Contextualising risk, constructing choice: Breastfeeding and good mothering in risk society

Abstract

The ‘whats’ and ‘hows’ of feeding babies is a key interest in the arena of public health. In recent years, this has translated into an ever-increasing emphasis on breastfeeding; namely, on trying to get more mothers to breastfeed, to breastfeed exclusively, and to breastfeed for longer. It is argued, however, that this discourse is not a benign communiqué about the relative benefits of breastfeeding, but an ideologically infused, moral discourse about what it means to be a ‘good mother’ in an advanced capitalist society. With the dual aim of (a) building upon existing cultural analyses of infant feeding, and (b) furthering our understanding of the construction of' ‘good mothering’ in risk society, this paper examines how notions of risk/benefit are taken up and used in mothers' talk about their infant feeding decisions and experiences. The findings detailed in this paper support the thesis that the authority to define and monitor ‘risk’ in parenting is increasingly the purview of medical-scientific discourse. The analysis further demonstrates how, within such a framework, mothers' risk consciousness vis-a-vis infant feeding is activated primarily as an issue of identity, of ‘good mothering’ as defined by the dominant, expert-guided, scientific-medical discourse.

Keywords:

• parenting
• risk
• risk communication
• risk perception
• public health
• uncertainty
• breastfeeding

Notes

1. Without question, these efforts have resulted in changing behaviours towards breastfeeding. Data from Canada, for example, show that 85% of mothers in 2003 initiated breastfeeding, compared to only 62% in 1980s, and 75% in the 1990s (Millar and Maclean 2005). Nearly half (47%) of mothers breastfeed for six months or more, and approximately 18% are currently meeting the WHO target of exclusive breastfeeding for the first six months of a child's life (Millar and Maclean 2005).

2. It is worth noting that the breastfeeding rate for the province of Alberta is, at 88% (1999 data), the second highest of all Canadian provinces (Health Canada 2003).

3. And while not all mothers held such strong views about formula as ‘bad,’ there was a common theme of feeling guilty or hesitant when it came to formula feeding, even when formula was being used temporarily, or as a backup/supplement to breastfeeding. The exception to this was when formula was introduced later on, in line with the introduction of other solid foods.

4. According to Hays (1996), contemporary definitions of ‘good parenting’ rely on the following main tenets: (a) the belief that mothers should be self-sacrificing and selfless; (b) the belief that rearing should be done primarily by individual mothers; and (c) the belief that it should be entirely centered on children's needs with ‘methods that are informed by experts, labour-intensive, and costly’ (Hays 1996, p. 21).

5. For most mothers, this meant maintaining (or returning to) a practice of exclusive breastfeeding. For a few mothers, this meant a practice involving formula supplementation and/or feeding expressed breast milk via bottle.

6. A number of mothers also noted that while the pressure to breastfeed did exist in the health care context, their specific interactions with health care professionals were positive, characterised by flexibility and understanding.

7. It is notable that the issue of severe bodily discomfort has all but disappeared from today's dominant infant feeding discourse (Knaak 2005), despite the fact that many sexual abuse survivors have a particularly difficult time breastfeeding … (and) 43% of new mothers who are not breastfeeding describe it as ‘primitive,’ ‘ugly,’ or ‘unpleasant’ (Kukla 2006, p. 163).