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Journal of Social, Evolutionary, and Cultural Psychology

2013, 7(4), 326-335.

Letter

THE SITUATED MOTHER: EVOLUTIONARY THEORY AND


FEMINISM AS COMPLEMENTARY COMPONENTS TO
UNDERSTANDING BREASTFEEDING BEHAVIOR

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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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The situated mother

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

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characterized breastfeeding as natural and instinctual (Doyle, 2011). In essence,


mothers were openly critiqued and advised on their individual duty to breastfeed.
Eventually, the same industrial force that contributed to a greater dependency on
artificial feeding helped make possible further innovation and scientific discovery,
leading to better methods of food preservation and an analysis of breast milk, and
ultimately, to a spike in demand for commercial infant food (Radbill, 1981; Wickes,
1953). Fifty years after the first evaporated milk patent in 1835, there were 27 patented
brands of infant food (Fomon, 2001). Innovations in bottles and bottle nipples, aggressive
marketing, politics, cultural norms, and recommendations by physicians all contributed to
a record decline in breastfeeding in 1970, when breastfeeding initiation rates in the U.S.
were at 28% and only 8% of infants still breastfed at age 3 months (Fomon, 2001;
Hirschman, 1979; Houston, 1981; Osborn, 1979; Wickes, 1953).
This would not be the case for very long, however, because as Diane Thulier
notes, whenever the pendulum swings too far in one direction, its return to the center is
almost inevitable (2009, pg. 89). The second wave of feminism that developed in the
U.S. in the 1960s spurred various views on mothering, but ultimately proved a positive
force for breastfeeding by empowering women to challenge medical authority and gain
control over their own bodies. While La Leche League and other activists' agendas were
often at odds with feminist discourse, the group was founded on the mission of providing
women with more information through experienced mothers instead of doctors, and
hence aligned with feminist interests (Thulier, 2009; Wolf, 2006). As political
momentum grew in the 1970s and 80s, the first in-depth medical and scientific analyses
of breastfeeding began documenting the benefits for full-term and preterm infants (e.g.
Atkinson, Bryan, & Anderson, 1978) and the new profession of Lactation Consultant was
born. As continued research uncovers more benefits to breastfeeding, breastfeeding
advocates arm women with the knowledge of these benefits in hopes that they will
choose to breastfeed. But in the last decade, advertising campaigns have emphasized the
risks of not breastfeeding with the logic that risks would better prompt mothers to change
their behavior (Wolf, 2006). The resulting rhetoric seems to have led our historical
pendulum down a familiar pathone that is centered on using sentiment, nature, instinct,
and morality to convince women of their responsibility to breastfeed.
Feminist Critiques of Advocacy
Given these aforementioned historical roots, it is unsurprising that many
contemporary feminist scholars (e.g. Hausman 2012) have participated in critiques of
breastfeeding advocacy. Of particular import to this discussion is a critique of the use of
medical information to emphasize maternal responsibility. This approach is based on
valuing womens experiences and the perspectives they develop from them, referred to as
situated knowledge (see also Haraway, 1988). Public health promotion of breastfeeding
relies heavily on health messaging and choice paradigms in which a mother chooses
good or bad decisions, defined according to public health goals. Examples of this
health messaging include the Calgary Breastfeeding Matters Group Foundations bus
advertisement that reads Babies who arent breastfed have higher risk of diabetes. Learn
more (n.d.). Citing La Leche League and the National Breastfeeding Awareness
Campaign, Hausman (2012) also demonstrates how the ideology of the good mother
has been used implicitly and explicitly to moralize and circumscribe womens
breastfeeding behavior. This approach fails to recognize the constraints involved in
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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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Table 1. Examples of Evolution-Based Quantitative Research on Flexible Weaning and Investment


Author(s)
Wander &
Mattison 2013

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

Test PI theory, TriversWillard hypothesis - for


breastfeeding

Au and Gnau ethnic


groups in the Sandaun
Province of Papua
New Guinea

Differences among age categories in feeding


frequency was not significant (p=0.9), but in
feeding duration was (p=0.004) between age
groups 0-6 and 13-18 months. Mean suckling
duration or frequency based on sex of child was
not statistically significant (p=0.87, 0.55).

Quinlan,
Quinlan, &
Flinn 2003

Test PI theory, TriversWillard hypothesis - for


weaning and breastfeeding

Village of Bwa
Mawego, rural
Dominica

Father-present children were breastfed longer


than father-absent (p=0.006), more alloparents
predicted briefer breastfeeding (p=0.001), wealth
was associated with earlier weaning (p=0.002),
boys are weaned earlier than girls (0.01<P<0.02)

Jackson et al.
1992

patterns of weaning and


early supplementation

City of Chiang Mai,


Thailand

Supplementary foods introduced earlier for


infants of large households (p=0.018), those
living in remote area (p=0.019), and those whose
mother's main occupation was farming (p=0.03).
Duration of breastfeeding predicted by mother's
age (p=0.023), number of children in the
household (p=0.49), and whether first
supplementary food was formula (0.036).

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.

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While it is unclear why evolutionary considerations such as these are omitted by


advocates, medical professionals, and scientists alike, it could be inferred that a long
history of critiquing mothering techniques in the West contributes to the ideology that the
role of mother is one that must be enforced by society and thus drives what evidence is
included or excluded from the primary discourse.
Discussion

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Evolutionary Context Supports a Feminist Approach to Breastfeeding


The above evolutionary context points to a number of factors that contribute to a
woman's situated knowledgethat is, they affect the body of experience-based
information that influences her perspectives and decisions regarding breastfeeding.
Physiological attributes, instincts, the presence of experienced support figures, and the
concept of survival affect a mother's situated knowledge, just as do societal, economic,
and cultural factors. By expanding the discussion of situated knowledge to
bioevolutionary and ecological factors, feminist scholars gain additional perspective on
influencing experiences, and how knowledge and attitudes are formed by mothers. In
short, evolution helps to inform us that human mothers rely greatly on social support and
that individualistic natural/medical messaging fails to recognize this constraint (among
others, as critiqued by Hausman, 2012). To be sure, this is not to say that using medical
knowledge to inform women of the benefits of breastfeeding is beside the point, but
rather that medical knowledge in the context of evolutionary-based social constraints may
serve to better inform breastfeeding discourse and initiatives. In particular, I envision this
evolutionary context being used to support feminist critiques of nature/culture
dichotomies, medicalization, and moralization of breastfeeding. In this way, evolution
emerges as a partial but essential context for medical practice and research, and also for
any consideration of a mothers experiences in pursuit of breastfeeding her infant.
Feminist breastfeeding advocates can use this addition to situated knowledge in order to
navigate the various ideologies and, more importantly, to bolster the call for a movement
towards support-based messaging. Identifying social and bioevolutionary constraints can
be helpful in creating a more holistic view of the difficulties of infant feeding.
Feminism Human Behavior within Contemporary Social Constraints
Just as evolutionary thought can foster new ways of thinking within feminism, so
too can feminism equip researchers in evolution-based disciplines. First, feminism
provides researchers with an understanding of gender-based societal issues that can
positively influence a researcher's theory, practice, or writing. For example, being aware
of the immense pressures of motherhood, a researcher should be able to acknowledge
how their research may be interpreted, choose to address conflicts or discourses, or to use
sensitive wording. For the sake of demonstrating this tool, I will use the example of
Gallup and Hobbs' (2011) publication in Medical Hypotheses called "Evolutionary
medicine: Bottle feeding, birth spacing, and autism." The authors choose to address
mothers (or parents) in the last sentence of their abstract: "The decision to bottle feed
your last child may unwittingly put your next child at risk of being autistic" (Gallup &
Hobbs, 2011). This is a rather titillating sentence, with the potential to enflame, terrify, or
panic infant caregivers over an assertion that has not yet been tested. Had the authors
been engaged in feminism, they may have been more aware of the current social contexts
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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
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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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