Abstract
Is Breasts Best? accumulates and critiques the current empirical evidence on whether breast-feeding is best for babies. Joan Wolf provides a feminist critique of current public health policy and scientific research; government-supported campaigns touting the benefits of breast-feeding (i.e., fewer infections, gastro intestinal problems and earaches; higher IQs; lower rates of obesity and diabetes); and, the gendered assumptions that women are solely responsible for child feeding and rearing, no matter their own circumstances. She positions these factors within a risk culture that requires mothers to engage in “total motherhood” to protect their children from any and all dangers (p. xv).
Wolf’s primary critique of the current empirical evidence is that epidemiological studies on the benefits of breast-feeding examine only the relationship between variables of interest and outcome health indicators, not causation. The research has yet to control for many important confounding variables that include the very act of deciding to breast-feed. She notes that researchers do not even understand “how breast milk works in a baby’s body to protect or promote health” (p. xii).
Wolf accuses the U.S. Department of Health and Human Services, and others, of engaging in campaigns that scare and shame women about their breast-feeding decisions. Using weak evidence, medical journalists often overexaggerate the benefits of breast-feeding. Nonscientific journalists in the popular media interpret this information for the general public, many of whom (journalist and consumer) have minimal understanding of the differences between correlation and causation. These campaigns stigmatize women who do not, or cannot, breast-feed.
Wolf provides a feminist critique of societal expectations that women must engage in total motherhood that begins in pregnancy. Total motherhood is strongly predicated on mothers being responsible for reducing all risks to which children could be exposed: health, mental health, education, economic, and so on. She exposes the strong class and ethnic bias in the expectation that women alone bear these responsibilities, clearly documenting the challenges many working women face that may influence or determine their decision to breast-feed. She notes that most research ignores the cultural meaning women assign to breast-feeding based on historical oppression and exploitation.
I adopted what Wolf refers to as total motherhood: a natural home birth with midwife; baby-led weaning that I finally stopped when my child was three; carrying my child in an over the shoulder baby holder (sling); and, adopting the family bed until my child was eight years old. These decisions, made 25 years ago as a first-time mother, were given little thought. I never questioned that breast milk was best: The colostrum provided important nutrients and antibodies, and I believed continued breast-feeding provided a range of health benefits including fewer psychological problems later on since my child would be nurtured as the goddess had intended. At the time, I considered these choices natural—in rebellion to what had become the medicalization of childbirth and child feeding in the early half of the 20th century. Reclaiming breast-feeding, and doing so publicly, also rejected society’s sexualization of women’s breasts.
Wolf, however, compels us to consider factors not previously addressed, recognize the limitations of the current research, including the overexaggeration of breast-feeding benefits, the gendered assumption about women’s bodies and roles and the impact of this scrutiny and control on women’s behavior. This is an excellent feminist critique of breast-feeding that social workers should read to inform their discussions with women about parenting and child-feeding decisions. As practitioners, we do not want to shame or stigmatize women who do not, or cannot, breast-feed. Wolf helps us understand that the decision to breast-feed or not is complex with many personal, social, and political factors to consider.