Social Justice at the Core of Breastfeeding Protection, Promotion and Support: A Conceptualization

Abstract

Despite widespread awareness of the health benefits for both mothers and babies we are far from achieving universal breastfeeding. Breastfeeding rates globally are lower than recommended levels and there are concerns that some global breastfeeding efforts have stalled (1, 2). In addition, we see persistent disparities in breastfeeding rates by race, ethnicity, class and status (3). A growing literature documents how a range of injustices, including gender inequality (7), racism (8), poverty (9), and violence (10, 11) shape whether, how exclusive, and for how long mothers and others will be able to breastfeed or feed their infants human milk. These social injustices and inequities work to privilege breastfeeding even as the health message becomes more mainstreamed and human milk more desirable. A social justice approach could help us address the gender, race, and sexuality-based inequities and injustices in opportunities, resources, status, and power that are influencing the patterns of breastfeeding we see today. The 12th Breastfeeding and Feminism International Conference held in 2017 took as its theme Breastfeeding as Social Justice: From Crucial Conversation to Inspired Action. The planning team for that conference identified seven core domains that could help us conceptualize a framework for placing social justice at the core of our work. This paper presents this framework and suggestions for policy and practice that follow.

Breastfeeding woman or lactating object? A critical philosophical discussion on the influence of Cartesian dualism on breastfeeding in the neonatal intensive care unit

“…Authors Johnson, Williamson, Lyttle, and Leeming () point out that modern discourse on breastfeeding, which has been largely mechanistic in nature, has contributed to the de‐contextualisation of our understanding of breastfeeding. The role of gender, power and politics on women's breasts and breastfeeding‐related choices also play highly influential contextual roles (Smith, ; Smith, Hausman, & Labbok, ). In reality, both mother and infant are entrenched within complex social, cultural and political spheres that impact, amongst many other dimensions of motherhood, decisions related to feeding.…”

“…In reality, both mother and infant are entrenched within complex social, cultural and political spheres that impact, amongst many other dimensions of motherhood, decisions related to feeding. We cannot discount the existing social and structural inequities that influence a woman's ability to choose to breastfeed as it often goes beyond choice (Brown, ; Smith, ). As Palmer () identifies, the ability to decide lies largely on a woman's social and/or economic position, influenced by dimensions of privilege, power and sex.…”

Concordance as a Person‐Centered Measure of Breastfeeding Success: From Adequacy to Agency

“…7,8,15,16 One challenge with the current framing of breastfeeding and its promotion is its focus on the acts of an individual, rather than on the larger social contexts, and on ensuring adherence to universal recommendations. 17 In public health work, the common perspective is a focus is on improving the health of a population via health improvement of the individual. This approach has been very effective in many situations, such as vaccination and smoking cessation.…”

Applying Feminist Poststructuralism as a Framework for Exploring Infant Feeding Interactions in the Neonatal Intensive Care Unit

“…Utilising these methods both directly and indirectly raise serious ethical and moral concerns. As several feminist scholars have identified, the decision to breast(chest)feed largely goes beyond choiceit is a complex process entrenched in one's social and economic location, intricately linked with gender and positions of privilege and power (Brown, 2017;Smith, 2018;Smith, Hausman & Labbok, 2012;Palmer, 2009). Creating safe spaces to identify and discuss different breast(chest)feeding discourses if often difficult.…”