title: When 'breast' is no longer 'best': Post-partum constructions of infant-feeding in the hospital.
abstract: In this paper, we focus on the initial experiences of breastfeeding among mothers to examine the ways that infant-feeding is socially constructed in the hospital. Data comes from 51 in-depth interviews with 17 first-time mothers in Ontario, Canada. Analysis reveals 52 magnified moments that we categorize as Successful, Ultimately Successful and Unsuccessful. For mothers who describe Successful and Ultimately Successful moments, breastfeeding is understood as physiologically natural, and as something they must learn to do. Unsuccessful moments reveal that when health care providers interpret breastfeeding as not working, the breastfeeding discourse frequently shifts to one that incorporates formula as the means to achieve optimal infant health. In other words, in the hospital 'breast is best' holds true when breast 'works', otherwise mothers are often directed to give their babies formula. While formula appears to be compulsory in these moments, it is not typically understood as a "good or best" infant-feeding practice. For mothers in this situation, the shift from breast to formula is experienced as failures or evidence of inadequacy in their mothering. Paradoxically, our results suggest that formula may not, in and of itself, pose a threat to mothers' overall continued practice of breastfeeding. It appears that Successful and Ultimately Successful moments coincide with the current dominant 'breast is best' understanding. Unsuccessful moments, conversely, are insightful because they reveal when and how hospital practices disrupt mothers' understanding of their bodies and their role in providing the 'best' form of infant food. The implications for policy and practice are discussed.
authors.affiliation: Department of Sociology, McMaster University, 1280 Main Street West, Hamilton, Ontario L8S 4L8, Canada. Electronic address: braimoja@mcmaster.ca.
authors.forename: Jessica
authors.initials: J
authors.lastname: Braimoh
authors.affiliation: Department of Sociology, University of Western Ontario, 1151 Richmond Street, London, Ontario N6A 5C2, Canada. Electronic address: ldavies@uwo.ca.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Davies
mesh_terms: D000328:Adult; D001903:Bottle Feeding; D001942:Breast Feeding; D005260:Female; D006761:Hospitals; D006801:Humans; D007225:Infant Food; D007407:Interviews as Topic; D049590:Postpartum Period; D036301:Qualitative Research; D055815:Young Adult
keywords: Breastfeeding; Canada; Hospital; Supplementation; Unsuccessful moments