Contested moral landscapes: Negotiating breastfeeding stigma in breastmilk sharing, nighttime breastfeeding, and long-term breastfeeding in the U.S. and the U.K.
Recent public health breastfeeding promotion efforts have galvanized media debates about breastfeeding in wealthy, Euro-American settings. A growing body of research demonstrates that while breastfeeding is increasingly viewed as important for health, mothers continue to face significant structural and cultural barriers. Concerns have been raised about the moralizing aspects of breastfeeding promotion and its detrimental effects on those who do not breastfeed. Far less, however, is known about the moral experiences of those who pursue breastfeeding. This study draws together research on breastmilk sharing (2012-2016) and nighttime breastfeeding from the U.S. (2006-2009), and long-term breastfeeding from the U.K. (2008-2009) from three ethnographic projects to address this gap. Comparative analysis of these cases reveals that while breastfeeding is considered ideal infant nutrition, aspects of its practice continue to evoke physical and moral danger, even when these practices are implemented to facilitate breastfeeding. Breastmilk sharing to maintain exclusive breastmilk feeding, nighttime breastfeeding and bedsharing to facilitate breastfeeding, and breastfeeding beyond the accepted duration are considered unnecessary, unhealthy, harmful or even deadly. The sexual connotations of breastfeeding enhance the morally threatening qualities of these practices. The cessation of these "problematic" breastfeeding practices and their replacement with formula-feeding or other foods is viewed as a way to restore the normative social and moral order. Mothers manage the stigmatization of these breastfeeding practices through secrecy and avoidance of health professionals and others who might judge them, often leading to social isolation. Our findings highlight the divide between perceptions of the ideal of breastfeeding and its actual practice and point to the contested moral status of breastfeeding in the U.S. and the U.K. Further comparative ethnographic research is needed to illuminate the lived social and moral experiences of breastfeeding, and inform initiatives to normalize and support its practice without stigmatizing parents who do not breastfeed.
Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: ctomori1@jhu.edu.
Cecilia
C
Tomori
Elon University, Elon, NC, USA.
Aunchalee E L
AE
Palmquist
University of the West of England, Bristol, United Kingdom.
Sally
S
Dowling
D000328:Adult; D001942:Breast Feeding / Q000208:ethnology / Q000523:psychology*; D005260:Female; D006801:Humans; D008895:Milk, Human; D009035:Mothers / Q000523:psychology*; D057545:Social Stigma; D013997:Time Factors; D006113:United Kingdom / Q000208:ethnology; D014481:United States / Q000208:ethnology
Bedsharing; Breastfeeding; Breastmilk sharing; Long-term breastfeeding; Nighttime breastfeeding; Stigma; United Kingdom; United States
Pediatrics. 2011 Nov;128(5):e1341-67
22007003
Health Place. 2011 Mar;17 (2):430-7
20655272
Rev Obstet Gynecol. 2009 Fall;2(4):222-31
20111658
Matern Child Nutr. 2008 Jan;4(1):74-9
18171409
Health Place. 2012 May;18(3):552-60
22366299
Breastfeed Rev. 2008 Mar;16(1):5-15
18546572
Public Health Nutr. 2007 Sep;10 (9):957-64
17381914
Soc Sci Med. 2014 May;109:55-65
24698713
J Hum Lact. 1996 Mar;12(1):1-4
8715226
J Epidemiol Community Health. 2009 Jun;63(6):418-9
19439576
Matern Child Nutr. 2016 Apr;12 (2):278-90
26607304
Curr Anthropol. 2014 Apr;55(2):200-15, 226-9
24991682
Lancet. 2016 Jan 30;387(10017):413-5
26869552
Soc Sci Med. 2013 Feb;79:84-91
22571891
Health Care Women Int. 2008 Sep;29(8):807-25
18726793
J Hum Lact. 2001 Nov;17(4):304-12
11847899
Lancet. 2016 Jan 30;387(10017):475-90
26869575
Int Breastfeed J. 2011 Jun 25;6:8
21702986
J Health Polit Policy Law. 2007 Aug;32(4):595-636
17639013
J Obstet Gynecol Neonatal Nurs. 2014 Mar-Apr;43(2):139-59
24502196
Soc Sci Med. 2014 Dec;122:140-7
25441326
Australas Med J. 2012;5(5):275-83
22848324
Breastfeed Med. 2013 Feb;8(1):45-52
23199303
J Hum Lact. 2014 May;30(2):195-200
24614263
BMJ Open. 2013 Jun 20;3(6):null
23794590
J Hum Lact. 2016 Feb;32(1):141-51
26112473
Paediatr Respir Rev. 2005 Jun;6(2):134-52
15911459
Health Care Women Int. 2011 Jun;32(6):538-54
21547805
J Hum Lact. 2004 Aug;20(3):306-18
15296585
Soc Sci Med. 2007 Apr;64(7):1524-35
17188411
Pediatrics. 2010 Nov;126(5):e1119-26
20956410
J Hum Lact. 2014 May;30(2):209-16
24186645
Acta Paediatr. 2016 Jan;105(1):17-21
26295452
J Obstet Gynecol Neonatal Nurs. 2012 Nov-Dec;41(6):E41-50
22861175
Lancet. 2016 Jan 30;387(10017):491-504
26869576
Matern Child Nutr. 2015 Jan;11(1):33-46
25138617
Soc Sci Med. 2010 Mar;70(6):951-8
20074841
Med Anthropol Q. 2008 Dec;22(4):410-5
19189725
Breastfeed Rev. 2014 Mar;22(1):11-21
24804519
Public Health Rep. 2011 Mar-Apr;126(2):161-4
21387943
Sociol Health Illn. 2007 Nov;29(7):1075-90
18092984
Health (London). 2017 Jan;21(1):57-75
26226954