Nursing grievances: Breasts and bottles in the early 21st century

This presentation is part of the “Female Complaints”: Medicine, Markets and Women\u27s Health track. The public health campaign in favor of breastfeeding has been wide-spread, visible, and well-funded. Still, most women nurse well below the recommended period of time. In this paper, I want to isolate a number of the ideological factors that have been undermining the “breast is best” message. Much has been written about the paternalistic ideology accompanying what one theorist has called “medical motherhood”: a woman is rendered passive in the childbirth process and required to defer to the (generally male) physician for knowledge and advice about the natural functioning of her own body. Although this is an important part of the story, I want to argue that there are more fundamental factors at work, and I wish to explore in particular the rationalizing function of medical motherhood in the promotion of formula feeding. The rise of capitalism is famously accompanied by a reordering of experience to allow for a more efficient administration of our productive potential both spatially and temporally. Spatially we come to view ourselves in an increasingly individualized (alienated) manner, as isolated agents on the free market whose relations are mediated by market considerations. Temporally, we regulate our time so as to be able to maximize our productivity: our time is governed by the clock rather than the sun, and divided into quantitatively comparable units. There are numerous mechanisms by which these regulative functions have operated directly on our bodies, and I want to suggest that bottle-feeding is one such mechanism. Spatially, the intervention of medical technology in the parent child bond is dramatically enacted in certain rituals of separation – the baby is removed from the parents after birth and sent to a nursery, parents are urged to keep the baby in a separate sleeping room or at least separate bed, etc. These arrangements work to undermine lactation, which at any rate is replaced by bottles of formula. More basically perhaps, bottle-feeding clarifies or perhaps constitutes the distinction between infant and mother, creating a duality out of what has been called a “dyad”. The infant-mother bond is a supple one, and birth does not need to be experienced as an absolute sundering of two bodies – it points to ambiguities in our notion of individualized subjectivity, and systems of control might be predictably concerned to disambiguate the situation. Psychoanalysis has explored ways in which this is accomplished, but I believe bottle-feeding has a role in this regard, in separating the infant from the mother’s body. This separation is often described in the language of liberation: the mother is no longer “tied down” to the nursing regime, no longer “forced” to pay attention to her diet, is “free” to stay away from the infant for as long as she wishes, or to engage other people to feed the baby. This language of liberation allows bottle-feeding to be positioned as a boon to feminism and a way of furthering feminist goals. The bottle regime allows the mother’s breasts to be removed from the functional role of nursing and wholly reintegrated into the specular economy of adult sexuality. It also lends itself more readily to a sleeping arrangement where the baby is in its own room or at least its own cot. Breastfeeding is facilitated by (although it certainly does not necessitate) a co-sleeping arrangement that allows the nursing mother to doze off and wake up in response to the baby’s nursing needs without having to get out of bed. Separate sleeping also works to condition and reinforce a sense of separation between mother and baby and independence of mother from baby and vice versa. It also facilitates a stricter regulation of time. While the breastfed infant needs to be allowed to nurse continuously (at least for the first few weeks of life), formula need not be administered continuously. Formula is more difficult to digest than breast milk, and the signals for satiation are not as obvious to the infant. Therefore, it is up to the care-giver to determine when and how much they should eat, using some sort of schedule (every four hours is typical for a newborn). This enables the caregiver(s) to regulate the baby’s sleep patterns much more reliably than with a breastfed infant whose continuous feeding will make for erratic and broken sleep for the mother. It is important to see that these exigencies of control and regulation are still in effect in spite of more recent public health messages urging mothers to breastfeed if possible. Although women are urged to breastfeed, the practice does not fit naturally into an environment where separation and regulation are valued and even encouraged, perhaps couched in terms of (spuriously) feminist goals. The debate over nursing has been taken up inappropriately into feminism, I believe. “Market” feminism proposes its own solution to the dilemma of nursing at work: pumping. Increasingly, “lactation-friendly” business environments are promoted by such feminist groups as NOW as a way of both working and feeding breast milk to the baby. While advertising themselves as sensitive to the mother’s needs, the business is certainly sensitive to its own, as such accommodations are relatively inexpensive compared with either maternity leave or even replacing a highly skilled worker. Corporate lactation programs are ways in which the corporate world stoops to conquer, expending a small amount of resources to offer a degraded solution within the system in order to forestall any more radical demands. This solution maintains the regulatory imperative of the bottle-feeding norm, only replacing the fluid that is on offer. The practice of breastfeeding poses a set of urgent challenges to an economic system and the notion of agency within an economic system predicated on imperatives of quantification, regulation and control. It entails a notion of time that is governed by biological rhythm and a supple conception of human relationship and identity. It reveals a set of contradictions within late capitalism that cannot be resolved by the false synthesis of corporate lactation programs