The Legacy Of Scientific Motherhood:  Why Breastfeeding And Attachment Parenting Come Under Constant Fire. 

A commentary by Marie Davis, RN, IBCLC

Where did society go wrong? When did we stop trusting in Mother Nature and start thinking that humankind could improve on the marvelous plan already created? “Cultural, social and medical interventions during the past 3000 years have so modified child care practices that we now find it difficult to see what ‘nature . . . intended.’ I freely admit that as a scientist I do not believe in the theory of evolution. The more I have studied the intricacies of pregnancy, human milk and this machine we call “human body,” the more I am absolutely convinced that none of this happened by chance. 
Somewhere, somehow we were all led astray. Traditional belief in the miracles of our innate physiology is lost in western societies. Often, we have become too scientific, believing that somehow the original design was flawed. Suzanne Arms states “We have paid dearly for every ‘advancement’ because each step has altered our world view.” By becoming so technical “we have lost a respect and reverence for nature and all natural processes . . . ”

Maybe it all started with wet nursing? Not the wet nursing that was essential when a mother died or a baby was abandoned. Feeding a baby anything other than human milk was called “dry nursing” and was often a dismal failure. There came an era when women began to believe that they were beyond breastfeeding their own children. Wet nursing became deeply ingrained in ancient cultures. The Babylonian King, Hammurabi, wrote a set of laws concerning the wet nurse’s care of the infant. Wet nursing began as a lucrative profession causing many a young women to abandon or kill her infant to go and work in a wealthy home as a pampered wet nurse. The use of a wet nurse separated the mother from the child for hours every day. Maybe so she could spend her time doing something considered more important? This was probably the beginning of what is now called “detached parenting.” 
The practice of wet nursing continued among the aristocracy throughout the Greek and Roman empires. In an era when land holdings and imperial lines depended on offspring (in some cases only males), people knew that breastfeeding would make their offspring healthier, taller and stronger than the average person. Breastfeeding delayed subsequent pregnancies. Infant mortality rates were very high. It was not uncommon for royal families to have 10 or more children with only one living into adulthood. Having more pregnancies gave the royal classes the chance that some children survived into adulthood and also assured the throne would remain within the family. Wet nursing was probably introduced to Europe during the Roman occupation In European countries from 1500 to 1700 the hiring of wet nurses was the norm. The expectant mother was responsible for choosing a wet nurse of good temperament and morals. The wet nurse was under the strict supervision of the mother in her home. Wet nursing was exported to the New World. Colonial news papers advertised the services of wet nurses as early as 1711 
For a time, live-in wet nurses went out of fashion. Newborns were sent to live in the wet nurse’s home until they were weaned. The “farming out” of newborns further removed the child from his immediate family. A mother may not have seen her own child between birth and weaning.

Those “farmed out” babies began dying enmasse under the care of wet nurses. By the mid- 18th century it became fashionable again for the wealthy to nurse their own infants. There were legitimate concerns that diseases were transmitted through breastmilk. Today, some women “cross nurse”, or wet nurse, or share their milk with the children of close friends or sisters, but the practice has been highly discouraged due to the possibility of HIV and hepatitis transmission. 

The Legacy of Scientific Motherhood
Raphael traces the decline of breastfeeding to the industrial revolution. . In 1880, 95% of all infants were breastfed for two to four years. By 1990 only 50% were breastfed at birth. Three quarters of those infants were weaned by six months. The rapid decline of breastfeeding occurred in this century, reaching its nadir in 1971. 

Decline and Fall of Breastfeeding
Maybe some time after Darwin’s ideas became accepted as more than theory, science came to the false conclusion that babies needed to be separated from their mothers to produce a physically and mentally healthy child? 
Degeneration of breastfeeding into bottle feeding began as scientific fields and sociological changes converged. Edward Newton’s forward in Breastfeeding: Biocultural Perspectives, cites five major cultural phenomena that led to the decline of breastfeeding 1) The loss of community/family knowledge, role models and support of breastfeeding, 2) The tendency to hand over responsibility for personal health to the medical profession, 3) an increasingly more patronizing attitude toward patients by the medical professions, 4) a greater reliance on institutions, along with their structured environments, and 5) premature application of poorly conceived and poorly tested medical theory. Along with a greater reliance on medical technology also came an increased reliance on devices and gadgets, cribs, cradles, bottles, strollers, pacifiers and the like.
To understand why women choose to breastfeed or why they bottle feed, or why they practice attachment parenting it is important to look at how a society views babies. Our attitudes toward breastfeeding and mothering are indicators of our very attitudes toward children . 
“At the beginning of the 20th century, psychologists, physicians and even religious leaders were convinced that babies developed best if they were raised according to hard and fast rules .” Sheila Kitzinger calls this the beginning of the era of “The Monster Baby” . The medical and psychological communities began advising mothers that they must gain control over the infant and show the baby that she is the master. “The medical profession sought to regulate the breastfeeding [and mothering] process for women, [by] imposing arbitrary rules with little physiological basis .” Historically feeding recommendations ranged from benign to dangerous. 

In 1896, a book called The Care and Feeding of Infants began the scientific raising of children. The author, L. Emmet Holt, recommended feeding children by the clock. He felt that too much handling, cuddling etc., . . . weakened the child. His book was available until 1935. The rules for raising children treated babies as if they were merely, evil, little strong willed adults. 
In 1930, Nelson’s Textbook of Pediatrics warned against rigid scheduling “The disadvantage of a rigid schedule for feeding is that the time of the feeding or the intervals between may not correspond with the infant’s natural ‘hunger rhythm.’ This results in prolonged crying; and the infant develops various types of feeding difficulties.”

Enter The Psychological Piece Of The Puzzle
Sigmund Freud (1856-1939), often called the father of modern Psychology, mistakenly related sexuality and normal childhood genital touching to adult mental illness and crime. Breastfeeding was suddenly seen as a sexual act and was banned as unhealthy. This idea of combining breastfeeding and sexuality carries over today. 
The psychologist John Watson (1878-1958) believed in rigorous behavioralism. After studying animals he concluded that all behavior was one of two types: stimulus or response. In 1918, he was allowed to extended his research at John Hopkins to the principles of behavior in children. He was an outspoken advocate of extreme manipulation of the environment. Watson believed that suppressing the normal impulses of childhood with rigid schedules would lead to adult mental health. He frowned on outward displays of affection. Infants were to eat, sleep, even excrete at a specified time 
B.F. Skinner (1904-1990) highly influenced by Watson’s writings, was also an avid behaviorist. He too believed that behavior was governed by the environment. Skinner recommended that a child be kept in a controlled environment and tried to prove his point by raising his own children in a padded box. Our modern day crib and bumper pads are said to be leftovers of “Skinner’s Box.” Babies were removed from the warmth and comfort of the family bed for the sake of mental health. This fostered a still more distant, detached style of parenting. 

Erik Erikson (1902-1994) was among the first psychologists to study normal, well-adjusted individuals. Erikson set forth a group of age-related developmental tasks. Each stage is a positive task verses a negative one. He believed that how the individual completes each task determines personal identity. The developmental task in the first year of life is: trust versus mistrust. An infant must learn that his needs are met to develop trust, if his needs are not met, the baby develops mistrust. The next task, typical of toddlers, is autonomy versus shame and doubt. Erikson’s ages and stages of development continue throughout the life cycle.

Post World War II Era Produces And Sells A Need For Formula
After World War II, women entered the work force in great numbers. Women wanted, and often needed to work, but they had to work in primarily male industrial setting that did not make provisions for a breastfeeding mother and baby. The need for human milk substitutes was greater than ever. Companies that mass-produced artificial baby milk were started. “Somehow during the lifetime of our mothers or grandmothers due mostly to profound social changes but also smart marketing bottle feeding became ‘normal’ in the collective consciousness of western society . . . We must all work now to reestablish the breastfeeding baby as the
model for normal society”.  As science was applied to all things in life, everything was reduced to cold, hard, sterile, “scientific” fact. Formula was calculated to the last calorie, was measurable and was very much a scientific process. Breastfeeding was not viewed as sterile nor was it the least bit scientific. It was not seen as measurable. The formula industry was in full swing. By the sixties, the Space Age was on. Artificial baby milk was proclaimed the “modern way” to feed a baby. Now that formula was considered “safe,” nursing was banned as unhealthy and the push was on for “better” babies through “superior” infant formulas. 
During the seventies, the “Flower Children” and back-to-nature movements were spawned. Going back to Mother Earth, the young women of these movements breastfed. But by the eighties, breastfeeding was still not accepted as the norm. Today, although breastfeeding rates linger near 50%, at least one author believes that it is “politically incorrect” to bottle feed .

FEMALE BREASTS A CULTURAL PARADOX
Only recently have authors begun to look at the broader context of culture. “Every cultural group holds beliefs about the primary function of a woman’s breasts . . . .” Thanks in part to magazines and movies, our society has narrow definition of feminine beauty, so too is its view of breasts and breastfeeding.
Renaissance paintings often depict nude women with full matronly figures. Round bellies and large hips are common. If one looks carefully at the armless statue of Venus de Milo, her erect breasts and bulging tummy make it clear the model was postpartum. Such was the cultural embodiment of womanhood and value motherhood held at the time. The traditional Madonna is a full figured woman offering her naked breast to a cherub-like child. 

Following World War II, when artificial feeding became a viable option, the cultural context of a woman’s breasts began to shift from functional to purely sexual. 

Enter Hollywood 
Photographs in popular magazines in the 1940’s began to depict women with large breasts as the ideal in beauty. Simple camisoles thanks to Frederick’s of Hollywood and in part to Howard Hughes became what we know today as bras. “By 1940 . . . the ideal shape of the breast changed, it now consisted of two pointed cones attached at right angles to the female chest .” “Sweater Girls,” as they were called, became popular. “Blond Bombshells” were noticeably heavy on top with pencil thin waistlines. Movie actresses began to resemble an exaggerated caricature of femininity. Closer to Jessica In Disney’s Rodger Rabbit than women. In December 1953 the first issue of Playboy appeared and its narrow definition of beauty, proscribed breast shape, areolar shape and size quickly became a part of American culture. 
“U.S. culture defines a small range of acceptable breast shapes and sizes .” Large, erect breasts are the “look” that this culture demands. Small breasts are treated as if they are a disease (Ask any plastic surgeon: it has a medical diagnosis). 
Dettwyler likens our cultural fascination with breast size and resultant breast augmentation surgery to the now forbidden Chinese custom of foot binding. As you read this description look at your own feet and imagine what it much have been like. If your feet were not bound it was unlikely that you could find a man willing to marry you. Chinese mothers began the painful binding process with their daughters between six and eight years of age. The feet were folded over (toes down) and bound. The process was painful and often caused the feet to decay. The bound feet were forced into smaller and smaller shoes “until they achieved the desired THREE INCHES in length . . . (177).” (emphasis added) The woman’s feet were rendered nearly useless for walking. Similarly today, the woman who has breast augmentation or reduction surgery, may be unable to use her breasts for their intended purpose- breastfeeding. Women choose bras that push the breasts into unnatural positions or are filled with extra padding to achieve that “look.” Women falsely believe that breastfeeding will make their breasts sag. In cultures, where more emphasis is placed on the value of motherhood, erect breasts are viewed as a sign of a woman’s immaturity. Katherine Dettwyler’s eloquent chapter in Breastfeeding: Biocultural Perspectives, called “Beauty and the Breast,” lists four current cultural assumptions about female breasts and breastfeeding in western societies: 1) Breasts are for sex, 2) Breastfeeding serves only a nutritional function, 3) Breastfeeding should be limited to very young infants, 4) Breastfeeding (like sexual activity) is appropriate only when done in private. Many of the cultural difficulties women experience in breastfeeding can be traced to these four points.
“The biggest block [to breastfeeding] in the minds of women relates to feelings of shame associated with breastfeeding . . . shame is the result of relating the breast to concepts of sexuality.” Susan Love says that this shame and “Ignorance about our breasts ... leads to emotional pain, confusion and sometimes serious health problems.” Western culture is “hung up” on women’s breasts, as if the value of the female breast lies in sexual excitement alone. From topless bars and adult magazines, to the number of breast augmentation surgeries done worldwide, the emphasis is placed on some intangible sexual level. Our youth learn that the sexual function of a woman’s breast is more important than its maternal one. Young men are led to believe that large, erect breasts are sexually desirable. Yet male sexual attraction to female breasts is not widespread nor is it a universal phenomenon occurring across all cultures The breast is not intrinsically erotic. Sexual excitement through breast manipulation is learned behavior. Such pleasure is not wrong, but the idea itself forms a paradox. Every text about breastfeeding includes discussions of the possibility that a woman could derive sexual pleasure from breastfeeding. Whether that is true or not remains to be seen. The author has asked thousands of women if they ever experienced sexual sensations or feelings while breastfeeding and the answer was always a resounding no. However, both men and women who may be uncomfortable with their own sexuality, might shy away from breastfeeding based on this idea alone.

It is more culturally acceptable to “expose the breasts for erotic purposes than to expose them for breastfeeding.” Recently, many states have found it necessary to enact laws that protect an infant’s right to breastfeed anywhere. Some states had to redefine indecent exposure statutes regarding nipple exposure and “mouth to breast” contact. On the federal level in 1999 Rep. Carolyn Maloney introduced several pieces of legislation that protect breastfeeding.
In the pamphlets from formula companies breastfeeding is almost always portrayed in a bedroom, with a mother in a negligee and breastfeeding a nearly newborn baby. In many of those pamphlets and unfortunately other pictures of women breastfeeding, far too much of the breast is exposed. For educational purposed photographers feel that more exposure helps the teaching point. Women do not have to expose themselves to breastfeed. But, many women fear ridicule and embarrassment if they breastfeed outside their homes. Unfortunately women who nurse in public are frequently subjected to shame and scorn. They may choose to bottle feed in public. Even in the privacy of their own homes, the mother may hide away to nurse or bottle feed if guests are in the house.
Women also feel that there is a social stigma attached to nursing an infant beyond 6 months. Why? Because those are the images they have grown up with. This social stigma has “driven many well-educated, caring, dedicated mothers to conceal nursing, called closet nursing.” Some women even hide away from their older children to nurse the new baby. Children learn about the breast and breastfeeding and mothering from their mothers. When a mother nurses away from her older children or forbids them to watch the new baby nurse, the child may get the idea that there is shame or guilt associated with breastfeeding. As a result the child may develop shameful feelings about breasts. The necessary cultural changes to support breastfeeding will be slow and difficult. What may be needed is a strong, grass-roots educational campaign. Look at any child’s story book, baby doll or toy animal. How often do stories and children’s toys include bottles as the only method of feeding? Children must be taught that 1) All mammals have breasts for optimal nourishment of their young, 2) Breast size bears no relationship to function, 3) Female breasts are not parts of genitalia, 4) Breastfeeding is not a sexual activity. These ideas must be presented repeatedly and reinforced throughout the child’s life, into adulthood.

The December 1997 American Academy of Pediatrics (AAP) policy statement “Breastfeeding and the Use of Human Milk” heralded a new bias toward breastfeeding in the United States. The policy reflects “ . . . the considerable advances that have occurred in recent years in the scientific knowledge of breastfeeding, the mechanisms underlying these benefits and in the practice of breastfeeding.” 
A critical, yet overlooked, aspect of the 1997 AAP statement is the acknowledgment of the breastfed infant as the “reference or normative model (AAP1 1).” The breastfed infant is the normal standard against which all research and recommendations for infant feeding should be made. This is a paradigm shift in American scientific thinking. Research in all areas of maternal - child health should use exclusively breastfeeding infants and their mothers as the study controls. Breastfeeding and human milk are the “Gold Standard” by which all infant feeding and developmental issues should be measured. 
This is only the tip of the iceberg. Because the statement also signals a bias toward mothering in our culture. Yet breastfeeding remains perhaps the most misunderstood aspect of motherhood in our society today. 
In conclusion...
It is the author’s belief is that our society will continue to suffer from a myriad of ills until we place more emphasis on the well-being of our children. The emphasis must begin in infancy. With the infant far removed from the closeness of his parents, not being comforted when he cries, fed or changed unless the schedule says its time, developing trust is in jeopardy. So too is our future.

Nearly 2000 years ago a man warned his friend ”...keep that which is committed to thy trust avoiding profane and vain babblings and oppositions of science falsely so called, which some professing have erred...” We have not learned the lesson yet.

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