Beruflich Dokumente
Kultur Dokumente
Letter
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Kaitlin H. Drouin
Department of Anthropology, Binghamton University
Abstract
While it is accepted within evolutionary studies that social support and social techniquelearning are uniquely essential to breastfeeding in humans, public health campaigns
continue to draw on medical research to develop agendas that focus on individual
responsibility. The messages and actions of these agendas simultaneously medicalize
breastfeeding while enacting a nature/culture dichotomy. This paper utilizes historical
accounts, evolutionary evidence, and feminist critiques of breastfeeding advocacy
approaches to expose the ideologies behind these agendas. It will also address how an
evolutionary context provides support for a feminist approach to breastfeeding advocacy
and how feminism can, in turn, equip researchers with the tools to examine the
evolutionary basis for human behavior within contemporary social constraints. When
analyzed, evolution and feminism emerge as complementary components to a more
holistic view of maternal breastfeeding behavior and social support.
Keywords: Breastfeeding, human evolution, lactation, evolutionary psychology,
feminism, situated knowledge, social support, social learning, breastfeeding advocacy
Introduction
Mounting medical and scientific evidence directly implicates breastfeeding in
numerous beneficial health outcomes for both mother and child. Studies showing strong
correlations between breastfeeding and a reduction in both chronic diseases (e.g. Ip et al.,
2007) and infectious diseases (e.g. Ladomenou et al., 2010) assure its place as a key
public health issue. This research has been frequently referenced in breastfeeding
advocacy efforts (Hausman, 2012; Wolf, 2007) to increase exclusive breastfeeding rates,
and it fuels breastfeeding activism by garnering the attention and funding of various
organizations (CDC, WHO, Unicef, and others). Although exclusive breastfeeding rates
have been on the rise in western countries (76.9% and 81% initiation rates in the US and
UK respectively), they have failed to reach rates observed in non-Western countries
only 16.3% in the US and 1% in the UK were exclusively breastfed at 6 months (Centers
for Disease Control and Prevention, 2012, Health and Social Care Information Centre,
2012). In comparison, 2011 rates of exclusive breastfeeding up to age 6 months in
AUTHOR NOTE: Direct correspondence to Kaitlin H. Drouin, Department of Anthropology,
Binghamton University, P.O. Box 6000, Binghamton, NY 13902. Email:
kdrouin1@binghamton.edu
2013 Journal of Social, Evolutionary, and Cultural Psychology
326
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This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
developing nations such as Cambodia (74%), Malawi (72%), and Rwanda (85%) far
exceed their Western counterparts (Unicef Child Info, 2012). While it has been
demonstrated that mothers are more likely to intend to exclusively breastfeed if they
know the benefits (e.g. Stuebe & Bonuck, 2011), intention can often be hampered by
support-related barriers such as an unsupportive partner (Wojcicki et al., 2010), single
motherhood in rural areas (Sparks, 2011), depression (Isabella & Isabella, 1994), having
no previous experience with breastfeeding, and a lack of support from family and friends
(Tenfelde et al., 2012). Correspondingly, the idea that social support is necessary for
successful breastfeeding is supported by evolved behavioral and physiological attributes
in humans (Hrdy, 1999; 2009; Volk, 2009).
While some breastfeeding advocates have recently embraced a more supportbased agenda, many still focus on the concept of individual responsibility. How did the
concept of individual responsibility become so prevalent in breastfeeding advocacy? Why
are critical elements of human evolution omitted by advocacy groups while other
evolutionary and medical evidence is employed? In this paper, I will utilize historical
accounts, evolutionary evidence, and feminist critiques of breastfeeding advocacy
approaches to reveal the ideologies behind these agendas. I will also address how an
evolutionary context provides support for a feminist approach to breastfeeding advocacy
and how feminism can, in turn, equip researchers with the tools to examine the
evolutionary basis for human behavior within contemporary social constraints. When
analyzed, evolution and feminism emerge as complementary components to a more
holistic view of maternal breastfeeding behavior and social support.
A Historical Account of Infant Feeding
Contemporary discourse on breastfeeding is deeply rooted in historical context.
Infant feeding methods have been documented for thousands of years and have taken
numerous forms beyond mother-to-infant breastfeeding (e.g. wet nursing, bottle feeding,
animal milk). While the demographics of feeding methods vary across time and space,
the decision of which method(s) to employ is largely based on factors related to
occupational, biological, or societal constraints of mothers (Stevens, Patrick, & Pickler,
2009). Industrialization caused a shift in mothers occupations, and as a result families
became dependent on other methods of infant feeding (Osborn, 1979). The rise in
artificial feeding proved deadly when combined with the lack of regulation or knowledge
about proper cleaning of feeding devicesduring the early 19th century a third of
artificially fed infants in the U.S. died within their first year of life (Weinberg, 1993).
As industrialization began to shape families in Western nations, dialogs
regarding motherhood and breastfeeding became prominent. Midwives, doctors,
scientists, and philosophers were engaged in the analysis of natural and moral
motherhood, marking a shift from the 18th-century characterization of womanhood as
fulfilling the roles of a good Christian, wife, and companion (Bloch, 2003). In contrast,
the turn of the 19th century marked an emphasis on a womans identity as directly related
to motherhood, domestic competence and the ideal of the moral mother, demonstrating
the influence of the Enlightenment on public and professional views (Bloch, 2003). It
was during this time that many mothering advice manuals were published, with
breastfeeding showcased as a central pillar of good mothering. These manuals criticized
mothers who did not breastfeed, emphasized the sentimental value of breastfeeding, and
Journal of Social, Evolutionary, and Cultural Psychology ISSN 1933-5377 Volume 7(4). 2013.
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womens choices, and can result in women feeling pressure to breastfeed without being
supported in their efforts to do so. Additionally, Hausman (2012) points out that scientific
evidence has historically been used to restrict womens freedom, causing many feminists
to interpret the use of medical studies in messaging as tools to maintain or reinforce
female domesticity and subjugation.
Campaigns also emphasize that breastfeeding is natural, framing it within a
nature/culture dichotomy (for an example, see Calderdale Clinical Commissioning
Group, 2009). This dichotomy has been prominent in the discussion of infant feeding for
hundreds of years, and continues to be perpetuated in contemporary discourse (Wall,
2001). As Wall notes, such framing lends itself to the idea that successful breastfeeding is
universally feasible and easily implemented among all women. The dichotomy
simultaneously emphasizes the natural while medicalizing breastfeeding, using rhetoric
of infant feeding facts of which women need to be informed (Wall, 2001).
Evolutionary Context for Breastfeeding Behavior
It is interesting, then, that the most basic evolutionary context for breastfeeding is
ignored in this discourse. By observing the behavioral ecology of non-human primates,
pre- and post-industrial feeding patterns, and models of optimal growth and development
for contemporary infants and children, researchers have been able to approximate the
human infant feeding ecology of our evolutionary past. A consensus has formed that the
following were likely components of our evolutionary past: on-demand infant feeding,
infant carrying, co-sleeping, initiation of breastfeeding within one hour of birth, exclusive
breastfeeding for about six months followed by complementary feeding, continued
breastfeeding until three years of age, reliance on social learning and support, and
flexible weaning with a shift of care to allo-caregivers (Sellen, 2007).
Flexible weaning in particular is a vital component to our infant feeding
behavior. As Sellen (2007) describes, human mothers are physiologically and
behaviorally adapted to choose duration or patterns of breastfeeding, allowing them to
curb metabolic demands, create shorter inter-birth intervals, and adapt to social factors
such as availability of cooperative childcare or socioeconomic status (Sellen, 2007).
Theory based on this variation in feeding and weaning have been quantified by numerous
researchers (for examples, see Table 1). This flexible choice-based behavior provides
more options to mothers but also creates a dependence on social learning. As Volk (2009)
elaborates, primates are unique among mammals in their need for social learning in order
to breastfeed. This need is more acute in great apes, and humans are the most dependent
of all. While human infants have reflexes such as the sucking reflex and the rooting
reflex, human mothers have no instinct to breastfeed and certain factors such as the
particular shape of the human breast and the physiological trigger for letdown of milk
necessitate a highly specific technique that is not always easily learned (Volk, 2009).
And, since human infants are extremely altricial at birth, they need more care than other
mammalian infants including help to place their mouths, heads, and bodies in the
appropriate position in order to properly breastfeed (Righard & Alade, 1992).
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This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
Topic
Test parental investment (PI)
theory, Trivers-Willard
hypothesis, life history
theory (LHT) - for weaning
Population(s)
Chagga ethnic group
in the Machame area
of Kilimanjaro,
Tanzania
Results
Predictors of early weaning that were significant
(p<0.05): Sex by SES, Birth Order, Birth Weight.
Predicted Probability of Early Weaning was low
in Males of High SES (0.17) and Females of Low
SES (0.15), high in Males of Low SES (0.29) and
Females of High SES (0.3)
Tracer 2009
Quinlan,
Quinlan, &
Flinn 2003
Village of Bwa
Mawego, rural
Dominica
Jackson et al.
1992
Allo-caregiving is tied to both the care of the child and the facilitated learning of
the mother. Of notable importance is the role of intense paternal care, which humans
share with only five primate species and can vary greatly based on ecological and social
environment (Fernandez-Duque, Valeggia, & Mendoza, 2009). A growing body of
research demonstrates that a fathers involvement in partnership and child care influences
the decision to breastfeed, assistance at first feeding, duration of breastfeeding, and risk
factors related to bottle feeding (Bar-Yam & Darby, 1997; Raj & Plichata, 1998; Susin,
2008), and that a good couple relationship is generally associated with more
breastfeeding support and involvement in infant care (Falceto et al, 2004). Trevathan
(2010) adds that breastfeeding role models who are present in parts of the world with
high breastfeeding rates would have been ubiquitous in our evolutionary past. Volk
(2009) also highlights this lack of so-called "breastfeeding role models" and suggests that
a natural experiment is occurring in Western countries. A long-term societal reliance on
formula resulted in multiple generations of mothers who had very little knowledge or
experience related to breastfeeding (and therefore are not well-equipped to help others
learn the behavior socially), which contributes to the comparatively low breastfeeding
rates currently (Trevathan, 2010; Volk, 2009). Trevathan (2010) uses our evolutionary
history to point out that, while breastfeeding is optimal, humans have rarely been able to
pursue the optimal and trade-offs are frequently employed in a "good enough" strategy.
Journal of Social, Evolutionary, and Cultural Psychology ISSN 1933-5377 Volume 7(4). 2013.
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331
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of motherhood and anticipated that such a sentence could spark a negative response.
Additionally, feminism within scientific disciplines (as proposed by Donna Haraway)
also has the potential to "facilitate revisionings of fundamental, persistent western
narratives about difference, especially racial and sexual difference; about reproduction,
especially in terms of the multiplicities of generators and offspring; and about survival,
especially about survival imagined in the boundary conditions of both the origins and
ends of history, as told within western traditions of that complex genre" (1989).
Second, feminist perspectives can equip researchers with the ability to examine
the evolutionary basis for human behavior within a myriad of social constraints.
Particularly, intersectional feminism illuminates ways in which socioeconomic status,
race, and gender influence the behavior of individuals and groups by acknowledging
other sources of societal privilege not limited to gender. The feminist concept of situated
knowledge provides evolutionary psychologists with a means to parse apart more novel
behavioral constraints from constraints that may have been present in our evolutionary
past, while considering them as a composite of influences on contemporary human
behavior. Volk (2009) hints at the knowledges of women through generational
accumulation (or lack thereof), and an expansion on what other behaviors are being
influenced by these knowledges would no doubt prove a fruitful line of inquiry. The
concept of situated knowledge also serves as a reminder that generalizations made
regarding human behavior are limited in function and beg for a more nuanced approach.
Conclusion
Cultivating a Holistic View of Breastfeeding Behavior
Critiques of breastfeeding advocacy from both feminist and evolutionary
standpoints highlight their respective contributions to the discussion at hand. More
importantly, these contributions come together to create a more holistic view of
breastfeeding behavior for utilization by advocates, feminists, and scientists. This
showcases the inherent value in using evolution in feminism, and feminism in evolution,
with each containing narratives and tools that offer themselves to be repurposed.
By revising current scientific, evolutionary, and public health narratives of infant
feeding, binaries and tropes can be deconstructed while hybrid discourses can be
constructed on the experienced limitations of breastfeeding. In doing so, this approach
draws on the works of Donna Haraway, specifically Situated Knowledges and A Cyborg
Manifesto (Haraway, 1988 & 1991), and aims to encourage creative combinations and
collaborations between a variety of fields. It outlines and traverses grey areas of
breastfeeding promotion, adds evolutionary context to the medical research used in
breastfeeding activism, and gives medical professionals and scientists motive to reflect on
the intentions of their work and consider how their research and recommendations can be
interpreted and implemented.
With the recent heightening of the rhetorical debate between health advocates
and feminists centered on medical evidence (Hausman, 2012), a paper of this nature at
this point in time could lead the debate away from the validity or power of medical
research and reposition stakeholders in a less polarizing and more productive reflection of
infant feeding narratives. It also opens up the potential for new research territory within
this new hybrid of disciplines, including changes in breastfeeding behavior and sources
of breastfeeding support. Special attention should also be paid to advocacy campaigns
Journal of Social, Evolutionary, and Cultural Psychology ISSN 1933-5377 Volume 7(4). 2013.
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that are diverging from messages of individual maternal responsibility and focusing on a
more support-based rhetoric. We have seen the pendulum swing in both directions in
recent Western history; let us not allow history to repeat itself.
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