The construction and navigation of riskscapes in public health advice and mothers’ accounts of weaning

Abstract

This paper adds to critical studies of risk and mothering by illustrating and conceptualising how risk is constructed in public health advice and mothers’ accounts of weaning. Previous research points towards a gap between public health scientific definitions of risk and mothers’ contextual understandings and experience of handling complex and often conflicting risks linked to food and feeding. It has been suggested that public health discourse misses out on or even silences risks defined by women in their everyday care practices. Therefore, our aim is to conceptualise and map various co-existing constructions of risk and discuss how an awareness of the multiplicity of risk can inform public health advice that take mothers’ point of view into account. Using the concept ‘riskscape’, we explore and compare how public health and mothers’ constructions of risk diverge and overlap. Our findings illustrate how mothers belong to a community of practice where weaning is understood and practiced in relation to their everyday life and eating practices involving multiple concerns that are not addressed in public health advice, especially the wider food and information landscape. The study also indicate that this divergence can provoke feelings of insecurity and anxiety among mothers and make public health advice seem less relevant. In sum, our findings suggest a need for public health to acknowledge mothers’ experience of weaning as a compound practice similar to their own eating practices and to widen the present focus on risk as a domestic and individual responsibility.

Keywords:

• risk
• riskscape
• mothering
• weaning
• public health

Introduction

This paper seeks to explore the way risk is constructed in public health advice and in mothers accounts of weaning. Drawing on the concept ‘riskscape’ we illustrate the way public health definitions and mothers’ understandings of risk overlap and diverge and discuss how mothers’ navigational acts can be supported in risk communication to mothers. Our findings illustrate how mothers belong to a community of practice where weaning is understood and practiced in relation to their everyday life involving multiple concerns that are not addressed in public health advice on weaning. Public health definitions and advice on risk handling are present in the accounts of mothers but it is also evident that mothers’ construct additional risks in relation to other domains, especially the wider food and information landscape. Public health print materials locate risk in the domestic sphere and in individual performances of cooking and feeding practice while mothers speak of the risks located outside the cooking and feeding situation and beyond the grasp of individual choice. To support mothers public health advice on weaning should also address risks linked to these wider concerns and avoid adding to mothers’ sense of individual responsibility.

Health and baby care discourse currently positions mothers as responsible for handling food risks from pregnancy planning to breastfeeding and weaning (Atkinson, 2014; Kehily, 2014; Lee, 2008). Mothers are held accountable for the health and wellbeing of their children but are at the same time described as lacking capabilities and coping strategies for handling food risks. Public health discourse generally positions mothers (and their babies) as vulnerable and in need of scientific and medical advice and support (Apple, 1995; Bentley, 2014; Fox, Nicholson, & Heffernan, 2009; Kehily, 2014). In this context food and feeding are presented as unsafe territory that mothers must navigate using a plethora of advice on optimal and safe diets to conceive, carry, and care for an infant (Keenan & Stapleton, 2010; Kehily, 2014; Lee, 2007).

Previous research has described mothers’ feelings of anxiety, ambiguity and uncertainty following this dual move of attributing responsibility to mothers while at the same time questioning their capabilities (Lupton, 2011). Mothers are generally well aware of public health definitions of food risk and recommendations for risk handling but also experience insecurity when having to combine these definitions and recommendation with other demands following the everyday care and nurturing of a baby (for example Crighton et al., 2013; Knaak, 2010; Lee, 2008; Ludlow et al., 2012). As Knaak (2010) tellingly argues, professionals ‘are the primary experts of childrearing and “good parenting” is non-contextual and non-experiential’ (Knaak, 2010, p. 352). Hence, previous research repeatedly points towards a gap between public health definitions and recommendations for risk handling and mothers contextual understanding of risk and their lived experience of handling complex and often conflicting risks linked to the task of feeding a baby. This tension and the balancing thereof, has been shown to be central to mothers’ identity work in relation to dominant ideals like ‘the good mother’ and ‘intensive mothering’ (Ludlow et al, 2012; Knaak, 2010; Lee, 2008). Public health definitions of risks are central to the formation of these ideals (Lee, 2007; 2008). Mothers’ aspirations to and enactment of ‘good mothering’ is therefore highly dependent on their abilities to navigate risks as defined by public health discourse. The gap between public health scientifically based definitions of risk and the contextualised view of mother have an immediate impact on mothers’ navigational acts, as well as feelings of ambiguity and insecurity linked to their sense of accomplishment as mothers (Lupton, 2011).

While previous research traces the tension between public health discourse and mothers contextualised understandings of risk historically (for example Atkinson, 2014; The VOICE group, 2010) and points towards its general contemporary existence (Knaak, 2010; Lee, 2007; 2008), few studies explore and contrast how public health and mothers construct and navigate food risk in a localised setting. How, more specifically, do public health definitions and mothers contextualised understandings of food risk differ and how do they overlap? And could a mapping of differences and overlaps be used to improve public health guidance in a manner that strengthen rather than weaken mothers?

In this paper, we continue and add to previous critical reflections on risk and mothering (Faircloth, 2010; Knaak, 2010; Lee, 2007; 2008; Ludlow et al., 2012) by illustrating and conceptualising how risk is constructed in public health advice and in mothers accounts of baby food and feeding and discuss how overlaps and divergences can be acknowledged and mothers’ navigational acts supported in risk communication to mothers. Our aim is to conceptualise and map various co-existing constructions of risk and discuss how an awareness of the multiplicity of risk can inform the development of public health advice that take mothers’ point of view into account.

More specifically, we take interest in the way that public health advice and mothers define and handle food risk during weaning, that is the specific practice of gradually introducing a baby to solid foods (Brembeck & Fuentes, 2017; Fuentes & Brembeck, 2017). By focusing on weaning and using the concept of riskscape (Müller-Mahn & Everts, 2013), we explore risk as a multiple and dynamic construct embedded in practice. In the following section, we outline our analytical framework introducing the concept riskscapes that underlines the situational, context specific and multiple nature of risk.

Riskscapes

To acknowledge the situational and context-specific nature of risk we take a constructionist stance to this concept. More specifically, we follow the work of geographers Detlef Müller-Mahn and Jonathan Everts (2013) and use the concept of riskscape to conceptualise the intricate relationships of particular concerns, places, and practices (Müller-Mahn & Everts, 2013, p. 27). The concept builds on a constructivist view of risk (see, for example, Boholm & Corvellec, 2011) as shaped and enacted in practice and underlines its spatial dimension. Müller-Mahn and Everts (2013) describe risk as a multi-dimensional construct that is ‘not isolated or restricted to one place and one moment in time’ (Müller-Mahn & Everts, 2013, p. 22). Risks are social in nature and entangled in the formation of social groups, and therefore, risks represent various views and understandings of the world. Thus, different notions of risks can and do co-exist in the same place at the same time.

The concept of riskscape is a way of underlining the multiplicity of risk. As asserted by Müller-Mahn and Everts (2013), whose reasoning follows Appadurai (1990), the basis of the term ‘scape’ comes from the concept ‘landscape’ and corresponds to ‘points of view.’ The same territory or stretch of land can be perceived and comprehended differently, depending on the viewpoint of the observer (Müller-Mahn & Everts, 2013, p. 26). Hence, ‘riskscapes, viewed from different perspectives and by different authors, are partially overlapping, intrinsically connected, and at the same time, often controversial socio-spatial images of risk’ (Müller-Mahn & Everts, 2013, p. 26; emphasis in original). Müller-Mahn and Everts (2013) highlight three aspects of their conceptualisation: (1) riskscapes are combinations of materials located in physical landscapes and the way people make sense of them in daily practice, (2) the same place or territory involves not one but several riskscapes, and (3) this diversity of riskscapes and the particular agencies and dependencies that go along with each must be acknowledged in any risk management effort.

Müller-Mahn and Everts’ conceptualisation of riskscapes also draws on Sutherland and colleagues (2012, p. 48), who claim that ‘citizens carry the history of place and their narratives with them’ and that these memories and narratives shape notions of risk and riskscapes. This notion of risk as socially embedded in practice and narrative is further unpacked by Boholm and Corvellec (2011). They describe risk as a continuously performed social and conceptual construct (see, for example, Boholm & Corvellec, 2011). What does and does not constitute risk is the result of classification. This classification involves ordering the objects and actors entangled in a situation where something of value is seen as threatened by certain objects or circumstances (ibid.). This act of classification is social but also material (Boholm & Corvellec, 2011), and as Müller-Mahn and Everts (2013) remind us, it manifests in spatial terms.

Müller-Mahn and Everts (2013) use the term signpost (see also November, Camacho-Hübner, & Latour, 2010; November, Penelas, & Viot, 2009) to conceptualise the classification of what does and does not constitute a risk. They describe riskscapes as enacted by various sets of signs or signposts that are used by people in practice to navigate their riskscape (Müller-Mahn & Everts, 2013, p. 27). Riskscapes are constructed around entities of value that are seen as being threatened by specific objects or circumstances; signalling occurs via signposts. A signpost could be symptoms of illness, low growth rates, or reports of food hazards. These signposts are then linked to specific acts of navigation. Acts of navigation involve interpretation, re-interpretation, assessments, and prescribing changes in spatial practice (Müller-Mahn & Everts, 2013, p. 28).

We consider the concept of riskscape to be a useful analytical tool for unpacking discrepancies and struggles between expert and lay understandings and responses to risk but we also see it as a fruitful way to acknowledge the construction of risk in a compound and spatially dispersed practice like weaning.

We have previously conceptualised weaning as a social practice (Brembeck & Fuentes, 2017), that is a composite set of knowledge, norms and meanings, which form an entity that endures across individual actions (Shove et al., 2007). We have also acknowledged the moral character of this practice and how it is often represented and framed in relation to various risks (Fuentes & Brembeck, 2017). In this paper we analyse the way weaning practice is represented in public health print material on weaning and parents accounts of this practice. More specifically we conceptualise weaning as a practice of eating (Warde, 2016) and following Warde (2016) we acknowledge the importance of studying representations of a practice, in the case of this study public health print material and parents accounts of weaning. Central to our work is also Warde’s conceptualisation of eating as a compound practice (Warde, 2016), that is a practice dependent on and interlinked with many other practices and therefore also dispersed over time and place. Acknowledging the compound character of weaning brings the complexity of this practice to the fore as well as its link to multiple understandings of risk. This accentuates the relevance of a spatial approach acknowledging its dispersed character. Hence, the concept riskscapes enables us to capture various constructions of risk and their embedment in understandings and use of place.

Below, we account for two overlapping but somewhat contrasting riskscapes of weaning that were identified in our study conducted in the rural town of Falköping. First, we describe our fieldwork and analysis.

Field and methods

Study setting

The primary location of our study was a ‘baby café’ at a health care centre in Falköping, a small town with approximately 13,500 inhabitants that is situated in the middle of the plains of western Sweden. ‘Baby cafes’, that is informal gatherings where babies and parents meet to share a meal, play, sing children’s songs and socialise are a common feature at Swedish child care centres. In Sweden all 0-5-year-old children are offered free health care involving regular check-ups and health advice from nurses and doctors at local child care centres. Babies growth and development are carefully monitored and parents are given written and oral advice regarding food and weaning and how to prevent accidents in the home. In Sweden the public health care programme is not mandatory but a majority of babies and their parents partake in the program and visit health care centres regularly.

In Falköping, as in many other Swedish municipalities, the baby café was organised in the same facilities as the local child care centre where medical examinations and guidance are offered. We have had previous positive experience using ‘baby cafés’ as field sites for studies of mothers in relation to pregnancy, motherhood, food and risk (Brembeck, 2011; 2013; Milne, Wenzer, Brembeck, & Brodin, 2011) and the one in Falköping was chosen in an effort to reach mothers with mixed backgrounds in terms of education, age, and socioeconomic status. Smaller Swedish towns, like Falköping, generally only have one health care centre that typically cater to the whole municipality whilst health care centres in larger cities are district-based and parents attending them tend to be more homogenous in terms of socioeconomic and educational background.

In Falköping the baby café activities were led by a trained pre-school teacher. This pre-school teacher acted as our facilitator, helping us to recruit participants. We were invited to visit the baby café and take part in the activities that were organised once a week. Each occasion gathered a group of 20–25 parents and most of them participated regularly in these weekly meetings. When the parents gathered, we introduced ourselves and presented our study. We informed the parents that we would visit the café regularly over the following months and that participation in the study included interviews at the health care centre and some additional homework (that is, answering questions via email). We also handed out brochures and links to the project webpage. We came back for a second time and repeated the presentation. Between sessions, the facilitator encouraged women whom she thought might have an interest in participating. In all, 19 parents were recruited for this study (Please see Table 1).

Table 1. List of parentes participating in the study.

Amanda, age 25–30, office administrator. Her daughter is 8 months old and her first child.

Anette, age 25–30, unemployed. Her daughter is 7 months old and her first child.

Cecilia, age 31–35, works at a farm. Her daughter is the youngest of four.

Karin, age 35–40, teacher. Mother of nine-month year old boy and an older boy and girl.

Ella, age 20–25, unemployed. Her seven months old son is her first child.

Felicia, age 26–30, student. Her daughter, 10 months old is her first child.

Ingrid, age 20–25, works at day care centre and has a 7 months old son.

Jessica, age 31–35, preschool teacher, 8 months old daughter with an older brother.

Jenny, age 31–35, teacher. Her son is 5 ½ months and her first child.

Judith, age 20–25, works at a day care centre. 8 months old child who is a first child.

Klara, age 31–35, engineer, her son is almost 12 months and a first child.

Katarina, age 26–30, nurse, her seven months old son is her first child.

Petra, age 26–30, chef, her seven months old son is her second child.

Susanne, age 26–30, teacher. They have a 9 months old daughter.

Sigrid, age 31–35, manager, her daughter is 7 ½ months old and her first child

Signe, age 31–35, factory worker. Two sons, 7 weeks and 2 ½ (who she tells about in the interview).

Ulla, age 31–35, factory worker. Has 9-month-old son and an older girl.

Veronica, age 20–25, factory worker. A son, eight months is her first child.

We were successful in recruiting a heterogenous group of parents in relation to various criteria. The mothers were of diverse ages ranging from 20 to 40. They had different educational backgrounds varying from high school to university degrees. Most of them were employed in various service or educational work and were on parental leave at the time of the study. Two of the mothers described themselves as unemployed. None of them described themselves as a single parent. They also had different experiences with child rearing. A majority of them were first time mothers but six of the participants were second, third or even forth time mothers. The target age of the children that we focused discussions around was between 5 and 12 months old; in most cases, they were 7–8 months old.

Using the baby café as our primary location meant that we primarily met mothers. Although Swedish parents have equal rights to 390 days of government funded parental leave per child, mothers still use the majority of these days. There were 1 or 2 fathers present at every baby café gathering and in some of the interviews the fathers were present but when we approached the parents it was always the mother who volunteered to respond to our questions while the father cared for the baby and kept him or her content. During the interviews it however became clear that the fathers were involved in the practices of weaning. Mothers often used ‘we’ in their descriptions on how they fed their babies and it was clear that descriptions on what and how to feed the baby was a subject for discussion and sometimes debate in a household. It was however also clear that most mothers interviewed were on parental leave for a longer period of time, compared to their partners, and that they, based on their descriptions, acted as primary caregivers during this period. Many of them also commented that the fathers would act as primary caregivers when they were on parental leave. This is an important point made by the mothers participating in this study as we are aware of the norms around mothers being primary caregivers and risk managers. What this study show in this respect is that the parent who cares for the baby during the day, who participate and organise daily activities, also assume the role as primary care giver. This could be a mother or a father depending on who is on parental leave. It suggests that the person performing the daily weaning practice is also taking the responsibility for managing risks linked to this practice.

Using the baby café as our primary location for the study also meant that we only met parents who were either born and raised or raised in Sweden. After visiting the baby café a few times, we learned that parents who came to Sweden as migrants or refugees more recently, were engaging in the health care program but they did not visit the baby café. The pre-school teacher described immigrant and refugee parents as a group they had trouble reaching. She emphasised that the baby café activities were open for everyone and that the nurses at the health centre told all parents about their activities, but for some reason parents who came to Sweden more recently did not attend. Although open, friendly and inclusive, it was clear from attending the baby café that the gatherings were organised in Swedish and in a format that was much more recognisable and familiar to parents with experience of, for example, the Swedish pre-school or school system than for someone with little or no experience of Swedish child care or parental culture.

Methods and data

Data and analysis presented below are based on an ethnographic approach involving 1) observations, interviews, and emailed interviews with the parents visiting the baby café; 2) an analysis of Swedish public health printed materials to examine the construction of weaning riskscapes from different perspectives.

Data at the baby café included interviews and observations every second Thursday during the autumn of 2014. We conducted formal interviews with 19 mothers and made small talk with staff and parents during feeding time. The interviews were guided by a set of open-ended questions on practices of weaning, eating together with the family, who is feeding the baby, where information comes from, and values related to baby food, such as health, convenience, taste, price, and commensality. All mothers interviewed also had their babies with them and therefore the interviews took place in one of two playrooms available at the cafe. Observational data were recorded with still photos and field notes of the activities taking place in the playroom and the kitchen area of the facilities where many of the parents would serve their babies a meal.

Another set of data that we collected at the baby café was questions by e-mail that we sent in four packages until the child reached one year of age. Themes covered feeding practices at home, shopping for baby food, eating out/on the go with the baby, and a retrospective reflection on weaning (that is, when the baby reached one year of age) to consider what did and did not work. Eleven women participated in this part of the study, and the women were also encouraged to take pictures of different feeding situations using their cell phones and send them to us, which some of them did.

By combining interviews with observations and e-mailed accounts we gathered a rich material on parents’ doings and sayings related to baby care, baby food and weaning. In this paper we centre our analysis on the oral and written accounts collected through interviews and e-mailed stories. Although the observations of parents and babies sharing meals offer insight into the doing of weaning is it not possible to link a certain action to notions of risk and risk handling without written or oral accounts of what the parent is doing and why. This paper therefor builds on an analysis of the written and oral accounts (the observational data is used elsewhere, for example Brembeck & Fuentes, 2017)

We also collected information leaflets and written material about baby food and weaning from public health bodies that the women received or were likely to come into contact with. More specifically we analysed Barnmat: råd och recept [Children’s food: advice and recipes] (Trädgårdh Tornhill, 2012) a 48 page book offered to all parents visiting child care centres in western Sweden at the time of our study (please see Image 1). The book offers guidance and advise on how to wean a baby, for example what food to offer, how to handle the food, how to interest and respond to the baby and also a number of recipes. We also analysed advise on baby food and weaning offered at the National food agency webb-page as this was a source of information mentioned in our interviews with parents.

The print and internet-based material analysed here represent the Swedish public health discourse on baby food and feeding. It is almost identical to the information found in Rikshandboken för barnhälsovård [National Handbook of Child Health] a national guideline for health-care professionals. As we were interested in comparing the construction of risk in public health discourse and the accounts of mothers, we did not include interviews with nurses or observations of nurses offering advice to parents. Although such material would offer interesting insights on the practice of advising parents and nurses’ constructions of risk, this was not our focus in this project. Instead our aim was to compare the everyday practices of parents and their reflections on these practices with the official public health discourse on weaning.

Analysis

The data obtained at the baby café primarily included interviews, emailed ‘stories’, and written advice on weaning. The observations of feeding taking place at the baby café was part of the general analysis of weaning practice (see Brembeck & Fuentes, 2017) while the present analysis of risk mainly draw on interviews, e-mailed stories and written advice. The interviews were transcribed, and the transcripts, emailed stories, and written text were analysed following common ethnographic standards of comparison and by looking for themes and categories (Ehn & Löfgren, 2012; Hammersley & Atkinson, 2007).

Using riskscape as our analytical framework, we identified concerns related to baby food and weaning and unpacked their entanglement in place and practice. Particular attention was given to acts of classification (Boholm & Corvellec, 2011) related to weaning practice and its embeddedness in place (its location). As we will show in the analysis below the parents stories and advice material addressed various concerns in a weaning context and constructed these concerns as risks by assigning value to something (for example the health of the babies) while at the same time identifying various entities or circumstances that signalled a risk posed to this value (for example food with salt or unfamiliar provenance of ingredients). This approach meant that we analysed the material to find appointed signposts, (that is, entities or circumstances signalling a threat to the health of babies) and acts of navigation (that is, the various interpretations of signposts and changes or calls for changes in spatial practice; Müller-Mahn & Everts, 2013, p. 28).

We treated our transcripts and the advice material as resources for weaning and risk-related discourse and as sources of information regarding various weaning practices. Using riskscape, signpost and acts of navigation as sensitising concepts, the analysis involved a two-step selective coding procedure (see for example Strauss & Corbin, 1998). In a first step we used coding combined with memos to work through the interviews and the print material to identify properties and dimensions of various definitions and understandings of risk and ways of handling them. In a second step we re-read the interview material and the print material highlighting spatial dimensions present in the accounts of weaning practice, thereby developing our initial coding of risk.

Constructions of riskscapes

We identified two different but overlapping constructions of riskscapes: the public health riskscape and the mothers’ riskscape. The two riskscapes were shaped in tandem with accounts of weaning practice and involved different risk constructions and handling strategies. The Mothers participating in our study described consulting public health information as an integrated part of weaning practice. The risks defined in the public health material were also present in the accounts of mothers. But mothers also identified additional risks. While the public health riskscape was assembled in relation to the production of a meal and expert claims on its nutritional content and fit with developmental stages (see also Müller-Mahn & Everts, 2013, p. 28), the riskscapes of mothers were assembled in relation to the participants’ everyday lives. These were not circumscribed to a meal but included a wider set of practices. Although the two riskscapes overlapped it was clear that they were assembled and shaped in relation to different narratives of place, risk and food.

The following sections present the way weaning practices have been described in the public health advice and by the parents, and account for the two riskscapes identified, placing specific focus on signposts and acts of navigation defining public health and mothers’ riskscapes. We then discuss their similarities and differences. Finally, we conclude with a discussion of how an awareness of discrepancies can inform the development of public health advice.

Weaning practice and risks in public health discourse

The written information offered to parents by public health centres and by the website of the National Food Agency was described as based on established scientific knowledge. For example, on the Swedish national food Agency’s website the section ‘Good food for babies’ opens with the line ”The Swedish National Food Agency’s advice on food for children up to one year is based on collected research and is intended to be support for parents.”(Livsmedelsverket, 2019-06-22). Another example is found on the back cover of ‘Barnmat: råd och recept’ (Trädgårdh Tornhill, 2012) where it is emphasised that the material was developed by experts in clinical nutrition and paediatrics working at a the University hospital in Lund.

Throughout the public health print materials and websites analysed, weaning was described as a sequential process involving various steps, techniques, and specific foods. After breastfeeding for at least 6 months – guidelines that are strongly promoted and protected by current national and international public health policies – solid food introduction was recommended using a step-by-step approach. First, mothers are advised to offer complementary foods before adding increasing levels of complexity in flavour and texture in combination with an array of suitable techniques and tools. At 4 months of age, but not before, weaning begins, and the parents are advised to let the baby sporadically taste a tiny bit of their own food if he or she is interested.

Some children become interested in food early on. When your child is four months, but not before, you can let your child taste a tiny bit of your own food with a spoon or from your fingertip. Continue breastfeeding fully or offer formula.” (Trädgårdh Tornhill, 2012, p. 15)

This initial introduction is to be followed by proper tasting portions at 6 to 8 months of age: namely, enlarged taste samples are to be given more frequently. Porridge has a special place in the baby’s diet and may be served for breakfast, dinner, or as a snack, preferably together with vitamin C-rich fruits or berry puree (Trädgårdh Tornhill, 2012). At 8 to 12 months, finely mashed purees should disappear, and the child should instead progress to chewing, which can be taught by serving larger pieces of cooked potatoes, turnips, carrots, etc., and ripe fruits like bananas, kiwis, papayas, and melons (Trädgårdh Tornhill, 2012). At 12 months, the child should be weaned completely and be ready physically to eat the same food as the rest of the family (Trädgårdh Tornhill, 2012).

Different from international trends of parent-led weaning where foods should be pureed and offered via a spoon and in contrast to a baby-led approach that focuses on the introduction of finger foods and self-feeding when the baby is deemed ready (see, for example, Keenan and Stapleton, 2014), the recommended weaning practice does not fall into either category. Nor is it similar to the mothering ideal described as intensive mothering (Afflerback, Carter, Anthony, & Grauerholtz, 2013; Atkinson, 2014; Hays, 1998). Although the method discussed has many similarities to intensive mothering, such as the simultaneous juggling of career and child nourishment, weaning and childrearing are not considered to be solely the mother’s duty. Fathers are ideally present and participate, as are authorities and baby food companies with a range of convenience products acknowledged by public health authorities. For example, in ‘Barnmat – råd och recept’ parents are reassured ‘You don’t have to choose between home cooking or ready made baby food, both options has its advantages’ (Trädgårdh Tornhill, 2012, p. 1). Labour-intensive practices are not necessarily given preference over convenience-based ones (Brembeck & Fuentes, 2017). Instead, weaning, as with upbringing, is tinged with ideals of democratic parenthood and family life and should take place in a dialogue with the child. The child’s opinions are to be taken into serious consideration. For example, the book Barnmat – råd och recept [Children and food – advice and receipts] (Trädgårdh Tornhill, 2012) offer the following advice under the heading ‘If it does not work … ’:

“If your child refuses to eat what you serve, try something else. Do not force your child to eat something he/she does not accept. Wait a few days and try again. Try the food yourself and show that you enjoy eating it. It might make feeding easier since children are happy to imitate. Since your child is breastfeeding and/or given formula that contain lots of nourishments you do not need to worry if your child wants to proceed slowly with starting to eat regular food. Do not give up!” (Trädgårdh Tornhill, 2012, p. 5)

Aside from general descriptions of how to introduce babies to food, the public health information on weaning analysed here, specifically addresses a number of food risks present in the weaning process. The risks involve a range of issues. In ‘Barnmat – råd och recept’ parents are, for example, offered advice on making sure the baby is not fed large pieces of food or whole nuts to prevent choking, or avoiding salt, milk products (specifically unpasteurised), gluten, honey, or green leafy vegetables that may contain substances (that is, bacteria, spores) that the baby’s body is unable to process.

“There are some foods that you should avoid feeding a child under 12 months, after 12 months it is ok.

Do not feed your child

Salt or herbal salt. A baby’s kidneys are not fully developed. You do not need to avoid the small amount of salt included in different sorts of margarine or that occurs naturally in different foods.

Honey. It might contain spores of a bacteria that can cause poisoning in young children.

Green leafy plants such as salad, spinach, chard, nettles and colewart. These vegetables contain nitrate that can turn into nitrite. Nitrite can inhibit oxygen consumption in small children.” (Trädgårdh Tornhill, 2012, p. 7)

The information also covers the risks of excessive snacking (poor dental health and appetite). All of these risks are defined by linking various foods, substances, and ways of feeding to the negative effects on the developing baby’s body that have been established in scientific research.

Although the advice found in leaflets and on webpages generally lacked references to specific studies, the substances here framed as signposts – items or circumstances signalling risks – originate in research findings. In the texts specific food items are described as potential risks. These food items are described as containing substances that are harmful to the baby. The food items are described as risk objects (Boholm & Corvellec, 2011) in relation to the baby – the object at risk signalling the possibility of harm. This way food stuff like green leaves, salt, nuts, honey, water from private wells as well as large pieces of food, bacteria in common foods like chicken, along with snacking are ascribed the role of signposts suggesting there is a need to handle a potential threat to the baby. Together these, and the other signposts populate a riskscape where they signal the need for specific acts of navigation. The main act of navigation suggested by the public health material to remedy these risks is simply to avoid foodstuff that places these objects of risk in relation to the riskobject – the underdeveloped baby body.

What is interesting about this labelling of signposts is firstly the focus on the meal and the food stuff. In the public health material analysed weaning is represented as a rather circumscribed moment that involves parents, babies and foodstuff. Cooking, storing and feeding are the practices mentioned and it is also in these practices that risks are identified. They are all practices linked to the domestic setting and interestingly risks are predominantly linked to foodstuff prepared by the parent. Commercial baby food is mentioned but briefly, and parents are reassured that this foodstuff bought in the store is safe and of good quality. Hence, the riskscape constructed in the public health material is one where risks are present in the food itself and acts of navigation involve avoiding specific food stuff and snacking.

The public health discourse analysed here, assembles a riskscape anchored in the meal that is prepared and eaten, if not at home at least in a domestic context. It is a riskscape shaped by scientific notions of what is safe, healthy, that is nutritious, and suggest ‘best practice’ meal patterns where risks are avoided. It is also clear that in the riskscape assembled by the public health material analysed here, parents are responsible for and capable of handling the risks. The acts of navigation suggested, avoiding specific food stuff and snacking, are straight forward, clearly communicated and seem easy to follow.

Weaning practice and risks in parents’ accounts

All of the mothers described themselves as attentive to the advice they received from nurses and written materials. Their accounts of the weaning process involved the same sequential phases as described in the public health discourse. They all agreed that weaning was not a spontaneous process that just happened as the baby grew older. Instead, it was a methodical process where parents had to learn weaning skills and babies had to learn eating skills. This process, in turn, required the knowledge and ability to handle a variety of risks. Most mothers started introducing samples of food when the baby was 4–5 months old, and as the babies reached 6 months in age, many mothers started to give their babies portions of, for example, porridge. They simultaneously started introducing foods like pureed potatoes, corn, or carrots and eventually dishes with multiple ingredients and textures suitable for the developmental stage of the baby. Some mothers cooked most of the food themselves, while others relied primarily on commercial baby food. Most mothers mixed homemade and fresh ingredients with commercial products. They also described attempting to feed their babies food that was healthy. They enjoyed making weaning a pleasant experience for the baby but also sought to promote healthy food habits (Brembeck & Fuentes, 2017; Fuentes & Brembeck, 2017).

The riskscape of the mothers in this study was created both in relation to advice and warnings about risks from public health and in relation to everyday life. The signposts and acts of navigation defined by public health were well known to these mothers. They knew and described how they practiced the acts of navigation advocated by public health, such as cooking or buying separate food for the baby to avoid salt and refined sugar, maintaining a regular feeding schedule, and avoiding food that the baby could choke on, all of which are considered signs of risk in public health realm. It would seem therefore that the mothers internalised the advice given to them.

However, aside from these known and manageable risks, the mothers assembled their riskscapes from signposts involving a wider set of practices and places. Besides the riskscape defined by public health in relation to ‘scientific’ findings, their notion of risk involved a wider territory. While the public health advice centred on the preparation and consumption of individual meals, the parent and the relationship between the baby and specific food stuff, the riskscape of the parents in our study included events and actors not taking part in the meal. For the parents in our study there were additional signposts that required various acts of navigation.

While commercial baby food was generally considered a convenient option (see also Brembeck & Fuentes, 2017) the parents also linked commercial food to several risks. Parents in our study described commercial food production as non-transparent and linked it to risks, such as chemical or medical residues, quality of ingredients, and poor or even hazardous production methods. Many of the mothers described aspects of the food production system as risky, specifically mentioning the use of toxins in farming but also long-distance transportation supply chains and foods produced in other countries. It was clear that brands were used as signposts for potential risks and acts of navigation to avoid these risks involved choosing locally produced or organic products. Choosing locally produced food was important, and studies confirm that Swedes generally trust locally produced food to be safe and healthy (Brembeck & Fuentes, 2017), although there were risks connected to such products.

When you buy Semper baby food, you believe that Semper is a Swedish brand. But no, it is made in Spain! What is that? And then we found a brand called Hipp. It is also organic baby food. The company seemed to be Swedish. However, we saw it in Norway too, and then it did not seem as local. There is also a product called Ella. It also seemed Swedish. However, it was apparently British. (Klara, age 31, first child)¹

For Klara, and parents like her, the provenance of food products signalled potential risks. As Klaras’s account illustrates, provenance is a complex issue linked to consumers understandings of the foods they buy and the way they buy them (Meah & Watson, 2013). Our analysis suggest that parents use provenance outside Sweden as a signpost for risk. The mothers in this study ascribed ingredients or products originating outside Sweden the role of risk objects threatening the object at risk – the baby. Following previous studies of consumers understandings of food, risk and trust, this study suggests that consumers frame food from their home country as less risky than food from other countries (Halkier, 2010). Most of the mothers in this study expressed a preference for local food, meaning food produced in the area they lived in or produced in Sweden. In this sense the parents link their weaning practice and the food they feed their babies to discourses on local and international food landscapes. While the public health material construct risk in relation to the meal and its actors, parents include producers and the production of foods in their riskscape. It is also evident that the more dispersed riskscape of parents is linked to media stories and other societal discourses favouring national and local production (Fuentes & Fuentes, 2015). During the interviews it also became apparent that the parents were familiar with and ascribed meaning to living in an area with a long tradition of producing and refining various foods. They were familiar with the food industries in the area, some of them knew people who worked in dairy production. All in all, they saw the local food production as of good quality and safe while food production in other countries were less familiar and known to them more from news media reports.

Other signposts described by the mothers in this study were poor appetite and not following the weaning program, signalling a dual risk of babies not getting enough nutrients and mothers not adhering to the public health standards. When the baby did not want to eat, the mother described using various tricks and techniques they found in information from public health centres. ‘I usually attempt to play with the spoon, open wide and taste or pretend to taste the food myself to get her interested,’ Ella (age 21, first child) told us. Ulla (age 34, second child) admitted that she sometimes ‘tricked’ her daughter, although this is not recommended by the authorities, by ‘handing out a toy or spout mug with water, or letting her play with an empty spoon and when she opens her mouth to get these things in her mouth, we quickly put a spoon with food into her mouth’.

For some women, the problems with following the weaning program had begun with nursing, and they experienced difficulties adhering to the norm of 6 months of breastfeeding. Sometimes breastfeeding did not work at all, and sometimes the baby never wanted to stop nursing. Having a child who did not follow the weaning schedule was stressful. Some children refused to taste food samples, did not want solid food, or accepted only certain foods.

I attempted to feed her cooked food, but she did not want anything that I cooked. She did not even like potatoes. Ordinary potatoes! She almost vomits when she eats something I have cooked, so we buy food instead. It is the only thing that works. (Amanda, age 27, first child)

Lastly, the signpost information inconsistency was linked to risks connected with adhering to the amount of information participants received, inconsistencies in this information, and ultimately the risk of not weaning the ‘right’ way. Issues arose if the children could not tolerate certain foods or if the parents were vegetarians or vegans, and parents were frustrated at the lack of relevant information. The most common complaint was not the amount of advice or that the advice was irrelevant but that the information was not clear and consistent. For example, the advice on how to administer tasting samples caused some confusion: should you give the child a sample of the same food for a whole week before attempting something else, which was recently advised, or was it sufficient to make just one attempt before moving on to something new, which is the current advice? Should one mix the sample with breast milk, which was sometimes advised? Should one serve the sample on your fingertip or use a spoon? These apparently small differences became puzzling obstacles for first-time mothers or second- or third-time mothers who did not attempt these practices with their first baby.

Our nurse at the baby clinic said that at 6 months, we should start with one meal a day. It was porridge that we were to begin with. We then talked with someone else at the clinic. She said that we could offer her some more flavours in the evening, too. Everyone says something slightly different. You can never be sure. (Ingrid, age 22, first child)

Information inconsistancy was managed by relying on the community of practice to which the participant belonged and where public health was but one, albeit prominent, node. Additionally, pieces of information were modulated in the encounter with everyday practices where some practices were successful and others not because they were simply not ‘doable’ (Halkier, 2010, p. 6), for example Amanda’s efforts to serve her baby potatoes as advised by the public health material. What we found in our analysis was that second- or third-time mothers expressed less concern and anxiety linked to the actual performance of weaning practice. To us this suggests that having performed weaning practice before made risks, as defined by public health agencies, less troubling and most important, it made slight deviations from the program less troubling.

This means that the riskscapes constructed by the mothers participating in this study were manifold. A wider set of practices were included. Practically no food-related practices – shopping, cooking, feeding, searching for information – were devoid of risks and therefore potentially vulnerability-inducing activities. Acts of navigation, that is mothers’ ways of handling potential risks, were diverse and included combined strategies of avoidance, juggling, and negotiation. The mothers’ descriptions correspond with previous conceptualisations of everyday risk handling as ‘in between’ strategies (Zinn, 2008). The mothers’ described strategies situated in between what Zinn (2008) describes as orthodox notions of risk handling as either rational or irrational. Instead their accounts illustrated the social embeddedness of risk and risk handling. In the mother’s accounts risk was not necessarily an objective calculable category but rather something lived and made sense of using previous experiences (Zinn, 2008).

Some of the mothers in our study lacked previous experience of weaning, and several described shorter or longer moments of temporary vulnerability, for example, in relation to inconsistent information from public health centres. However, after feeling lost for varying periods of time, all participants described how they eventually found strategies to manage the situation, and the state of vulnerability ended (Brembeck & Fuentes, 2017). For the mothers in our study, vulnerability was situational (Jackson & Meah, 2018) – a result of contextual factors surrounding their performance of weaning practice rather than their age or socioeconomic status. It was also diachronic; these mothers moved in and out of vulnerable positions as their everyday practices involved events where the baby – the object at risk – were suddenly placed in relation to an risk object, for example processed food with non-Swedish origin as in the case of Klara, or inconsistent information as in the case of Ingrid. Klara’s and Ingrid’s accounts illustrate a sense of vulnerability reported in a clear majority of the interviews. They tell of events when parents have found a way to handle risk and insecurities (buy a specific brand, follow advice) but then the act of navigation is put into question (the branded food is not produced in Sweden, inconsistent advice) placing them in a vulnerable position.

It is also interesting to note that the participants did express vulnerability, not primarily in relation to the meal-centric riskscape defined by public health, but to a wider riskscape involving multiple actors and practices. In this study the mothers identified risk in relation to everyday problems of babies not wanting to eat and when they were unable to follow the prescribed weaning program but also in relation to other practices and wider discourses on international food production and inconsistency of information on food and health. They were bewildered by the complexity of the food industry and the (general) overflow and inconsistency of information on weaning from public health authorities and other media. The risks that mothers define and negotiate in their everyday lives tend to be overlooked or even silenced in public health discourse as a consequence of authorities’ ways of framing issues that they communicate (see for example Brembeck, 2013).

This analysis suggests that the gap between public health riskscape and mothers’ riskscape can create a sense of vulnerability and a sense of estrangement or alienation. The mothers described the information they received as relevant for the most part, but there were also instances where mothers reported feelings of frustration and a sense of not receiving consistent information or relevant information, for example in relation a vegan or vegetarian diet. Feelings of vulnerability and alienation are important to acknowledge as they signal potential risks of losing public trust in public health advice. Following the work of Müller-Mahn and Everts (2013) this study highlights how some uncertainties can be ‘heightened in our “post-trust societies”’ (p. 35) by the way some risks (such as the industrialised food system or information overload) are simultaneously defined as tolerable and intolerable by different groups.

A demarcated riskscape meets a dispersed riskscape

As the analysis above shows, public health information and mothers’ accounts of weaning assembled different but overlapping riskscapes. The riskscapes centred the same object at risk (Boholm & Corvellec, 2011) – the babies’ health, but definitions and localisations of risks and harm as well as prescribed navigational acts varied.

The public health material analysed in this study, represented weaning as a practice involving a baby, parents and individual foods and as a practice centred around preparing and feeding meals. The riskscape assembled in these representations centred on the developing baby’s body and its needs for nourishment and protection from individual foods and substances. Risks were predominantly defined and described in the cooking and feeding context, and not outside the actual meal situation. Hence, public health discourse mainly localised risks in the domestic sphere. Written information and guidance cautioned mothers to avoid specific foods when cooking and feeding the baby while activities like shopping or commercial food processing were left out.

The mothers’ riskscape included many of the same signposts as the public health riskscape. Mothers also described individual ingredients and large pieces of food as potential risks to be avoided. In this sense the mothers in our study had internalised the risks defined and described in the public health material. Our findings however also clearly illustrate how mothers belonged to a community of practice where weaning was understood and practiced in relation to their everyday life and eating, involving multiple concerns not addressed in public health advice. The mothers’ defined additional risks in relation to other domains, especially the wider food and information landscape. The parents in our study understood and practiced weaning as a form of eating – a compound practice (Warde, 2016) linked to a wider food landscape populated but multiple risks and abound with information from various actors. They did not perceive cooking, feeding or the domestic sphere as the primary site of risk.

Our analysis show that signposts and navigational acts, although sometimes overlapping, were part of diverse social contexts and ways of making sense of the world (Müller-Mahn & Everts, 2013). Following Zinn (2008) the analysis illustrates the different organising principles or logics that underpinned the public health and the mothers’ riskscapes. While the public health riskscape was characterised by a scientific logic of rational risk handling, cause and effect, the mother’s riskscape seemed shaped by a logic of ‘analogy’ (Zinn, 2008).

The public health material accounted for weaning as a sequential and demarcated process involving the domestic sphere and two actors – the baby and parent. Addressing the parent, the public health material described how she or he could protect the baby from harm by, for example, excluding salt, honey, whole nuts and developing regular feeding habits. Risks were clearly defined, as were the possible effects of not avoiding these causes of harm. Making ‘rational’ choices based on knowledge were the main navigational act prescribed. As a result, public health material account for risk handling as an issue of making informed choices and as an individual responsibility.

In contrast, and similar to previous work on food risk and mothering, our study suggests mothers’ experience of food and feeding a baby to be more complex. Like Lee (2007) we find that the term ‘choice’ is ill-fitted for framing the mothers’ accounts of feeding a baby (p. 306). As Lee (2007) puts it mothers’ experience is ‘shaped by the actual (often difficult) experience of feeding a baby’ (Lee, 2007, p. 307) and there is no room for calculative ‘rational’ risk handling processes. Like Lee (2007) our analysis suggests that the mother’s risk handling was integrated with the actions and materials of the actual practice of weaning. The mothers seemed to understand and manage advice from public health by unpacking it and translating it into their weaning practice. Ways of navigation risk like cooking without salt or avoiding large pieces were, for example, were accounted for, not as ‘choices’ but as a form of form of know-how integrated in weaning practice.

This way of handling risk, as part of practice rather than rational or informed choices could be better described as ‘in between’ strategies, that ways of handling risk that are neither fully rational and based on informed choices nor irrational and exempt from reasoning (Zinn, 2008). Our analysis suggests that the mothers made up analogies between weaning practice and their eating practices. The mothers’ understood weaning as a practice separate from other practices but in their accounts, constant comparisons were made between weaning and their own way of eating. Understandings and ways of handling risk were no exception and previous experiences of handling risks and uncertainties linked to food and eating were linked to the way they understood and handled risk in weaning practice. It was also clear that second- or third-time mothers with previous weaning experience expressed less concern and anxiety related to difficulties and uncertainties. Having weaned a baby before, these mothers handled difficulties and potential risks by using previous experience of not just eating but also weaning practice. Mother’s with previous experience of weaning described themselves as less vulnerable in terms of unpacking health care advice and navigating the public health as well as their own riskscapes. Second time mothers described how they had acquired tacit knowledge that could be utilised in navigating uncertainties and risks in their weaning practice. The study therefore suggests that the gap between public health and mothers’ riskscapes can be more troublesome to handle for first time mothers.

Conclusion

In this article, our aim was to conceptualise and map various co-existing constructions of risk and discuss how an awareness of the multiplicity of risk can inform the development of public health advice that take mothers’ point of view into account. Drawing on the concept riskscape our analysis illustrates the co-existence of different constructions of risk in weaning practices in Sweden today. While public health discourse defines risk in ‘scientific’ and meal-centred terms, the mothers in our study define risk in terms of everyday practice and the wider food landscape. Although the riskscapes of public health and mothers shared many characteristics and partially overlapped, they also displayed discrepancies and seemed underpinned by different logics, suggesting that public health discourse misses out on or even silences risks defined by women in their everyday experience of weaning.

We see the findings that public health material primarily place and address risk in the domestic setting while the parents also include risk situated outside the domestic sphere as particularly important. It suggests that the public health print material does not acknowledge the compound nature of weaning practice and therefore misses out on risks identified by parents.

In addition, the study suggests that the public health focus on information is insufficient in terms of addressing risk, as mothers’ understanding of risk and need for guidance originate in experiencing difficulties performing weaning practices rather than a deficient understanding of this practice.

Thus, while the information mothers received on how to prepare the baby’s food or use commercial baby food appeared to offer sufficient guidance to make rational choices on how to wean a baby, it did not always support mothers as it gave little to no guidance on how to handle the risks of a wider food landscape or how to build ‘in between strategies’ (Zinn, 2008). Based on the findings of this study we argue that there are gains to be made by acknowledging the way mothers’ experience weaning and how they understand risks and, following this, address a wider variety of risks.

First, this would involve acknowledging that risk and risk handling can be defined and organised according to different logics or ways of reasoning. If mothers understand and handle risk in a manner analogous to the way they define and understand risk in their everyday eating practice any efforts to support mothers’ risk handling should be designed accordingly. Like previous work (for example Crighton, 2013) our study suggests that mothers felt more secure handling risks present in the domestic setting where they were more in control. Information should therefore avoid centring on the domestic sphere only and address risks found in other places outside this context. It should for example address uncertainties linked to the industrialised food system or present-day overflow of information.

Second, the tacit aspects of weaning and risk handling should be emphasised. The written public health information analysed in this study gave little guidance on how to practically perform everyday weaning. The practice and difficulties of feeding was, for example, not described in the print material and none of the parents interviewed in this study had been given any hands-on guidance from public health care. Following this analysis as well as previous work on mothers and risk handling (see for example, Romagnoli & Wall, 2012) public health should acknowledge the possible benefits of other forms of support than education and information that run the risk of increasing individual responsibility for risk handling.

Acknowledgements

The authors would like to thank the anonymous reviewers for valuable and constructive critique and Professor Peter Jackson, Professor Bente Halkier, Professor Jonathan Everts and the FOCAS-group for discussions and comments.

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

This work is part of the “Food, convenience and sustainability” (FOCAS) project, which is included in the ERA-Net SUSFOOD Programme (2014–2017). FOCAS is a collaboration between researchers in Great Britain, Denmark, The Netherlands and Sweden (www.sheffield.ac.uk/focas). The Swedish part of the project is funded by The Swedish Research Council FORMAS (grant no 222-2014-50)

Notes

1. All names of the respondents are pseudonyms.