Breastfeeding

New Anthropological Approaches

Cecília Tomori, Aunchalee E. L. Palmquist, EA Quinn, Cecília Tomori, Aunchalee E. L. Palmquist, EA Quinn

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781351383608
• Edition: 1
• Topic: Sozialwissenschaften
• Subtopic: Anthropologie

Breastfeeding: New Anthropological Approaches unites sociocultural, biological, and archaeological anthropological scholarship to spark new conversations and research about breastfeeding. While breastfeeding has become the subject of intense debate in many settings, anthropological perspectives have played a limited role in these conversations. The present volume seeks to broaden discussions around breastfeeding by showcasing fresh insights gleaned from an array of theoretical and methodological approaches, which are grounded in the close study of people across the globe.

Drawing on case studies and analyses of key issues in the field, the book highlights the power of anthropological research to illuminate the evolutionary, historical, biological, and sociocultural context of the complex, lived experience of breastfeeding. By bringing together researchers across three anthropological subfields, the volume seeks to produce transformative knowledge about human lactation, breastfeeding, and human milk.

This book is a key resource for scholars of medical and biological anthropology, evolutionary biology, bioarchaeology, sociocultural anthropology, and human development. Lactation professionals and peer supporters, midwives, and others who support infant feeding will find the book an essential read.

1
Introduction

Towards new anthropologies of breastfeeding

Cecília Tomori, Aunchalee E. L. Palmquist, and EA Quinn

This book seeks to spark new research and theoretical innovation that bridges anthropological subfields around breastfeeding. The volume is particularly timely since breastfeeding has become a focal point of attention and debate in the Western media. After many decades of decline and disinterest driven by historical, political, economic, and sociocultural transformations, breastfeeding and human milk are increasingly valued in biomedicine, public health, and society at large. The recent Lancet series of breastfeeding has summarized a vast, and rapidly expanding, body of breastfeeding research and has highlighted these impacts for both low- and middle-income as well as high-income settings (Victora et al. 2016; Rollins et al. 2016). With over 800,000 child deaths and 20,000 breast cancer deaths averted if breastfeeding was practiced according to current global health recommendations, and a multitude of other health implications, breastfeeding not only has a tremendous effect on the health of infants and mothers, but on the health and wellbeing of entire communities (Victora et al. 2016; Rollins et al. 2016). The recent waves of public health breastfeeding advocacy, however, have also led to controversy and backlash in many settings, where infant feeding with artificial breast milk substitutes has been the infant feeding norm. Across the U.S. and (Western) Europe, for instance, critics routinely question the scientific evidence used to support breastfeeding advocacy, often depicting breastfeeding as limiting women’s autonomy and promoting unequal gender norms. Some critics have raised concerns about the undue pressure placed on mothers for breastfeeding (Jung 2015; Oster 2015; Wolf 2011; Badinter 2012). Moreover, breastfeeding (e.g. breastfeeding in public) and the use of human milk (e.g. in human milk sharing) remain controversial in many contexts, and structural policies often offer only limited support (Tomori 2014; Palmquist and Doehler 2014; Carter, Reyes-Foster, and Rogers 2015; Rollins et al. 2016; Palmquist and Doehler 2015; Tomori, Palmquist, and Dowling 2016). These controversies point to gaps between the idealized values and social realities attributed to breastfeeding and human milk, as well as to the complex ways in which the physiological process of breastfeeding is part and parcel of the social, cultural, and political economic environment.

To date anthropological research has played a relatively minor role in public discourses about breastfeeding, yet anthropology is essential to understanding breastfeeding in this complex and polarized global landscape. Unlike media debates that are often based on a narrow set of arguments from wealthy, Western settings, anthropology’s disciplinary traditions are rooted in close studies of local populations examined in the context of comparative cross-cultural, historical, and evolutionary perspectives. Anthropological research can provide insight into epidemiological data that currently forms the evidence-base for breastfeeding research and can transform the very assumptions and questions asked. Moreover, anthropological approaches can play a key role in addressing the roots of contemporary debates, shedding light on how breastfeeding became controversial in the first place and offering critical evidence on the interplay of the biological and social role of breastfeeding. Indeed, partly stimulated by growing popular interest in the topic, the discipline of anthropology has experienced renewed interest in breastfeeding research across its subfields. Despite significant efforts by some scholars to incorporate knowledge and approaches from across the discipline, substantive dialogue and collaborative research among these breastfeeding scholars has been limited due to epistemological and methodological differences.

This volume draws together leading-edge research across anthropological subfields that pertain to breastfeeding, human lactation, and human milk, with the purpose of stimulating intellectual exchange and new thinking about ways to approach their measures and meanings. We highlight work from biological, bioarchaeological, and sociocultural anthropology, where the majority of anthropological research has been carried out in recent decades. Featuring studies from geographically diverse settings and populations, this book offers examples of the rich insights anthropological studies have produced, sometimes blurring conventional boundaries between subfields. Finally, the book highlights paths toward future work that integrates research across these areas of anthropology to produce transformative knowledge and theory that are timely and relevant for informing policies that aim to support breastfeeding.

Disciplinary traditions and approaches to breastfeeding

Biological and bioarchaeological anthropological perspectives on breastfeeding

Biological anthropologists have played a key role in anthropological studies of breastfeeding. In this tradition, breastfeeding has been investigated as one of many biocultural processes in which biology, ecology, sociocultural influences, and evolutionary significance are inextricably linked. Biocultural studies have also greatly contributed to broader breastfeeding discourses in their attention to cross-cultural variation in breastfeeding ideologies and practices (cf. Stuart-Macadam and Dettwyler 1995).

Biological anthropologists studying breastfeeding and human lactation strive for a nuanced, dynamic portrait of breastfeeding and human milk as critical adaptations for human survival. The foundation of the subfield is rooted in key scientific approaches to and concepts of evolution, which recognizes the unique features of the human species, but examines humans in the web of a much broader context of life on Earth, both past and present. The sources of data on breastfeeding and human milk are primarily measurable biological outcomes and features that can be compared within and across contemporary human populations, as well as among non-human primates, other mammals, and fossil remains of Hominid ancestors and other animals. Within this broad evolutionary approach, which considers breastfeeding in the comparative context of a fundamental mammalian adaptation, breastfeeding is a flexible process situated within the nexus of multiple, interrelated physiological processes (e.g. development of the immune system, sleep, brain development, weaning) and ecological contexts for humans in particular but mammals (including primates) more generally.

Many of the evolutionary theories regarding breastfeeding in humans are grounded not only in the study of breastfeeding in contemporary human populations, but in comparative primatological studies. Ongoing studies of mothers and infants have identified considerable variability in feeding practices, weaning behaviors, and milk composition across primate species (Hinde and Milligan 2011; Power and Schulkin 2016). For example, early work showed that maternal carrying strategies predicted milk composition among prosimians, with species that cache their young having higher fat milk compared to species that carry offspring (Tilden and Oftedal 1997). Important early work among baboons identified maternal strategies to balance reproductive costs, with maternal body weight loss predicting weaning age (Altmann 1980). More recently, studies of captive and wild living primates have challenged existing ideas linking weaning to molar eruption (Smith et al. 2013), and shown increasing evidence for postnatal programming of infant behavior (Hinde et al. 2015). Anthropologists examining human nutrition and growth have also generated a robust literature in breastfeeding practices, which have informed theorizing contemporary human variation and population differences in human infant growth and development trajectories globally (Jenkins, Orr-Ewing, and Heywood 1984; Allen and Pelto 1985; Quandt 1985, 1998; Pelto 1987; Pelto, Levitt, and Thairu 2003; Dettwyler 1988; Dettwyler 2004; Dettwyler and Fishman 1992; Little 1989; Casiday et al. 2004; Castle 1996; Pelto and Armar-Klemesu 2011).

The wide variability in breastfeeding practices documented cross-culturally and understanding the factors that explain these differences has long been a focal point of biological anthropology. Such investigations were situated within larger theoretical frameworks of human ecology, life history theory, and studies of human adaptation (Solien de González 1964; Goodman et al. 1985; Hill 1993; Vitzthum 1994, 2008; Dufour and Sauther 2002; Robson 2004; Ellison 2009). Work ranged from studies of breastfeeding and infant and young child feeding in foraging groups (Hewlett et al. 1998; Kramer and Greaves 2010; Meehan and Roulette 2013) and small scale horticultural or pastoralist societies (Fink et al. 1992; Fouts, Hewlett, and Lamb 2005, 2012; Piperata and Mattern 2011; Meehan and Roulette 2013; Miller 2014) to urbanized or rapidly urbanizing societies (Konner and Worthman 1980; Martin et al. 2012; Quinn et al. 2015; Panter-Brick 1991, 1996; Ellison et al. 1993; Quandt 1998; Stallings, Worthman, and Panter-Brick 1998; Thairu and Pelto 2008; Veile and Kramer 2014; Tumilowicz et al. 2015; Sellen 2001a). More recently, such investigations into human lactation by biological anthropologists include collection and analysis of milk samples (from both human and non-human primates), which further allow for investigation into biological adaptation through milk and breastfeeding. Milk is, as Quinn (2016) has argued, “both a phenotype and the producer of subsequent phenotypes.” For example, there is a growing body of evidence suggesting that infant growth and development in human and non-human primates is correlated with milk-born hormones (Quinn and Childs 2017; Hinde et al. 2015; Fields and Demerath 2012; Hinde et al. 2014; Hinde 2013; Bernstein and Hinde 2016) but external evidence suggests that the act of breastfeeding, and not merely the consumption of human milk, may be important in long term development (DiSantis et al. 2011; Galán-Gónzalez et al. 2014).

Examination of the effects of breastfeeding and human milk on health across the life course continues to fuel groundbreaking research that may elucidate the evolutionary, biocultural, and ecological significance of breastfeeding in humans. Biological anthropologists at the forefront of this research have emphasized the complex interplay between mothers and infants in this research and are playing an important role in broadening the scope of investigation to include the evolutionary context and dynamic relationships between mothers, infants, and their environment (McDade and Worthman 1998; Vitzthum and Aguayo 1998; Trevathan 2010; Quinn 2013, 2014; Fujita et al. 2012, 2011; Rudzik, Breakey, and Bribiescas 2014; Thompson 2012; Thompson and Bentley 2013; Mattison, Wander, and Hinde 2015; Thompson et al. 2015; Miller 2016; Quinn, Diki Bista, and Childs 2016; Rudzik 2012; Miller and McConnell 2015; Sellen 2007, 2001b; Breakey et al. 2015). Biological anthropologists have also been instrumental in challenging biomedical assumptions about the process and physiology of breastfeeding, as in the case of examining the interrelationships between nighttime breastfeeding and maternal-infant sleep, pioneered by McKenna, Ball and colleagues (Gettler and McKenna 2011; Ball et al. 2016; McKenna and Gettler 2016; Volpe, Ball, and McKenna 2013) as well as situating human milk sharing and other cooperative breastfeeding practices in cross-cultural and evolutionary perspective (Hewlett and Winn 2014). Although there are a growing number of scholars who seek a fuller integration of culture and history into biocultural studies of breastfeeding, much of this research has had limited interaction with sociocultural anthropology.

Archaeological investigations into infant feeding behaviors in the past have relied on both the archaeological record and research using bioarchaeological techniques. One of the primary means for investigating breastfeeding in past populations has been through the analysis of stable isotope ratios in the body. Such investigations rely on trophic-level differences in the ratios of carbon, nitrogen, and oxygen in the body and allow researchers to use shifts in these ratios to estimate population trends in weaning age or uses of supplemental foods (Tsutaya and Yoneda 2015; Humphrey 2014) and how economic and social shifts may have impacted breastfeeding practices in populations (Nitsch, Humphrey, and Hedges 2011; Turner et al. 2007). These reconstructions are typically made from immature skeletal remains, but some techniques use isotope ratios in adult teeth as well (Burt 2013) and have been validated using hair and nails from living individuals with known histories (Fuller et al. 2006). In the archaeological record, preserved feeding vessels may illustrate alternative feeding methods, although the historical record suggests such efforts met with limited success.

Sociocultural anthropological perspectives on breastfeeding

Sociocultural anthropologists have integrated anthropological theory with ethnographic research to show that breastfeeding can provide a powerful lens for illuminating central aspects of human relationships. Nevertheless, while breastfeeding was certainly noted in early anthropological studies, it has not been a locus of intensive inquiry within the subfield. As with childbirth and other areas of reproduction, this was partly due to men’s dominance of early anthropology and their lack of interest in these areas, as well as men’s lack of access to aspects of women’s lives. Margaret Mead played a critical role in drawing attention to cross-cultural practices of childrearing, including infant feeding practices, highlighting differences between cultural norms in the U.S. and those in Samoa. This included Mead’s attention to the normative practice of breastfeeding as a response to the infant in Samoa versus the dominant white middle-class practices of feeding infants with artificial milk substitutes on a schedule in the U.S. Mead’s research sparked sustained comparative studies of child development and parenting practices, including infant feeding practices (Harkness and Super 2006; Super and Harkness 1982; Small 1998; Gottlieb 2004; Morelli et al. 1992; Harkness and Super 1996, 1983) and greater interest in women’s roles and experiences in society (Scheper-Hughes 1984).

Scholars turned to investigating childbirth, which also encompassed attention to breastfeeding, and used historical and cross-cultural comparison to challenge the medicalized approaches to birth, which also undermined breastfeeding and encouraged replacement feeding. Brigitte Jordan’s cross-cultural studies of childbirth (Jordan [1978] 1993) generated a substantial literature on comparative studies of childbirth (Davis-Floyd and Sargent 1997) and played a key role in igniting further interest in the anthropology of reproduction (Ginsburg and Rapp 1995b). Ginsburg and Rapp’s seminal 1995 volume Conceiving the New World Order, which aimed to “drag … reproduction to the center of social analysis” (2) consolidated this interest in the anthropology of reproduction and brought multiple theoretical directions together, combining feminist theory with studies of science and biomedicine, political economy, and kinship. Still, only a limited number of...