This is a response to the issue of inducing guilt in mothers who
can't/won't/don't breastfeed by promoting breastfeeding through BFHI.
I've been studying the rhetoric of the discourses concerning infant
feeding in the U.S. for about 7 years now, and this is what I
conclude about the "guilt issue":

First, Lawrence says, in the 4th edition of Breastfeeding: A Guide
for the Medical Profession, that there are no studies proving that
promoting breastfeeding induces guilt in women.  Instead, she writes,

"There are no studies in the literature that support this position
[denying mothers information about breastfeeding in order to avoid
inculcating guilt]. In the dozens of reports on efforts to increase
breastfeeding among many cultures, there is no report of producing
guilt feelings. Women interviewed in open-ended questionnaires have
not mentioned guilt feelings in response to the questioning. The only
individuals who ever mention guilt are the older generation whose
daughters are now choosing breastfeeding. The grandmother feels
guilty because noone [sic] ever told her; noone [sic] ever encouraged
her to breastfeed" (199).

Second, as some of the previous posts have indicated, the focus on
guilt promotes a focus on individual women and the effect of their
supposedly autonomous decisions in a context that we know is
influenced by a myriad of factors, ranging from how we are raised to
perceive bottle feeding as normal to contemporary pressures to
separate from our infants when they are very young to employment
situations that make the continuation of breastfeeding difficult if
not impossible.  It is also important to see how women are made to
feel responsible for all sorts of aspects of their children's
experiences that they cannot possibly control.

Third, guilt is only possible when breastfeeding and bottle feeding
with infant formula are equated as basically the same, with
breastfeeding offering additional optimizing benefits.  As noted by
others, there are plenty of behaviors we feel quite justified in
making people feel guilty about, but they tend to be ones that are
understood culturally to have recognizably dire effects (such as
smoking or not putting a baby in a car seat).  Thus, the guilt that
is said to arise from an emphasis on breastfeeding or from the
instantiation of BFHI arises because there is still not a baseline
cultural understanding of how breastfeeding is the normative practice
from which formula feeding deviates.  How to change this situation is
unclear to me, because it's like arguing that driving a car to work
every day has negative effects on the environment--we know it, but
our lives (in the U.S. at least) are structured around car culture.

Fourth, the opposite of guilt in this scenario is empowerment.  The
difficulty that many women face is that breastfeeding represents an
ideal of mothering (I'm talking about how the dominant American
culture represents it) that is difficult for them to realize in
practice.  Problematically, this view is sometimes promoted by overly
romanticized representations of the benefits of breastfeeding.  What
I'm getting at here is that many women, even most women, recognize
the benefits of breastfeeding (Lawrence argues this in another
article) but cannot see how to actualize it in practice--either
because they cannot approach their own bodies in this way, or because
they do not have support from family or employers to do so (these are
only examples).  The BFHI is an important step, but only refers to
the hospital setting.  How can women be empowered--in psychological,
political, and material terms--to fight for the right to information
about and support for breastfeeding?   How can we transform the
debate so that it is not about the guilt of individual women but
about the right to adequate health care and to community support for
maternity?

I'm sorry that this post is so long, but I wanted to offer the
insights of an "outsider" to this debate.  I'm looking forward to the
ILCA meeting in Sydney, where I'll be giving a talk.  I find the
discussions on LACT-NET so stimulating.

Bernice Hausman

********************************************************
Bernice L. Hausman
Associate Professor
English Dept. (0112)
Virginia Polytechnic Institute and State University
Blacksburg, VA 24061
540-231-5076 (office)
540-231-5692 (fax)

[log in to unmask]
http://athena.english.vt.edu/~hausman/hausman.html

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