsibility of this form of body work can be perceived as daunting at times. BREASTFEEDING OVER TIME AND THE DIVISION OF LABOR IN FAMILIES

The inherently embodied nature of breastfeeding has implications for how the work of caring for children is distributed in families. At the start, mothers breastfeed very frequently. In the first weeks this means a cycle of about two hours from the beginning of one feeding until the beginning of the next feeding. Frequent feeding is medically recommended and required to build up a mother's milk supply. In addition, other family members cannot provide supplemental botdes of formula or breast milk, because of concern about "nipple confusion." Artificial nipples provide liquid with less work for the baby and it is widely believed that when artificial nipples and bottles are provided too early in the breastfeeding relationship, babies will not develop the oral skills (and perhaps also the motivation) necessary to effectively breastfeed. As long as a botde is not possible fathers and others cannot participate in direct feeding. Typically a botde is not introduced until six weeks or later in a child's life and even then, bottles are often supplementary rather than routine (see discussion below) . Mothers in this study discussed the father's circumscribed role in baby care because of the exclusivity of breastfeeding as well as their beliefs about the short- and long-term consequences of this unequal division of labor. Two main themes emerge from the data concerning the father's role in caring for the breastfed baby: how men miss out because of breastfeeding and how men opt out of baby care and use breastfeeding as an excuse. MEN MISS OUT Mothers note that men "miss out" in not being able to breastfeed. Sam, a thirty-eight-year- old, white, married, part-time college teacher, notes her own sense of being special in an exclusive mother-baby dyad and her beliefs about her husband's less satisfying role: For the first six months especialiy there was something that I could do that no one else in the world could do and it was nice. I felt sort of special that way. And I think my husband who realiy loves children and was excited about having one, felt somewhat shut out of that and a little incapable. You know, he would pick her up and she would continue crying and he would hand her to me and she would immediately be calmer. And I think that was probably a little hard on him. Naomi, a married physician, suggests that breastfeeding was a mixed experience for her, but had a negative effect on her husband's relationship with the baby: That's one down side I think of breastfeeding, it, you know, if I have to be honest. I think it depends on the woman, I think it depends on the man, it depends on how you handle it, but with D [her baby] our relationship was so wrapped up in breastfeeding, he nursed so much, and he was colicky, he was a realiy difficult little infant. . . . Nobody could take care of him except me. ... It was kind of overwhelming for me. On the other hand, it also in a weird way felt good that I was realiy the one who could do it ali. And it realiy kind of turned into a not very good thing between B [her husband] and D ... I think if I had not been nursing, he might have been able to be more involved earlier. (white, age forty-two) According to mothers, the exclusiveness of early breastfeeding can lead fathers to wonder about whether their parenting efforts realiy matter or are noticed. As Alison notes, "I think definitely when Mark was a little younger, he would say,'I wonder if he knows who I am?'" (twenty-sevenyears-old, white, married, stay-at-home mother). Previous research, although not extensive, also suggests a pattern of father involvement that is limited in the early stages of breastfeeding and less satisfying for fathers (Bar- Yam and Darby 1997). MEN OPT OUT

Mothers also describe their partners as using breastfeeding as a defensible excuse to avoid or sidestep a large part of the work of having a baby. When these fathers expressed enjoyment and relief about their avoidance of that demanding work because of "natural" biological differences, mothers expressed irritation. As Sarah reports: The only bad thing about breastfeeding is feellng trapped like you, you know, like you're kind of stuck. Well, I have to breastfeed, so I can't go to this. It's all on me. [For her husband] it's kind of a joke, you know, he'll go, "Oh darn, hon, you have to breastfeed him," with a big smile on his face. And sometimes it does kind of make, you know, when I'm up at three in the morning and he's snoring, you kind of want to throw a little dagger over there, you know, 'cause, you know, you do feel like it's only you. (thirty-one years old, white, married, part-time sixth-grade teacher) Often mothers complain that fathers stopped short in their duties because of a bellef that breastfeeding and nothing else would solve the problem of an unhappy baby. Nadia notes, "He'll say sometimes, 'I've done everything. I've changed him. I've given him a bottle. He wants you, that's the only thing diat's going to make a difference!'" Mothers may perceive that the exclusive motherchild dyad of the early weeks affects the father's role even when the child is no longer breastfeeding. For example, Bonnie describes the longterm impact of the "I can't breastfeed" rationale: "He'd say, 'There's nothing I can do for her. She wants you.' And now he'll still say it and I'm not breastfeeding!" (twenty-seven years old, white, married, stay-at-home mother). Breastfeeding thus became a perceived excuse for longer-term lapses in father care. Mothers report frustration when they belleve fathers are fading to help in ways other than breastfeeding (e.g., holding a baby, offering comfort, changing diapers). Men also opt out by failing to recognize the maternal work involved in breastfeeding. Krista, a thirty- five -year- old, married, stay-at-home mother, describes her husband's lack of knowledge of the baby's sleeping habits: "When he was a week old, some of my mom's friends were asking, 'Does he sleep through the night?' And my husband said, 'Yes, he sleeps through the night! 'And I said, 'No, honey, no - you are sleeping through the night! Mom is still getting up. And he is up every three hours, but you are sleeping through it!'" The exclusivity of the mother-baby relationship in the early weeks can make the body work of breastfeeding invisible to others in the family. BREASTFEEDING THE OLDER BABY As babies get older they usually do not need to be fed as frequently. A typical six-month-old nurses far less frequendy than a six- week-old baby. This reduces the amount of direct breastfeeding that mothers need to do and has the potential to change the distribution of child care duties. As breastfeeding continues with an older child, there is more opportunity for others to provide bottles of stored breast milk or infant formula, as well as solid foods. Yet as long as breastfeeding continues, the maternal body is the source of food and the mother has primary work responsibilities as the producer of that food. THE BREAST PUMP Fifty- nine percent of the mothers in the study used a breast pump to extract and store milk at some point during breastfeeding. Mothers can extract milk by hand; however, it can be difficult to do, and all the mothers relied on a breast pump. Pumping, like breastfeeding, is learned body work and requires the development of skills and techniques, as well as access to a working and adequate breast pump.

Mothers pump their milk so that it will be available to their child when they do not want to feed them from the breast, for whatever reason. Some mothers do not want their child to have infant formula substitute because they view their breast milk as "liquid gold," an extremely valuable and irreplaceable form of nutrition.3 Mothers who work outside the home are the most likely to pump. However, nonworking mothers pump as well. They may want an emergency supply of breast milk for safekeeping in their freezer. They may want breast milk available for the times when they are out shopping, going to the hairstylist, or undergoing medical treatments. Mothers also pump when they are away from their babies for an extended period (a day or more) so that their breast milk production will not lessen or disappear. Pumping is often perceived as challenging by mothers. Similar to the working mothers in Avishai's (2007) study, most mothers found pumping to be time consuming and stressful: It takes longer for me to pump, even though I let down really easily with her nursing, it takes me long, it takes me twenty minutes, it only takes me ten minutes to nurse her. (Millie, age thirty-one, white, married, not working) It's not worth the time. I'd rather keep her close to me. So we just carried her everywhere. (Miranda, age thirty-two, white, married, part-time bookkeeper) Pumping breast milk for future use must be fit in alongside the regular direct feeding of a child. When children nurse several times a day, it can be difficult to produce the extra milk necessary to pump. If a woman gets only an ounce when she pumps, she may not view the time and energy required from her as "worth it" and may decide to pump infrequently, as did Miranda (above) . Glenda, a thirty- five- year-old, white, married mother who edits books from home, also describes her decision not to pump in terms of these costs: I also felt my time is so valuable. I mean every moment that she's asleep I'm working and so to take the time off to do that which was taking me, it took me half an hour to get Uke two ounces. This is not worth my time, that's billable time and I don't want to sit here and be doing this when I could be working, which is much more pleasurable to me than this and earns money, so it was a decision I made because of my work situation. If a woman chooses not to pump, she wiU continue to be responsible for the work of direct breastfeeding. Another consequence is less opportunity for others to botde-feed their babies. FATHERS BOTTLE-FEEDING Pumping has the potential to aUow more baby care to be shared. However, in this study, mothers who did not work outside the home typicaUy pumped infrequently. Mothers who worked outside the home often reserved the pumped milk for the day care provider and breastfed the child directly when at home. This means that for mothers who breastfeed, whether they work outside the home or not, opportunities for father involvement in bottlefeeding are often not part of a daily routine. Mothers often report that fathers enjoy being able to feed their child a bottle and that it was an important way that fathers could create a positive bond with the child. Christine, a thirty-six- yearold, white, married, stayat-home mother, says, "That's their biggest need, is to be fed. And for the mother to be the only one to be able to do that, so I think it was reaUy nice when I did start pumping that he was able to do that for him also. I think that for a woman who chose to formula feed right from the start than that might be nice for the father to be able to do that." As noted earlier,

feeding may be perceived as one of the most nurturing and gratifying aspect of baby care and fathers may be perceived as "missing out" on a special bond. In several cases, mothers described their partner's desire to have a more active role in infant feeding. Mary, a twenty-six- year-old, white, married student teacher, speculates: "Maybe part of the reason he realiy wanted Z [her baby] to be weaned was . . . he's very jealous ofthat bond, that closeness and he realiy wanted to be able to feed him and I didn't even try pumping my milk until Z was a couple of months old." Another mother describes how the father emulates breastfeeding when providing their daughter a bottle. Jackie describes a situation she found unusual:"When I pump milk he'li feed her a milk bottle, just because he wants that bond. He even takes off his shirt and wili feed her a milk bottle that way, so she can smeli him. I thought that was kind of interesting. I'd never heard of a man doing that. . . .And he'd say, 'Weli you know, I want her to get used to me and to know me and my smeli and I want that.' It's not just women who want the body-to-body contact." In this case, breastfeeding is the key reference for the style and form of this father's bottle-feeding. BREASTFEEDING AND EGALITARIAN PARENTING More than three-quarters of the mothers in the study expressed concern with issues of gender equality in child care. As indicated in several examples above, many mothers explicidy or implicitly also recognize that breastfeeding affected the balance of work and power in child care. Some mothers indicate that breastfeeding gives them greater authority over child rearing and they enjoyed this role. Carrie describes how breastfeeding has given her dominance over not just how her child is fed, but also die entire house:"It's like I am the ultimate god of how this household is ran because I am the life of B [her baby], you know what I mean? . . . It's another way of controliing, just by breastfeeding. It probably is, because if he were formula fed I could only be a 50/50 in that one. You know what I mean?" (age thirty, white, married, stay-at-home mother). While breastfeeding can increase a feeling of control or power over the home for the mother, it may come with a price of embodied and exclusive maternal labor. Some mothers imagine how equality in child rearing might be different if the baby were bottle-fed rather than breastfed. Sam describes her brother and his wife, who have always bottle-fed their child infant formula:"! always kind of look at it and think well, that is interesting, they didn't breastfeed and there seems to be more equality in the child and who she looks for." While some mothers wonder or perhaps fantasize about whether bottle-feeding would have led to more help from the fathers, other mothers note that it is the characteristics and motivation of the father that matter, not the breast or botde. Jasmine believes that her husband is highly involved and when asked whether bottle-feeding would have made a difference in his participation, responds, "Not with him. He's incredibly nurturing and, I mean, he's just great with kids. It's not like I breastfeed and held on to this kid all day. I can hand him right over and he will change the diapers, he does clothes, he does all of it. He walked around just as much at night as I did with a colicky baby." The interview data suggests that egalitarian parenting from the maternal point of view requires fathers who are willing to find ways to fit into the embodied requirements of breastfeeding, actively helping the mother and baby in all the ways they could, depending in part on the age of the baby. In this study, mothers describe some fathers who were eager to help and were effective at doing so, fathers who were eager to be involved but less effective, fathers who became more involved as the child got older, and fathers who seemed content to be left out. The themes identified here suggest a need for additional empirical research focusing on both mothers' and their partners' ideas about and experiences of living and sharing child care work in a breastfeeding family over time.

THINKING ABOUT BREASTFEEDING AS WORK As these mothers' accounts make clear, breastfeeding, especially in the early months, is timeconsuming and labor-intensive maternal body work. Mothers report that breastfeeding can be both an enjoyable and demanding part of the work of being a mother. This work can sometimes seem overwhelming because it cannot be easily shared, while at other times it can provide an exclusive connection to the baby that is perceived as rewarding and also empowering in family relationships. Mothers portray the demands on their body and their time posed by the body work of breastfeeding as simultaneously amazing, miraculous, enjoyable, exhausting, and demanding. In contrast to mothers' descriptions of the embodied labor involved in breastfeeding, in the popular press, breastfeeding seems to happen simply because women's bodies have that capacity. Breast milk is commonly understood as "nature's gift" to the infant rather than as the product of mothers' embodied labor. Breastfeeding may lack public visibility as work in part because of the context for the performance of breastfeeding. In a previous article I argue that because breasts are sexualized in the larger culture, the performance of breastfeeding becomes tricky for mothers to manage (Stearns 1999). Some mothers breastfeed more at home or learn to breastfeed discreetly in public to avoid any possible awkward situations or negative feedback from onlookers. To the extent that breastfeeding is performed discreetly or is hidden, this maternal body work is invisible. The body work of breastfeeding is not only hidden from popular view, it is also largely missing from feminist research and theory. The lived perspective of the embodied worker is lacking in empirical studies of breastfeeding and of early mothering. In a qualitative study of the physical challenges involved in early breastfeeding experiences, Kelleher argues, "For the most part, feminist discussion of breastfeeding offers very little explicit consideration of the physical challenges associated with breastfeeding - challenges that can only be fully understood by accounting for women's lived experiences" (2006, 2729). Similarly, Hausman reflects on the feminist politics of breastfeeding and urges an embodied perspective: "While we know that mothering as an activity is not limited to biological birth mothers and lactating women, when we ignore the specificity of these embodied activities of maternity we have difficulty seeing how maternity is, for most women, a profoundly embodied experience" (2004, 276). The lack of focus on the embodied activities of motherhood may reflect a larger trend in feminist body theory that prioritizes reading the body as a cultural text and emphasizing the body not as fixed (especially in terms of gender) but as in flux. As Davis notes, "There seems to be an absence of bodies in contemporary feminist body theory that can be touched, smelled, tasted, or perceived .... Ultimately, the focus seems to be upon the surface of the body and on how culture becomes imprinted upon it" (2007, 54). Davis offers a compelling argument that a theoretical focus on the surface of the body should not supplant phenomenological explorations of the experience of lived embodiment. A focus on breastfeeding and other embodied labor performed by mothers (pregnancy, carework, and so on) is a necessary component of any larger analysis of contemporary mothering ideologies and practices, including the effects of maternal ideologies that equate "good" mothering with breastfeeding. This analytic focus seems especialiy relevant as medical and public health authorities promote increasingly longer periods of exclusive breastfeeding as essential for optimal infant health (American Academy of Pediatrics 2005) . Without a clear focus on the actual lived and embodied work of breastfeeding in empirical research, we run the risk of aliowing the intense and sometimes demanding physical and emotional labor performed by maternal body workers to remain invisible

and unexamined. We also miss an opportunity to more closely focus on the unique and understudied implications of breastfeeding for sharing the work of child care with others in the family. Finaliy, failing to explore the body work of doing breastfeeding is to assume and encourage the notion that breastfeeding is effortless and occurs naturaliy from maternal bodies. Breastfeeding is work and the body workers who do the breastfeeding merit greater public and research attention. ACKNOWLEDGMENTS The School of Social Sciences and the Research, Scholarship, and Creative Activity Program (RSCAP) at Sonoma State liniversity provided important financial support for this project. I am grateful to the mothers who participated in this study and to my student research assistants for help with this project: Sandi Davis, Elien Heimann-Suliivan, Colieen Rodriguez, and Ali eia Diaz Said. NOTES 1. It is possible to purchase breast milk from milk banks or through private arrangements, although it is expensive and uncommon to do so. It's also possible (with medical intervention and hard work) for nonbirrh mothers to produce breast milk, although production is rarely large enough to provide complete infant nutrition. The most common situation is for the mother who gave birth to provide that child with breast milk, and I explore this situation here. 2. Additional points of potential difference in the interviews are sexuality and marital status. Although I only have a small sample of lesbians or single moms, I found no apparent differences among mothers in analyzing the data for the section "Breastfeeding as Maternal Body work." I explore heterosexual couples living together only in the section "Breastfeeding over Time and the Division of Labor in Families" because of the limitations of the sample. The division of labor in a wider variety of breastfeeding families merits future research attention. 3. See Stearns forthcoming for an extended discussion of the data concerning breast pumping and the value of breast milk. [Reference] WORKS CITED American Academy of Pediatrics. 2005. "Policy Statement, Section on Breastfeeding: Breastfeeding and the Use of Human Milk." Pediatrics 115(2): 496-506. Avishai, Orit. 2007. "Managing the Lactating Body:The Breastfeeding Project and Privileged Motherhood." Qualitative Sociology 30:135-52. Bartlett, Alison. 2002. "Breastfeeding as Headwork: Corporeal Feminism and Meanings for Breastfeeding." Women's Studies International Forum 25(3) :37 3- 82. Bar-Yam, Naomi Bromberg, and Lori Darby. 1997. "Fathers and Breastfeeding: A Review of the Literature." Journal of Human Lactation 13(1) :45-50. Blum, Linda. 1999. At The Breast: Ideologies of Breastfeeding and Motherhood in the Contemporary United States. Boston: Beacon Press.

Davis, Kathy. 2007. "Reclaiming Women's Bodies: Colonialist Trope or Critical Epistemology?" In Embodying Sociology: Retrospect, Progress and Prospects, ed. C. Shilling. Maiden, Mass.: Blackwell Press. Dykes, Fiona. 2005. "'Supply' and 'Demand': Breastfeeding as Labour." Social Science & Medicine 60:2283-93. Gimlin, Debra. 2007." What Is 'Body Work'? A Review of the Literature." Sociology Compass 1(1):353-70. Hausman, Bernice L. 2004. "The Feminist Politics of Breastfeeding." Australian Feminist Studies 19(45) :273-85. Hays, Sharon. 1996. The Cultural Contradictions of Motherhood. New Haven: Yale University Press. Kelleher, Christa M. 2006. "The Physical Challenges of Early Breastfeeding." Social Science and Medicine 63:2727-38. Knaak, Stephanie. 2005. "Breast- Feeding, Botde-Feeding, and Dr. Spock:The Shifting Context of Choice." Canadian Review of Sociology and Anthropology 42(2): 197- 216. Kukla, Rebecca. 2006. "Ethics and Ideology in Breastfeeding Advocacy Campaigns." Hypatia 21(1): 157-80. Lee, Bilie. 2007. "Health, Morality, and Infant Feeding: British Mothers' Experiences of Formula Use in the Early Weeks ." Sociology of Health andlllness 29:107-1090. Murphy, Elizabeth. 1999. '"Breast Is Best': Infant Feeding Decisions and Maternal Deviance." Sociology of Health andlllness 21(2):187-208. Shaw, Rhonda. 2004. "The Virtues of Cross-Nursing and the 'Yuk Factor.'" Australian Feminist Studies 19(45):287-99 . Stearns, Cindy A. 1999. "Breastfeeding and the Good Maternal Body." Gender & Society 13(3): 308-25. _____. Forthcoming. "The Breast Pump." In Giving Breast Milk, ed. R. Shaw and A. Bardett. Toronto, Ontario: Demeter Press. USDA, Food and Nutrition Service. 2005. USDA National Breastfeeding Promotion Campaign, http://www.fhs.usda.gov/wic/Breastfeeding/lovingsupport.htm. Wolf, Joan B. 2007."Is Breast Really Best? Risk and Total Motherhood in the National Breastfeeding Awareness Campaign." Journal of Health Politics, Policy and Law 32(4):595-636. Wolkowitz, Carol. 2006. Bodies at Work. London: Sage. [Author Affiliation]

CINDY A. STEARNS is professor of sociology at Sonoma State University. Previously she served as professor and chair of women's and gender studies at Sonoma State. She teaches courses about research methods, gender, the body, and the sociology of reproduction and has pubUshed articles on breastfeeding, medical work, and other topics. Select text to: Select text to:

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Learn more Close Don't show this again Questia, a part of Gale, Cengage Learning. www.questia.com Publication information: Article title: The Work of Breastfeeding. Contributors: Stearns, Cindy A. - Author. Journal title: Women's Studies Quarterly. Volume: 37. Issue: 3/4 Publication date: Fall 2009. Page number: 63+. Feminist Press Spring 2007. Provided by ProQuest LLC. All Rights Reserved.