Wednesday 29 July 2009

Thursday 23 July 2009

Mind The Gap



This is a ps to the previous post.

Vera's office have been busy little bees, and this version has been sent out to the MPs who prompted for a proper response. Not by Vera, or by the office bod I got mine from, but by Michael Foster MP, also at the Equalities Office. Michael, Deputy Lieutenant for East Sussex, btw, is also a law bod. However, he's listed as being interested in Poverty & Animal Welfare. One wonders why he's answering Vera's mail?

Anyhows, here's his response to Julie Kirkbride, MP:

Dear Julie,

Regarding [letter from constituent]

Thank you for your letter of 23rd June to the Vera Baird QC MP on behalf of the constituent Ms Goodwin concerning the Equality Bill. I am replying as the Minister responsible. I am sorry for puting you to the inconvenience of having to write a second letter as our first reply did not fully answer your constituent’s concerns. This was due to an administrative error.

On your constituent’s first point, if a mother was asked to stop feeding her child and leave a cafe, she will know that the law is on her side and this should give her the confidence to challenge the cafe owner by pointing out that he or she is treating her in a discriminatory manner. However, if for any reason she feels unable to do this, she can bring a discrimination claim against the cafe owner before the county court. Information and help on bringing a claim can be obtained from local Citizens Advice Bureaux, local Law Centres or the Equality and Human Rights Commission helpline.

With regard to her second point, the Equality Bill provides protection across specific areas - work, goods, facilities, services, public functions, premises and associations/private clubs. As is the case with discrimination law now, it therefore does not apply to exchanges between individuals in a personal or private capacity such as passers by in the street.

I hope this information is helpful to your constituent

Michael Foster DL MP


So it's his 'area' now, is it? Vera no longer in charge?

Anyway. I'd like to draw your attention to a gap.

It takes place here:

"..discriminatory manner. .................However, if for...."

Spotted it? Between the sentence 4 and 5 above? Second paragraph, starting "On your constituent first point..." that sentence and the next.

See that tiny gap? Here's what is in it:

"I'm telling you to go, you can't do that here."

"You can't throw me out. It's my right to stand here and feed my baby."

"Look love, this is a private Mall. You can't do that there, stop feeding now, and go into the toilets, or leave."

"I'm telling you, it's unlawful for you to throw me out. I will not stop feeding my baby, you are breaking the law"

"Look love, stop shouting, people are looking, let's move away from here."

"I'm not moving anywhere, I know my rights. You can't stop me feeding my baby, I'll sue."

"Right, move on now, right this second, or we'll have to throw you out."

"Don't touch me, I am not going, I am not stopping feeding my baby. Let go of my arm NOW!"

"Charlie, call through to control, and get the police here now. Right lady, let's move off outside the doors here, you're on private property and you must go right now. The police will be here, and they will deal with you."

"I'm going to sue you."

"Fine, sue us. But get off the property right now, or we'll have you charged for trespass."

Quite a lot to fit in a little gap, isn't it? Of course, she now has to collect evidence that this has happened, find a lawyer, sort through the funding and finances, and issue a claim. So the gap is quite a bit bigger than above.

Let's try the same gap, in Scotland...

"I'm telling you to go, you can't do that here."

"You can't throw me out. It's my right to stand here and feed my baby."

"Look love, this is a private Mall. You can't do that there, stop feeding now, and go into the toilets, or leave."

Mother picks up mobile phone. Dials police. "Hello, I'm breastfeeding my baby in the St Enoch Centre. Two Security guards are telling me to stop feeding my baby and leave the premises, please can you help me?" Police attend and defend the mother, cautioning the two security guards that they may be charged and fined. Also arrange to speak to employers about re-training.

Sheesh. Bit different, huh?

Lets now look at the sentence a bit further down.

"As is the case with discrimination law now, it therefore does not apply to exchanges between the individuals in a personal or private capacity such as passers by in the street."

Let's see how that pans out, shall we, between Edinburgh and Westminster?

Edinburgh:

"I'm sorry, I have children in this park, I'm not having them exposed to this. Stop that immediately."

"I'm sorry?"

"I find that offensive, and you're in sight of my children, stop it right now."

Mother phones police. "Hello, I'm in Princess Street Gardens, and I'm being asked to stop feeding my baby by a very annoyed woman who is shouting in my ear. Can you come and help me?" Police attend and defend the mother, cautioning the other woman that she may be charged and fined.

Westminster:

"I'm sorry, I have children in this park, I'm not having them exposed to this. Stop that immediately."

"I'm sorry?"

"I find that offensive, and you're in sight of my children, stop it right now."

"But I'm not doing anything wrong?"

"You're being obscene, and you're doing it in front of my children, and I want you to stop and go away. I've never seen anything so disgusting in my life, why don't you have some common decency and use a blanket, I don't want to see this and I certainly don't want my kids to see your saggy breasts."

And on it goes... Mum either has to shout back, stay her course with the tirade, or get up and leave.

Ho Hum.

An awful lot not in their letter, ain't it? Wonder how old that baby is, in his letter... we better get that clarified!

Of course, that's what we think would happen... what we suspect. We still don't know for sure, as no one will answer the question....

Hypothetical Breastfeeding Protection


Morgan to Unicef UK: If a mother is asked to leave a cafe, must she go?

Unicef UK: It is true that is this Bill becomes law as it is, a cafe owner could ask a woman to leave the cafe, but the bill would make that request unlawful.

Morgan To Vera Baird: If a mother is asked to leave a cafe, must she go?

Vera Baird: NO

Morgan to Equalities Office: If a mother is asked to leave a cafe, must she go?

Equalities Office: It is not for us to provide a yes or a no answer to a hypothetical questions as you have requested.

I'm so tempted to start this post with .. imagine a world where..? ;-)

So here we go, back to the Equalities Bill slog. Whereby, dear reader, we've had the Forces of Enquiring Minds, battling with the Forces of Brick Wall (Government division) for Quite Some Time.

Last week, we thought we have a crack on one of the bricks, when Vera Baird QC, MP, Solicitor General, finally replied to the question on all our lips with a very firm:

"NO"

But when asked to quantify this statement, refused to carry on the email discussion, and directed me to ask it via the Equalities Office. Which I did. Letter here.

The Equalities Office replied, yesterday, the day after Parliament went into Summer Recess. Coincidence, I'm sure.

This is their full reply:

Dear Ms Gallagher,
I am responding to your e-mail of 12 July to Vera Baird QC MP and your subsequent e-mail of 15 July to GEO enquiries.  I apologise that you were sent a standard reply to your previous requests for clarification on what protection breastfeeding mothers will have under the Equality Bill which did not answer all your questions.
Turning first to your e-mail of 12 July, the Equality Bill, which applies to England, Wales and Scotland, makes absolutely clear that breastfeeding mothers are protected from discrimination in relation to provision of services to the public, whatever their baby's age.  So a woman who is breastfeeding her baby in a restaurant or on a bus cannot lawfully be asked to leave, or get off, for that reason.
I believe that the clause in the Bill which caused you concern was clause 16(7) which introduced a "reasonableness" test which was intended to be used to judge whether discrimination had taken place.  We listened to representations by interested stakeholders and recognise that this clause would have had the unintended consequence of potentially allowing discrimination against pregnant women or new mothers if this could be shown to be reasonable.  Therefore on 9 June, we tabled amendments to clauses 16 and 17 of the Bill which prohibit pregnancy and maternity discrimination - one of which was to remove clause 16(7).  These amendments were briefly debated on 16 June and agreed, and therefore now stand part of the Bill.  We believe that these amendments will improve legal clarity without any risk of a loss of protection and will represent a return to the level of protection given under the Sex Discrimination Act 1975 (as amended).
You specifically asked for an answer to the question "if she is asked to leave the premises by a person in authority must she go?"  It is not for us to provide a yes or no answer to a hypothetical question as you have requested.  However, if this was in a café for instance, the person asking a woman to leave because she is breastfeeding would be acting unlawfully.  It would therefore be open to the woman to challenge the café owner.  However, if for any reason she did not want or felt unable to do this, she could bring a claim of discrimination against the café owner.
With regard to you 15 July e-mail, at your request, we have noted that you do not support the Bill.  With regard to the Bill making it unlawful to turn a woman away from a restaurant for instance because she is breastfeeding, this is what is covered by clause 16 (now clause 17 in the Bill as republished on 7 July.  This can be accessed electronically from the following link: http://www.publications.parliament.uk/pa/cm200809/cmbills/131/09131.i-vii.html). 
As and when the Bill is enacted, before it comes into law, guidance will be produced to explain what the Bill means and will cover matters such as these.  You should be aware however that the section 3B of the Sex Discrimination Act which makes maternity discrimination unlawful already protects a breastfeeding mother in the same way as clause 17 of the Bill does.  It is this that we are making clearer in the Bill.
I hope this provides the clarification that you seek.
Yours sincerely,
 Kate Stasik Government Equalities Office
Let me take you through that:
July 12th,  I ask this question, to Vera Baird:
"Could you please confirm that under the provision of Clause 16 in the  proposed Equalities Bill, that if a mother who is breastfeeding in  England & Wales is asked to leave premises providing her with goods or  services, she must leave? I do not wish to hear an answer that states  you think that as it is (note IS, not will be) an offence to do so, no  person in authority on those premises would ask a mother to do so. I’m  not interested in that response. I’m interested in the answer to the  question: if she is asked to leave premises by a person in authority…  must she go? The answer is either a ‘yes’ or a ‘no’: if that helps you  narrow down and formulate your response."
July 15th, Vera replies:
"NO"
July 15th I reply:
"Thank you.  At least we're getting somewhere. 
I'm sorry to say, I couldn't see your acknowledgement that I do not support the Bill.

Could you now please explain where in the Bill it explains the recourse available to the mother refusing to leave the premises when asked to do so? This needs to be passed on to mothers who have been asked to leave, so they know what to say if the person in authority states the police will be called if they refuse to leave the premises.

As other reputable sources involved in the Bill being formulated, such as UNICEF UK, has stated that yes, under the law the mother would have to leave, you can understand why it is so pressing to get the details correct from the highest source."

July 15th Vera replies with 'take it to the Equalities Office'. I do.

July 22nd Equalities Office replies:

"You specifically asked for an answer to the question "if she is asked to leave the premises by a person in authority must she go?" It is not for us to provide a yes or no answer to a hypothetical question as you have requested. However, if this was in a café for instance, the person asking a woman to leave because she is breastfeeding would be acting unlawfully. It would therefore be open to the woman to challenge the café owner. However, if for any reason she did not want or felt unable to do this, she could bring a claim of discrimination against the café owner."

Do note the repeating of the Government line - it's unlawful for them to ask a mother to leave. Do note I asked them NOT TO SAY THIS TO ME, as I knew that answer and was not interested in it.

Do note the refusal to answer the question asked. Again.

Complete refusal to actually answer the damn question.

Anyone would think I was asking the most pertinent question, the way they duck and dive and refuse to answer it.

Apart from Vera, of course. Who has replied in a way that cannot be quantified, verified or understood. Well, she is a lawyer.... isn't that so unfair to lawyers? It feels mean to lambast all lawyers, on behalf of Vera. I 'll try again.

Well, she is an MP... isn't that so unfair to MPs? Harrumph. We have really good MPs working for their constituents.... let's have another crack it it.

Well, she is an Government Minister... isn't that so unfair to Government Ministers?

Probably Not. But still feels mean.

Okay, try this... well, she is Solicitor General.

Yeah, that works.

*sigh*

Also very cute how they filled the answer up with lots of things I'd not asked. I especially liked the "I believe the clause in the Bill which caused you most concern was 16(7)..." That's an amazing amount of telepathy at work there! Exceptional. You don't think they just shoe-horned it all in, to make to look at how reasonable they are in listening to concerns? Notwithstanding it's not a concern I'd raised with them at all? Yes, I think so to.

HOWEVER.

However...

Don't miss out on what's really important in this reply. What's actually going to make it easier for MPs to now put real pressure on about getting answers. Don't miss the bits THAT ARE REAL GIVE AWAYS:

"You should be aware however that the section 3B of the Sex Discrimination Act which makes maternity discrimination unlawful already protects a breastfeeding mother in the same way as clause 17 of the Bill does. It is this that we are making clearer in the Bill."

"Therefore on 9 June, we tabled amendments to clauses 16 and 17 of the Bill which prohibit pregnancy and maternity discrimination - one of which was to remove clause 16(7). These amendments were briefly debated on 16 June and agreed, and therefore now stand part of the Bill. We believe that these amendments will improve legal clarity without any risk of a loss of protection and will represent a return to the level of protection given under the Sex Discrimination Act 1975 (as amended)."

There is no new protection. There is no new protection. Repeat after me: there is no new protection. When the Bill came out of committee, Clause 16 became Clause 17. That's why she's talking about Clause 17 being what is already in the Sex Discrimination Bill.

Nothing in the Bill is 'new'.

AND
".... the Equality Bill, which applies to England, Wales and Scotland, makes absolutely clear that breastfeeding mothers are protected from discrimination in relation to provision of services to the public, whatever their baby's age."
So... once again, the whole six-month fallacy nailed.  Despite the briefings to MPs, despite the discussions in committee.  They are continuing to answer questions without dwelling on the schism of how mothers claim after the event, depending on the age of their babies.  But it's so important they've put these two points - no new protection, just a clarifiying of existing protection, and no age limit - into this response.
Although, of course, they've kept to 'premises'.  Still no protection in public spaces Mums, just somewhere where there are premises and good and services.  Another little sleight of hand - good at it, ain't they?
I'm going to get this info back to the MPs who are working with their constituents on this - Alastair Burt, Simon Hughes, Cheryl Gillan, Annette Brooks and Ed Davy.  I'll also see if the tabled questions by Cheryl have been answered.
Watch This Space.



Wednesday 22 July 2009

David and Goliath - Nutricia & Breastfeeding Protectors



People who work to protect breastfeeding have something formula companies don't have: passion for baby's health. Formula companies have something breastfeeding supporters don't have: money. Oodles and oodles of money. Billions, in fact.

They more they sell, the more they make, the more they can promote and sell.

Breastfeeding protectors, usually have very little, or no money. They work in the background, scrimping and saving on the phone costs, and who used a first class stamp when a second class stamp would have done? Even the few lucky enough to be in paid employment, to protect breastfeeding, and therefore to protect babies' health.... earn a pittance for their skills and energy. They often work long hours unpaid, and go the extra kilometre unpaid and unremarked. They sit in small offices, or pouring over a hot computer in the kitchen, and work and work and work.

And fight and fight and fight.

And the ones with the expense account, the over valued salaries, the 'free' trips to Switzerland for 'research' for anyone who would like to come... they jet around the world... they pay for workers to visit hospitals and schmoose doctors, nurses, midwives... they don't need to fight. They pay others to do the fighting for them. They employ teams of lawyers, professional networkers, political supporters and researchers to 'prove' their fight. They pour their money endlessly out into the world, to stomp on, strangle down, and obliterate opposition to their corporate objective: to make more profit this year, than they made last year. Multi-billion pound Goliaths, sweeping the globe with the saving grace and power of their Branded Wonder Foods, available in all good retail outlets.

They hire the best advertising and marketing specialists on the face of the planet, and pay them to devise campaigns to hook mothers' in, and answer their fears about their baby's health, with beguiling copy on how they can help. How they can make their baby well.

In the background, the Davids, those fighting to protect breastfeeding at seemingly impossible odds.... harry around on the edge of the battlefield, picking up stones, and awaiting a good clean shot.

And two such good clean shots hit home yesterday, in the form of two rulings from the Advertising Standards Agency, here in the UK.

One David, Baby Milk Action, struck out against Nutricia/Milupa, for their advertising of Aptamil 'follow-on' formula.

The other David, the NCT, struck out against Nutricia/Cow & Gate, for their advertising of Cow & Gate follow-on milk.

Both were upheld! A bad morning over at Nutricia, one feels.

The rulings were about statements on the supposed 'immune boosting' qualities of both products. Aptamil's "immunofortis" and Cow & Gate follow-on.

Both complaints were upheld. Both were stated to breach advertising code, and that the claims being made for the products, were:

"On this point, the ads breached CAP Code clauses 3.1 (Substantiation), 7.1 (Truthfulness)"

and that Aptamil also breached: "19.1 (Comparisons)"

So both these adverts, claiming immune boosting properties to their modified cow's milk drinks, made unsubstantiated claims and were therefore untruthful. They lied. One also made false claims of being the best modified cow's milk drink, compared to the other modified cow's milk drink.

And make no mistake. These products ARE drinks. They are not baby formula. They are not food. Formula advertising is banned in the UK, in order to protect mothers and babies from marketing about baby milk, and what it can do for their baby. These are 'added' ingredient milk drinks, to supplement a baby's mixed food intake upon beginning the weaning process. You may choose as a parent to discontinue formula, and to switch to the cheaper 'follow-on' drinks... but that's a choice, not a nutritional necessity. There is no 'rule' that you stop formula and move to follow-on. Babies should be milk fed primarily, for the first two years in life. That you can choose the types of milks, breastmilk or a modified cow's milk, such as formula, and then also choose to move from either to 'follow-on' milk.... but there is no need for follow-on milk. It's a branding of a product to make people buy something they don't actually need. Also, coincidentally, follow-on milk advertising only really appears in countries that ban actual formula adverts. Strange that, the cynic might be tempted to think.... oh, sorry, where was I?

Just like a cynic might point out that Nutricia got its fingers wrapped over 'pre-biotic' claims in follow-on milk three years ago!

These are huge victories for the organisations concerned: Baby Milk Action and the NCT. Huge victories for babies' health. They deserve all kudos and support, for fighting...fighting.. fighting. And getting a good clean shot every now and then.

However...

Have you heard about all this at all, in today's news? Was it splashed across your newspaper this morning? Is it being debated on the radio as I type? Was huge shock and horror being expressed in your office, about how awful it was that parents were lied to about what they feed their babies...

I think not.

Following the story now, you can find a few reports, tucked into the back of online articles. In fact, the BBC news service is reporting on Teletext how the ASA upheld a complaint that a sausage advert was sexually suggestive! Well it had - it dropped it for the Glasgow Chicken Tikka Massala controversy, which has now also disappeared. Wow, isn't news fast? I'm amazed they can keep up with it all.

Reports, as I said are popping up, this has turned up on the Beeb website since I started this blog.

But given the size, nature and ferocity of attack on breastfeeding recently, particularly in the UK press... one wonders how easily this will be overlooked. Cynical? Moi? Or course not. I look forward to this being a lead on the Six O'Clock News.... and especially looking forward to the Newsnight report on how irresponsible it is during a swine flu pandemic, for Nutricia to be running ads telling people their product "supports your baby's natural immune system". I'll be transfixed when, no doubt, this is finally the breaking point we need, for serious news reportage of formula companies' claims about their products, to be brought to the public's attention.

Honest.

It's not like I'm suggesting that it's not only Justice that is Blind... but media coverage of infant feeding issues, is too.

Oh, sorry, that's IS what I am suggesting. Silly me.

So, whilst we're still left on the fringes of the media community, battered, belittled and bruised for being those nasty gestapo lacto-facists, we need to keep today's victories in mind. After all, it's not like the mainstream news is going to do that for us! And we need to thank Baby Milk Action and the NCT, and applaud them, and remember most of the work is done by volunteers in both organisations. And tell them they are fab.

And to keep pointing out to our critics that rulings like today is why we fight to make sure mothers using formula have facts, not advertising copy, to work with.

Whilst we keep our pockets well loaded with pebbles. :-)



Monday 20 July 2009

Antivenin


Antivenin (or antivenom or antivenene) is a biological product used in the treatment of venomous bites or stings. The name comes from the French word venin meaning venom, and historically the word antivenin was predominant around the world. For the English language the World Health Organization decided in 1981 that the preferred terminology in the English language would be "venom" and "antivenom" rather than "venin/antivenin" or "venen/antivenene". However, it is still called antivenin or antivenene by many organizations today.


-o0o-


Is breastfeeding advocacy anti-feminist? An essay by Katherine A. Dettwyler

“The anthropological study of women should rest upon a sound understanding of women's reproductive heritage.” Harrell (1981)

I began graduate school at Indiana University, Bloomington in 1977, and there were almost as many female anthropology graduate students as males in my cohort. In the late 1970s, the field was still in the early stages of a revolution against the traditional anthropological focus on males and male activities. Within the department, there was a decided preference among the social-cultural anthropologists for the far-away and exotic – few professors encouraged students to study in the US or other Western countries. Additionally, there was a preference for the “extraordinary” – elaborate, important religious rituals, “systems of thought,” or public performances that marked special occasions in the life of the group. The three physical anthropologists focused on osteology/paleopathology, human variation, and growth and development. The program truly embraced the four-field approach, and the physical anthropologists in particular urged students to consider the links between human evolution, human biology, and culture.

In 1981, when I set off for research in Mali, West Africa with my husband and young daughter, my research topic – cultural beliefs and practices surrounding infant feeding and their effects on the growth, development, and health of the children of Mali – was fully supported by my committee. Infant feeding studies were beginning to attract the attention of a number of anthropologists. The year I finished my degree, 1985, saw the publication of three books with a focus on breastfeeding: Breastfeeding, Child Health and Child Spacing: Cross-cultural Perspectives, edited by Valerie Hull and Mayling Simpson, Infant Care and Feeding in the South Pacific, edited by Leslie Marshall, and Only Mothers Know: Patterns of Infant Feeding in Traditional Cultures, by Dana Raphael and Flora Davis. These were joined the following year by The Infant-Feeding Triad: Infant, Mother, and Household, by Barry M. Popkin, Tamar Lasky, Judith Litvin, Deborah Spicer, and Monica E. Yamamoto (Dettwyler 1998). It was a good time to be studying breastfeeding, which was experiencing a cultural resurgence in the US and other Western countries, and attracting attention from national and international public health organizations as the negative consequences of the marketing practices of infant formula companies became more and more apparent, especially in developing country contexts.

The biocultural approach was still struggling to gain legitimacy, at least in part because many anthropologists still had difficulty accepting the notion that the constraints of human biology and physiology affected culture, as well as the notion that cultural beliefs and practices could affect human health. Perhaps more importantly, the ‘numbers crunchers’ reviewing journal manuscripts didn’t see the need for ‘all that ethnographic information,’ while the mainstream cultural anthropology reviewers cringed at the sight of data tables and statistical analyses. Gradually during the decade from 1985-95, the cross-cultural and biocultural study of infant feeding gained ground. Studying breastfeeding and lactation from an evolutionary and/or cross-primate perspective, however, was still virtually unknown. When life-history variables among primates were compared, the data for breastfeeding in modern humans was based on Western cultural practices, rather than any real understanding of what the underlying biology might be.

In the early 1990s, I began discussions with Patricia Stuart-Macadam about collaborating on an edited volume about breastfeeding that would specifically highlight biocultural and evolutionary perspectives. Stuart-Macadam was well-known at the time for her work on iron-deficiency anemia, and her assertion that women were stronger physiologically than men, and had lower rates of morbidity and mortality at all ages as a result of the strong impact of natural selection on female reproductive success. I originally suggested that in addition to writing a chapter about the cultural context of breasts and breastfeeding in the US (and how they inhibit breastfeeding), I would put together a review of the literature concerning what was known about ‘natural’ patterns of infant feeding and weaning in modern humans, based on comparisons with the nonhuman primates. To phrase it another way, I wanted to know what answers other researchers had found to the question of what the underlying human patterns might be if not influenced by specific local and relatively recent cultural beliefs. From an evolutionary perspective, how often, and for how long, would we expect human infants to nurse?

I quickly discovered that no one had ever asked the questions before. It was simply assumed that modern Western beliefs and practices were standard for the species, with no negative repercussions. And it was understood that in places where women nursed their children ‘often’, or for a long time, it was because they had to, due to lack of adequate weaning foods, lack of clean water with which to mix infant formula, and widespread disease. My research to try to answer this question (Dettwyler 1995) concluded that the ‘natural’ age of weaning for modern humans was between 2.5 and 7.0 years, with most of the predictions leaning toward the upper end of the range. In addition, I found no evidence that the biological underpinnings of this duration of breastfeeding had changed since the emergence of modern humans. As I began to present these data at conferences, and especially after they were published in 1995, I found an eager audience for my message among women in the United States (and internationally) who were breastfeeding their children for several years.

While appreciating that, as scientists, the kinds of questions we ask, and the methods we use to try to gather data to answer them are heavily influenced by our own culture and the times in which we live, I still believe that the scientific approach is our best hope for an objective, self-correcting, understanding of the world. In numerous presentations at conferences aimed either at breastfeeding mothers or at health care professionals, my goal has always been to encourage audiences to understand the evolutionary perspective and the insight we can gain from using it as our starting point. I have never denied the importance of cultural or personal beliefs, or the constraints that specific women face in their daily work to balance their productive and reproductive work.

Specifically, my publications and presentations always emphasized that I was not sending a ‘prescriptive’ message of “You must breastfeed, and you must breastfeed for this long.” On the contrary, the main take-home messages were always: (1) Breastfeeding matters, for the health of the child and the mother, and therefore women deserved to know the consequences of the choices they were making when they decided how to feed their children; (2) Breastfeeding a child for many years is normal for humans as a species, and therefore mothers who nurse their children beyond local/recent cultural norms should not be criticized, viewed as pathological, charged with sexual abuse, or face losing custody of their children in divorce cases due to long-term breastfeeding; and (3) The cultural context of mothering in the US, with its fairly strict separation of women’s productive and reproductive work, and a general devaluing of reproductive work, make it difficult for many women to breastfeed at all, or for as long as they want, and therefore we should work to change the sociocultural systems that impede breastfeeding, so that women who wanted to breastfeed, could, and those who wanted to breastfeed for a long time, could do so with impunity.

My ultimate goal has always been that all women have access to the information and support they need to breastfeed for as long as they want, wherever they want, couched within an understanding of the evolutionary history of our species. Within the scholarly community, both in anthropology and in related disciplines, my work has been variously embraced, dismissed, misinterpreted, or attacked. A number of people have cited my work to support their claim that the natural age of weaning is about 2 years, or about 3 years, even though my research suggests a range from 2.5 to 7.0 years. One biological anthropologist simply dismissed the research, telling me that, apart from women and children in dire straits, “Only you and your weird friends nurse children for that long.” [Bogin, pers. comm., 1996]. More recently, several authors have specifically accused me of being not only anti-feminist, but also racist, for suggesting that breastfeeding matters.

The perspective that not breastfeeding has consequences for the health of mothers and children has been portrayed as ‘essentializing’ women, reducing them to their biological functions, and as a call for a return to a patriarchal, pre-feminist system where women devoted all their time to child-bearing and child-rearing. Many of these personal attacks have been part of a larger set of criticisms of everyone involved in the promotion of breastfeeding for daring to promote breastfeeding at all, especially to ‘modern’ Western women, and most especially to modern African-American women who (everybody else seems to know) can’t breastfeed their children because of their history of slavery and the continuing constraints they face in US society (Wolf 2007).

To explore this recent criticism, in the following sections I lay out the foundations of both the evolutionary and feminist perspectives, as I understand them, and endeavor to convince the reader that understanding women’s reproductive heritage is not anti-feminist in the least.

The fundamental goals of the “human evolutionary medicine and health” project are, first, to understand the underlying biological and physiological heritage that we bring with us into our current world from our mammalian, primate, and early hominid evolutionary past. And second, to clarify that the forces of evolution, particularly natural selection, have left us with certain expectations that are, at times, wildly out of synch with the complex and ever-changing socio-cultural worlds we construct.

Within the evolutionary medicine and health paradigm, we ask, as scientists: To what extent do these mismatches between our evolutionary heritage and modern lifestyles contribute to poor health/illness/disease? And, once we understand the consequences, are there cultural changes we can make to reduce the mismatch, and/or to mitigate the effects?

The fundamental goals of the feminist movement have been, from the beginning, to offer women the same degree of agency and choice that men have traditionally enjoyed in Western cultural contexts. However, somewhere along the way, a few feminists have come to the conclusion that the goals of feminism are undermined by the evolutionary medicine and health perspective within anthropology and therefore, that the perspective must be wrong or irrelevant, and its advocates – especially its female advocates – must be anti-feminist.

Within mainstream US culture, the traditional (pre-feminist) cultural construction of the biological differences between the sexes, and therefore the proper roles for men and women in society, had two basic premises. First: “Women can’t do the things men do because all women are (a) Too weak (physical limitations, especially strength); (b) Too stupid (cognitive limitations, especially for science/math); and (c) Morally deficient (too emotional, not rational).” Second: “Only the things that men do are important: productive activities in the public sphere.” A corollary of the second premise is that the things that men specifically can’t do because of their biology – menstruating, conceiving, gestating, birthing, and lactating – are unimportant. These reproductive activities are part of the private, domestic sphere; they are ‘taken for granted’ as being what women do since they aren’t capable of achieving in the men’s world of true/real accomplishments.

Many feminists have devoted much of their time arguing against the first proposition (and rightly so), claiming and going on to prove that (at least some) women are capable of, and interested in, traditionally male productive activities, and deserve to have the opportunities to pursue them if they want. At the same time, some feminists have accepted – lock, stock, and barrel – the second proposition, agreeing with the general male view that only the things men do are important, and that the things only women can do, because of female biology, are unimportant. Anything that detracts a woman from pursuing success as defined in a male way, is viewed as oppressive by these feminists, because women’s contributions as the reproducers of the population, both biologically (through birth) and culturally (through child-rearing) are devalued in traditional Western cultural belief systems.

In direct contrast, human evolutionary biology, like all evolutionary biology, is valued in the coin of the realm, which is relative reproductive success – the number of children you reproduce and raise to adulthood. The more copies of your genes you leave behind, the better your reproductive fitness. For men, this is possible even while pursuing a strategy of traditional male success in career/politics/sports, or whatever, because reproductive success for men depends mainly on how many women you can impregnate. For many men, in a variety of cultural and environmental contexts, being successful as a man translates quite directly into more opportunities for sex, and fathering many children. Likewise, being unsuccessful as a man – a poor hunter, a poor provider, a coward – often translates into having few or no children.

For women, the situation is very different. For each reproductive attempt, a woman must devote nine months to the pregnancy, several years to breastfeeding (before modern replacements/antibiotics/immunizations/clean water/sewer systems, etc. etc. etc.), and even more years to general care of the children. For many women, especially in Western cultures, pursuing a strategy of reproductive success (many children) is directly at odds with pursuing productive success in the workplace, in terms of career, salary, travel, independence, prestige, etc. And likewise, if a woman devotes much of her time and energy to productive success in the public sphere, then she can’t devote as much time and effort to reproduction.

Since the first appearance of stone tools at 2.5 million years ago, cultural constructions have been a significant part of human adaptation to the environment. Systems of cultural beliefs and practices, emerging from a larger, more complex brain, can overcome significant biological limitations. Cultural constructions can also contribute to the problems that humans must adapt to. In the case of a modern woman living in a Western culture who wants to combine productive and reproductive labor, much of her reproductive work can be farmed out: a woman can pay someone else to be pregnant for her (and thus give birth for her); she can pay someone else to take care of her children part- or full-time, and she can use artificial infant formula instead of breastfeeding. If wealthy enough, she can even pay someone else to breastfeed her children for her.

In the early days of the feminist movement, many ‘career’ women only had careers until they got married (prairie school teachers are the perfect example of this). Then we moved on to a generation or more, with some overlap, of women who chose to have a career instead of marriage and a family, as even taking care of a husband was seen as incompatible with working outside the home and pursuing success as defined by males. Then we moved on to a generation of women who had careers and got married, but chose not to have kids – they could deal with the demands of a husband, maybe, but not the demands of children. Eventually, we moved on to a generation of women who had careers, got married, and had kids, but didn’t take any time off, didn’t care for the children much themselves, and didn’t breastfeed. Today, we have finally moved into a generation where a few women are having careers, getting married, and having kids, and some are breastfeeding their children, at least for a while. In the last decade a trend toward more and more women breastfeeding, with longer and longer durations of breastfeeding, has gathered strength and shows no signs of stopping.

We are also now starting to see the emergence of a generation of women who came of age after the major gains of the feminist movement had been made – who take it for granted that they can combine careers and children, and some of whom are even opting to deliberately drop out of the ‘rat race’ and stay home with their children for some years in the middle of a career they fully intend to return to when their children are older. But the conflict between the two sides in the “Mommy Wars” continues. Which is more important, reproductive success, or productive success? Can they be successfully combined?

The compromise that many modern Western women have settled for is to have only a few children, and to turn much of the care of those children, including bottle-feeding, over to others. Some women have chosen to adopt children, rather than go through pregnancy and childbirth themselves, in order to reduce the amount of time and effort they must take away from their jobs. This provides many of the joys of parenthood, but from a strictly evolutionary perspective doesn’t count as reproductive success. Others do give birth to their own biological children, but insist that childrearing is not their primary focus, and that breastfeeding and other activities that require mother-infant contact are a luxuries they can’t afford.

However, an explosion of research into infant nutrition and health over the past 20 years has shown unequivocally that formula-feeding is harmful to children, raising their lifetime risk of morbidity and mortality by interfering with normal immune system development and having adverse impacts on their cognitive development by interfering with normal brain growth and development. In addition, not having many children, and not breastfeeding raises a woman’s lifetime risk of reproductive cancers, and osteoporosis. If she does give birth, but doesn’t lactate, then she is left trying to “mother” her children without the benefit of the mothering hormones – oxytocin and prolactin – provided automatically by lactation. This lack of mothering hormones likely contributes to the high rates of child abuse and neglect, and postpartum depression among mothers in the United States.

This has led to a perplexing conundrum. Modern Western women live, for the most part, in cultures that are not supportive of their reproductive work, and that are not organized to allow women to combine their productive and reproductive work. We make it overly difficult. A sociocultural system that was truly supportive of women’s reproductive labor would look very different from what we have today. But rather than work to change the cultural milieu, a few feminist scholars have decided instead to attack the “near enemy” – their colleagues who insist that reproductive labor is important, and that breastfeeding matters (Goldin et al. 2006, Wolf 2007). Hausman (2003) provides an in-depth analysis of the rhetoric on both sides of the controversy.

When extremely well-supported research about the evolutionary underpinnings of human biology and physiology are presented, and when the consequences of not following the human biological pattern of childrearing and feeding are pointed out, we come up against resistance, and a backlash consisting of both denying the scientific evidence and accusing the researchers of being unscientific and anti-feminist. Critics of the human evolutionary medicine and health approach, and critics of breastfeeding advocacy in particular, frame their attacks in several ways. They deny the validity and reliability of research showing that children are healthier when breastfed (sicker when bottle-fed); they deny the research showing that mothers are healthier when they breastfeed (sicker if they don’t reproduce and/or don’t breastfeed or not for very long); and they deny the perspective that reproductive labor is important, insisting that only productive labor, success in the public ‘masculine’ sphere, counts.

Two brief examples will illustrate the lengths to which the critics go to discredit breastfeeding advocates. First, from the George Mason University STATS website (2006-present), which claims that none of the research on the adverse consequences of bottle-feeding is valid: “These kinds of arguments are simply bad (social) science, and are fed by conviction or opportunism rather than hard evidence. Even worse, it makes one suspect that scientific studies are biased by well-intentioned but possibly misguided doctors predisposed to nursing. . . There are many reasons to want to know if nursing is truly better, or if this is just a throw back public health campaign based on voodoo science.” Joan Wolf (2007) writes: [According to breastfeeding advocates] “Bottle-feeders, smokers, and people who are overweight are maligned for weakness, gluttony, and lack of selfdiscipline; for ignoring the imperative to take responsibility for their own health; and for preventing others from caring for themselves.”

Table 1 summarizes the conflict between what the breastfeeding advocates (BFAs) have said, and the implications that have been taken from their statements by the critics of the evolutionary perspective.

Table 1. Comparison of what breastfeeding advocates (BFAs) say and intend to imply,

versus how their perspectives have been portrayed by their critics

Statement by breastfeeding advocates in the scholarly literature

Statements by the critics

Intended implications, clearly stated in the BFA scholarly literature

Breastfeeding is normal

BFAs claim that women who don’t breastfeed are bad mothers

All children would benefit from breastfeeding and breastfeeding mothers should be supported

Infant formula is dangerous to the health of children

BFAs are unscientific fanatics who twist and misrepresent the facts to promote their views

Mothers have a right to accurate information about the consequences of the choices they make

“Extended” breastfeeding is the norm for modern humans (2.5 to 7.0 years)

BFAs think all women should breastfeed their children for 7.0 years

Women who breastfeed their children past local cultural norms (six weeks, six months, a year, etc.) are not sexual perverts and are not overly emotionally involved with their children; they should not be accused of child abuse or lose custody in divorce cases because of “extended” breastfeeding

All women should be supported to breastfeed their children for a minimum of 2.5 years

BFAs think all women should be forced to breastfeed for a minimum of 2.5 years, even though this means staying out of the workforce and giving up their career aspirations

We need to make significant changes to US culture to provide adequate maternity leave, on-site child care, the ability to combine reproductive and productive labor so that women can continue their careers/jobs while providing breast milk to their children

We have a culture that is not supportive of breastfeeding, making it difficult for women to do

Because it is difficult, we (the critics) should deny that it matters and claim all the scientific research is flawed/biased so that mothers don’t feel guilty

We should change the culture to make it easier for women to breastfeed, and we need to know how to mitigate the negative health consequences of formula-use for mother and child

Breastfeeding matters

Breastfeeding advocates are anti-feminist, because (the critics assert) only women’s productive work is important

Women’s reproductive work is as important as their productive work; from an evolutionary perspective, it is more important

In developed countries such as the United States, the risks of infant formula are partially mitigated by the cultural systems that provide (for most of us) sewage treatment, clean/safe water sources, immunizations, and antibiotics. But even all of these modern wonders haven’t completely erased the health consequences of not breastfeeding for children, and none of them affect the health consequences of not breastfeeding for mothers. However, proponents of an evolutionary understanding of female reproductive history are not suggesting that all women ought to spend their adult reproductive lives pregnant or lactating.

We are suggesting:

(1) That women have a right to know the consequences of the choices they make, both for themselves and their children, in terms of infant feeding;

(2) That women have a right to instrumental support for the choices they make. If that means breastfeeding, then it might include better maternity leave, on-site child care, and the ability to combine productive and reproductive work in creative ways. These might involve legislation that protects women’s right to breastfeed in public, as well as more general cultural changes that de-emphasize the sexual role of breasts, as well as many others. If a mother’s choice means not breastfeeding, or not breastfeeding for very long, then instrumental support might include research to improve infant formula (an ongoing project of the infant formula companies, as evidenced by the inclusion of DHA and ARA in formulas within the past decade), an understanding of the role of suckling, which would lead to tolerance for pacifier use and thumb-sucking to the age of 6-7 years. Or it might mean better designs for pacifiers and bottle nipples that more closely mimic the experience of breastfeeding, so that children’s facial bones and muscles develop correctly. There are many other approaches that might help mitigate the loss in IQ potential and visual acuity from not breastfeeding, including quicker treatment of infections, better compliance with immunization schedules, educational interventions, etc. (see detailed discussion in Dettwyler 1999);

(3) That everyone needs a better understanding that breastfeeding matters, and that the decision to have a child means many compromises, many opportunity costs, many consequences for mother and child – if women are not willing to make those adjustments, then no one is suggesting that they must have children. Because of the work of generations of feminists whose shoulders we stand on, women in Western countries now have the choice of whether or not to have children at all. No one calls into question our femininity or worth as people if we choose not to reproduce. Our culture has made childlessness a much more acceptable choice.

One particularly outspoken critic of breastfeeding advocacy suggests that a mother’s wants should trump her child’s needs. Wolf writes: “When mothers have wants, such as a sense of bodily, emotional, and psychological autonomy, but children have needs, such as an environment in which anything less than optimal is framed as perilous, good mothering is construed as behavior that reduces even minuscule or poorly understood risks to offspring, regardless of potential cost to the mother.” (Wolf 2007). She is referring here to breastfeeding being defined as good mothering, and bottle-feeding being defined as bad mothering.

Of course, the reality is that for many children in the US, bottle-feeding doesn’t represent a “miniscule or poorly understood risk” – it represents a well-established higher risk of many different diseases both in infancy and throughout life, as well as a risk of a lower cognitive functioning. And for some children, their mother’s choice to bottle-feed will result, directly or indirectly, in their death. Chen and Rogan (2004) have estimated that approximately 800 children in the US die every year because they were not breastfed. The problem is that for any specific mother and child, the consequences of not breastfeeding/formula-use cannot be known at the time the decision must be made.

Thus, mothers who choose not to breastfeed are accepting an unknown level of risk on behalf of each specific child. For some children, not being breastfed may have no lasting significant impact, but for others it will mean illness or even death. It is difficult to understand how denying this ambiguity (by claiming that formula-feeding carries no risks at all), or claiming that breastfeeding is oppressive, contributes to woman’s “sense of bodily, emotional, and psychological autonomy.” On the contrary, withholding information, or misleading women about the consequences of the choices they make, is intensely paternalistic and anti-feminist. A woman whose wants for “a sense of bodily, emotional, and psychological autonomy” are so intense that she would consider risking her child’s health and cognitive development to meet them may well decide against having children at all – which should be her choice to make.

A truly feminist perspective on women acknowledges that women’s reproductive work is what matters in terms of long term evolutionary fitness. A truly feminist perspective on women acknowledges that choosing not to reproduce, while not adaptive in an evolutionary sense, is perfectly acceptable in cultural terms. A truly feminist perspective on women acknowledges that cultural constructions can help or hinder women, whatever choices they make, but that denying women knowledge about the consequences of their choices is profoundly non-feminist and unfair.

References

Chen, Aimin, and Walter J. Rogan 2004 Breastfeeding and the Risk of Postneonatal Death in the United States. Pediatrics, Vol. 113, No. 5 (May, 2004), pp. e435-e439.

Dettwyler, K.A. 1988 Book reviews of Breastfeeding, Child Health and Child Spacing: Cross-cultural Perspectives , edited by Valerie Hull and Mayling Simpson (1985), Infant Care and Feeding in the South Pacific, edited by Leslie Marshall (1985), Only Mothers Know: Patterns of Infant Feeding in Traditional Cultures , by Dana Raphael and Flora Davis (1985), and The Infant-Feeding Triad: Infant, Mother, and Household , by Barry M. Popkin, Tamar Lasky, Judith Litvin, Deborah Spicer, and Monica E. Yamamoto (1986), Medical Anthropology Quarterly, 2(3):303-306.

Dettwyler, K.A. 1995 A Time to Wean: The Hominid Blueprint for the Natural Age of Weaning In Modern Human Populations. In Breastfeeding: Biocultural Perspectives , edited by Patricia Stuart-Macadam and Katherine A. Dettwyler, pp. 39-73. New York : Aldine de Gruyter.

Dettwyler, K.A. 1995 Beauty and the Breast: The Cultural Context of Breastfeeding in the United States . In Breastfeeding: Biocultural Perspectives, edited by Patricia Stuart-Macadam and Katherine A. Dettwyler, pp. 167-215. New York : Aldine de Gruyter.

Dettwyler, K.A. 1999 Evolutionary Medicine and Breastfeeding: Implications for Research and Pediatric Advice. The 1998-99 David Skomp Distinguished Lecture in Anthropology, Department of Anthropology, Indiana University, Bloomington, IN, 47405.

Dettwyler, Katherine A. 2004 When to Wean: Biological Versus Cultural Perspectives. Clinical Obstetrics and Gynecology, 47(3):712-723.

Goldin, Rebecca, Emer Smith, and Andrea Foulkes 2006 What Science Really Says About the Benefits of Breast-Feeding (and what the New York Times didn’t tell you). STATS at George Mason University: Checking out the facts and figures behind the news. Website: http://www.stats.org/stories/breast_feed_nyt_jun_20_06.htm. Accessed 17 January 2008.

Harrell, Barbara B. 1981 Lactation and Menstruation in Cultural Perspective. American Anthropologist, New Series, Vol. 83, No. 4 (Dec., 1981), pp. 796-823.

Hausman, Bernice 2003 Mother's Milk: Breastfeeding Controversies in American Culture. New York: Routledge.

Wolf, Joan B. 2007 Is Breast Really Best? Risk and Total Motherhood in the National Breastfeeding Awareness Campaign. Journal of Health Politics, Policy, and Law, Vol. 32, No. 4, August 2007.


copyright Katherine Dettwyler 2009