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Book Review Mother's Milk: Breastfeeding Controversies in American Culture

by Bernice L. Hausman
Softcover, 288 pages
Reviewed by Sara Dodder Furr
Lincoln NE USA
From: LEAVEN, Vol. 41 No. 1, February-March 2005, pp. 18-19.

Based on personal experience and an extensive review of breastfeeding literature and research, Bernice L. Hausman has written a book that provides an examination of how US culture both promotes and undermines breastfeeding. Mother’s Milk: Breastfeeding Controversies in American Culture examines the effectiveness of strategies used by breastfeeding advocates, such as Ruth Lawrence and Katherine Dettwyler, to make breastfeeding the cultural norm in the United States. The beliefs and concepts advocated by La Leche League are also analyzed in great detail.

The AAP recommends that infants be exclusively breastfed for approximately the first six months of life and that breastfeeding continue (at least) through the first year of life. Yet, according to recent data released by the United States Centers for Disease Control and Prevention, only 14 percent of infants are exclusively breastfed for six months and only 17 percent are breastfed any amount at one year of age. Why the disparity between what we promote and what we find to be the reality in the United States? Hausman draws upon her personal experience as a breastfeeding mother, an LLL member, a feminist, and an English professor to delve deeply into the reasons that breastfeeding as promoted by LLL is not the norm in the United States.

As I read this book, I sometimes felt as though I were listening, unobserved, while people I know and respect critically discuss an organization I love. There has been controversy, perhaps especially within LLL, regarding the purpose of the organization. This book is written by a mother who, through LLL, became aware of the importance of mother-baby togetherness in addition to breastfeeding, and who also went to what some of her professional colleagues might consider extremes in order to meet the needs of her baby. Because of her experience of the seeming conflict between feminist perspectives and LLL philosophy, Hausman was inspired to critically examine the nature of this conflict and controversy. This book has great value to Leaders and others interested in breastfeeding who are trying to come to grips with the current struggle, both within LLL and within the greater American culture, to balance the importance of breastfeeding and the baby’s need for the mother’s presence with the economic constraints within which we live.

Employment and Separation from Baby

In an email I received from Hausman, she wrote:

I will say that in writing Mother’s Milk I came to believe that the divisions that often separate feminists from LLL members are falsely represented. When I became a mother, I found my feminism altered and deepened, as I realized how the work of mothering is so disparaged culturally, even as it is upheld in impossible ideals of perfection. It is my hope that my scholarship on breastfeeding and motherhood contributes to opening dialogues between feminists and "motherists," so that we can realize how profoundly working together for women will help mothers worldwide. In my view, the oppression of women is maintained, in part, through the denigration of motherhood, as well as the negation of the important social, cultural, economic, and political work that mothers do every day.

Of LLL mother-to-mother support, Hausman writes:

This sort of woman-centered practice, in which the emphasis is on helping mothers make choices (often in the face of opposition from physicians), has always seemed profoundly feminist to me.

In her chapter "Womanly Arts," Hausman briefly presents the feminist critique of LLL, followed by an extensive evaluation of LLL philosophy and how it has changed from the first (1958) through the sixth (1997) editions of The Womanly Art of Breastfeeding (Hausman’s book was completed before the publication of the seventh edition of the WAB). She writes, "The conflict between La Leche League and feminist scholars..." is set up by the economic and social structure of the United States itself, in which mothers really have little true choice about how to practice their mothering. Women without means, especially since the 1996 "Personal Responsibility and Work Opportunity Act" (welfare reform), are expected to work outside the home for wages. Women linked to male providers are encouraged socially to stay home with young children and often have a difficult time making careers mesh with family expectations and needs.

Her bias in favor of LLL is clear. However, she effectively presents the argument of many feminists which is that:

Until La Leche League addresses how its optimistic focus on individual women excludes the experience of many or most poor women, women of color, and working women in the United States, it will not succeed in promoting a cultural climate in which all women can really choose to breastfeed.

The discussion of LLL is divided into two parts. The first part reviews the way nature, science, and working women are viewed within THE WOMANLY ART OF BREASTFEEDING—including various editions of THE WOMANLY ART OF BREASTFEEDING. Hausman writes that LLL emphasizes the naturalness of breastfeeding but also understands that in our society, this naturalness must be learned. As for LLL alignment with science, Hausman quotes from Dr. Herbert Ratner’s foreword to the third edition of the WAB, which noted that one LLL Leader had stated that:

A fanatic is a breastfeeding mother who for twenty years and against great odds has been doing and believing what physicians have only now discovered is a scientific truth.

The evolution of LLL recommendations in THE WOMANLY ART about breastfeeding mothers’ relationships with their physicians is interesting. In the early years of LLL, mothers were encouraged to be assertive in their dealings with medical professionals. It was suggested that mothers enlist physicians to help them, not direct them. The third edition of the WAB encourages mothers to change physicians if they do not like the advice they receive. Later editions also emphasize choosing a physician who shares the mother’s beliefs. According to Hausman:

Scientization enhances the mother’s authority. The more recent editions of THE WOMANLY ART OF BREASTFEEDING include an increasing amount of medical information concerning problems that might be faced by a nursing mother and baby.

Hausman asserts that LLL beliefs and practices, as outlined in the WAB, send "a political message about women’s place in contemporary society, although that message has changed over the decades and continues to develop." Early editions of the WAB simply assumed mothers were home with their babies while later editions devote entire chapters to working mothers.

The second section of the chapter entitled "Womanly Arts" is subtitled "The Manly Art of Fathering." This is an analysis of the changing view of the father’s role from the first edition, where the father was assumed to be most useful as an authority figure, to the present. LLL does express the view that parents have complementary roles, providing different kinds of nurturing. The discussion of the role of shared labor in the feminist perspective versus what is promoted by LLL is informative. Hausman notes that:

Breastfeeding does confer substantial burdens on women: it takes time, it can be physically challenging, and it binds the mother to the baby in a demanding physiological relationship. It can also be tremendously rewarding, but as Sarah Blaffer Hardy argues, all women make decisions as mothers that balance perceived rewards with actual costs. La Leche League reliance on maternal domesticity can be understood as pragmatic—to feed a baby in what she perceives to be a biologically appropriate manner, a mother needs to be available to her child—and the ideological bias, the promotion of good mothering through intensive maternal-infant contact through toddlerhood, follows from that pragmatism.

Hausman believes that there are economic and racial barriers to successful breastfeeding:

But poor children also represent a population most in need of structural and economic changes in order to be breastfed. For example, black women, like working-class and poor women in general, are likely to work in jobs that do not offer an opportunity to express breast milk and save it for the baby.

As LLL Leaders, we volunteer to offer information and support to help mothers breastfeed. Not all Leaders are interested in breastfeeding advocacy or in taking political action—and some Leaders are opposed to these activities completely. However, regardless of their interest in engaging in advocacy activities, many Leaders and others interested in breastfeeding will find this book identifies some possible barriers to breastfeeding and provides valuable insight into the perspective of others and how they view our messages.

Resources

Centers for Disease Control and Prevention, Department of Health and Human Services, National Immunization Survey 2003.
American Academy of Pediatrics Work Group on Breastfeeding. Breastfeeding and the use of human milk. Pediatrics 1997; 100(6):1035-37.

Sara Dodder Furr has been a Leader in Lincoln, Nebraska, USA since 1999. She and her husband have three children. Sara is the Area Professional Liaison for LLL of Nebraska. Leaven Book reviews are edited by Christine McNeil Montano. She lives in Connecticut, USA with her husband, Tony, and their children, Jay and John.

Last updated May 20, 2007 by jlm.
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