With my first child I was told to breastfeed, assumed I would and then was rather put out when no one would actually show me how to breastfeed. I was discharged from the hospital having never once actually latched my daughter by myself. A few days later, on a Friday, I realised that my sleepy baby was actually a dehydrated baby. My midwife referred me to a lactation consultant, but did not herself actually help me with breastfeeding. That night I had to work out how to make up some formula (because antenatal programmes are not allowed to demonstrate this) and felt like a terrible mother for doing so. I eventually managed to breastfeed, but not without spending a lot of money on lactation consultants and breast pumps.
With my second child, feeding came easier. Midwives were overall, much more hands on in teaching breastfeeding and breastfeeding classes were widely available. I fed happily in the knowledge that there was no better food source for her. I didn’t sleep through the night until breastfeeding stopped – when she was eighteen months old. I was confident that the benefits for my daughter were significant, and it was worth the great personal effort involved.
So it is with mixed feelings that I approached Lactivism. Courtney Jung, the author, is a political scientist and it is fascinating reading an evaluation of breastfeeding from this perspective. She was inspired to research breastfeeding after reading Hanna Rosin’s musings on breastfeeding in The Atlantic. Rosin discovered that the medical benefits of breastfeeding are far different than those outlined in popular culture. In fact, that a lot of the well-known benefits of breastfeeding have been somewhat overstated.
Courtney Jung focuses her work on breast milk as an increasingly in-demand product. Women are told that every drop of breastmilk is precious, and (particularly in the United States where you don’t have paid parental leave) that if they are at work they can just pump! And that there is legislation to support pumping! Except, the reality of the rather toothless legislation is that it isn’t really enforceable and many women find themselves punished by management and colleagues for trying to use the legislation to assist with pumping at work. When women are told that if they don’t breastfeed their baby will be less intelligent, more likely to be fat or get diabetes and more likely to be sick overall, you can see their motivation.
Jung goes through the relevant studies in a very easy to read manner. It seems that, particularly in the Western World, the benefits of exclusive breastfeeding for an individual baby are, overall, modest. She discusses controversial public health levers to encourage breastfeeding – including giving breastfeeding mothers and children more food than formula fed babies in programmes for low income mothers.
There is also a chapter on HIV and breastfeeding – where the evidence that breast milk carries the HIV virus and that infants can be directly infected from their mother solely through feeding has been minimised or denied in pursuit of the cause of breastfeeding promotion. It is sobering.
I would love to have read in more detail about breast milk as a product and the industry that has developed around breastfeeding. Breastfeeding is promoted as being free. But parents are certainly encouraged to buy breast pumps, special breastfeeding clothes and bras, feeding covers and feeding necklaces. There are so many products ‘supporting’ breastfeeding that it would be quite easy to spend as much on breastfeeding as you can on formula.
Jung’s linking of the diverse community groups that have made breastfeeding part of their advocacy work into poor policy outcomes is easy to read and a fascinating study into culture, business and policy. Regardless of your personal beliefs, knowledge or choices around infant feeding it is a fascinating insight into breastfeeding and public health policy.
Review by Emma Wong-Ming
by Courtney Jung
Published by Basic Books