Establishing the basis for a social foundation for the breastfeeding habit

 Establishing the basis for a social foundation for the breastfeeding habit

Examining the role of breasts and breastfeeding’s fall from grace 

As organs of nurturing, breasts bare immense cultural significance. Romulus and Remus nurse from the teats of a wolf – testimony to the loftiness of Rome; my own family deity, Annakodiyal, graces her devotees with a babe clutching to her bosoms, signifying the nurturing nature of the divine mother. Breasts are also important as agents of human beauty and sexuality – Sandro Botticelli’s ‘The Birth of Venus’ portrays Aphrodite standing near-naked, drawing attention to her breasts, ironically by covering them (cf. Venus Pudica); Sigmund Freud’s psychoanalytical studies attributed the addictability of cigars to the subvert resemblance of their use to suckling. In ancient Indian texts, foreplay often involve fondling of breasts – Jayadeva’s Gita Govinda exemplifies this.

But, these intimacies are associated with inimical obfuscations; church-state union, and the period of imperialism that followed imposed upon the world a sense of ‘decency’ that connotes to sexuality, breasts included, the carnality of sin. Acting in concert is the American ‘conveyer belt’ model of medicine (indeed, as we shall see medicine is tied inextricably to breastfeeding); fast-paced, impersonal and economically maximising. Thus breastfeeding was relegated to a position supplementary to that of bottle feeding.

Examining the advantages of breastfeeding

Modern-day scientific inquiry has revealed innumerable advantages to breastfeeding. Immediate post-partum breastfeeding bolsters neonatal immunity through its supplementation of anti-bodies and anti-microbial enzymes, prevents neonatal hypothermia, allays physiological jaundice and assists placental expulsion. Of course, nature herself shows the way here – the ‘breast crawl’ displayed by infants portends the evolutionary advantages of breastfeeding. In the long term, it supplies the growing infant with a steady stream of nutrients and allays feeding-associated infection, which is quite common with formula feeds. Further, fermentation of breast milk produces small curds in the intestine as opposed to formula milk which produces large curds, obscuring the digestive process of the infant. Additionally, it promotes the development of the brain and the jaw, and is associated with less childhood obesity. In the mother, breastfeeding helps offset pregnancy-associated weight gain and fight over post-partum depression, if present.  Moreover, breastfeeding allows for better mother-child bonding, protects against breast cancer and promotes inter-child spacing, a phenomenon known as lactational amenorrhea. A distinction must be made here between breastfeeding and exclusive breastfeeding; the latter which comprises the provision of nought except breast milk to the child is recommended for six months and provides the best possible room for most of the advantages listed above to come to fruition.  

Bio economically, breast milk is ‘cheaper’ to produce than formula milk, with respect to time and the resources that must be invested. Research has revealed that even children of malnourished mothers benefit from breast feeding. Since excessive warning and preparatory procedures aren’t mandated breast milk is more accessible. 

Looking at where India stands currently

There is a wide disparity in the prevalence of exclusive across regions of India with the two extremes - South India and the North-East differing by 11 percentage points in some accounts, with South India having more prevalence. At the same time, overall national exclusive breastfeeding percentages increased from 46.0 to 55.0 between 2005 and 2016. With the realisation that breastfeeding can potentially help reduce India’s under 5 mortality rate – currently 35; the aim must be for this number to increase. Regional discrepancies in breastfeeding prevalence can be attributed to the difference in the socio-economic status of the said regions; indeed, more educated households exhibit a higher tendency for exclusive breastfeeding. Still, specific local factors such as beliefs and customs play a role in breastfeeding tendency – these require, as discussed later, localised solutions. With this background in mind, and the theme for this year’s breastfeeding week - ‘Set up for Breastfeeding – Educate and Support’ in view, the complex issue of breastfeeding will be explored.

The role of administration 

Philologists theorize a cyclical model of thought and its translation into action, which suggests that intellectual realization slowly seeps down into administrative schema and eventually practice, only to be reconsidered. Over the last decade, a slew of Governmental programs and non-governmental initiatives have sought to promote breastfeeding. With restrictions placed on advertising for bottle feeding and the relative advantages of breastfeeding being promoted, at least segments of the populace have taken the decisive step forward.

Contemporary challenges

There are some caveats here – for instance, the need for career-focused women to return to their workplaces often compromises their ability to breastfeed. Paid maternity leave is one solution - it enables a women to not to worry about her monthly income. Yet, this does not presage the best solution, for it still does not address a working women’s need to keep in touch with her profession. Here, two solutions can be conceived off – firstly, the provision of breastfeeding rooms and day-care facilities in office complexes. Secondly the ‘work-from-home (WFH)’ model of working being promoted for at least a year post-partum. 

Rejuvenation – Lessons from East and West

Much of the ideas discussed here are tied to legislation. But legislation doesn’t necessarily draw itself from morality. In many cases the law itself is the barrier to morality, for instance, public breastfeeding is grounds to file a complaint. The solution then seems to be changing the notion of the community. For, it was this that pushed breastfeeding into the fringe. This presents an almost poetic opportunity for revival of the breastfeeding habit – something that has already started. 

Throughout the Western world, there has been increased demand for public breastfeeding spaces, ‘freeing the nipple’, as well as acceptance of bare-chested women. Much of this is due to the West’s rather newfound celebration of sexuality; the connotations that breastfeeding has here cannot be ignored. The wise have always stated that all forms of compassion are in essence the same. To the eye of this beholder, it is this compassion whose public display is being celebrated. 

While this can be attributed to the personalism of the West instigating a contrast with the East; it must be stated that even in Eastern countries, the family’s role as a unit of decision-making is on the decline. It seems that the East, armoured by the colonial drive to make it ‘more British than the British themselves’, has succumbed to the draw of Victorian civilization.

Even in the most educated Indian households, breastfeeding is looked upon a back watery, slow practice. In this reversal of roles, the East must re-examine its view of things. 

Critical annotations on proposed solutions

While those solutions that are commonly talked about will be recapitulated here and examined – there is another way of analysing this issue – which will be discussed later. 

1. Firstly, awareness generation in such a manner that disrupts information asymmetry between the Medical world and the proletariat-bourgeois is currently the tagline of breastfeeding campaigns. This can be achieved through various levels including Governmental support through schemes, online dissemination, celebrity endorsement and the hospital system per se. Here a proposed solution is to replicate the template of support group schemes – providing networks of information and practice discussion. 

2. Secondly the denouncement of Formula Feeding through legislation such as the Infant Milk Substitutes Act, Monitoring, and Enforcement; and dissemination of information through the same channels above mentioned deriding formula feeding. This is important, as examining the issue from a game theoretical perspective infant feeding constitutes a zero-sum game – an increase in breastfeeding can only accompany a decrease in alternatives. Of importance here, is that families often purchase formula milk in the belief that it is better. Tangentially, formula milk isn’t the only substituent for breast milk – juice, cow’s milk and water all replace breast milk depending on the household; in these cases, only awareness generation can tip the balance towards breastfeeding.

3. Thirdly, the supplication of public spaces for breastfeeding and provision of breastfeeding spaces in commercial establishments. Effectively, this proposal only helps so far as women are willing to breastfeed, in which case it can potently alleviate access inequality. 

4. Fourthly, marketing of breast milk pumps to aid those children who feed sporadically, and those mothers who cannot spend the entire day with their children; and the establishment of breast milk banks to assist in the case of mothers with conditions such as AIDS. Although stored breast milk is better as a child feed than formula feeds, many of the advantages of exclusive breastfeeding such as accessibility and infection prevention cannot be replicated. As a result, breast pumps should be discouraged and breast milk banks should be encouraged in the direst of needs. 

5. Finally, a critical re-examination of the schooling system is warranted - must it provide education in matters of technicalities such as breastfeeding, or a broad base in knowledge, like what it currently aims to do?  While Einstein himself expressed mixed feelings over this issue, the topic of breastfeeding really speaks for the former. 

Here, a note must be made on localised perceptional barriers to (exclusive) breastfeeding; for instance, the belief that feeding donkey milk to a newborn enriches its development in parts of Tamil Nadu. Such perceptions can only be tackled through effective antepartum counselling supplemented with information dissemination in vernacular.

Role of the social perception of breastfeeding – A Novel solution?

In light of what has been discussed in the sections prior – and that breastfeeding was once the natural behaviour,  the endeavour that is being taken upon here thus should not be thought of as a novelty, but one of rediscovery. The factors attributed to breastfeeding fall from grace are all either social or economic. While ideas annotated upon previously, almost exclusive address the economic aspect, the economic fall of breastfeeding was simply a successor to its social perception. How can one repair a home without first eradicating the termites that have eaten away at it?

Here is where the theme for this year’s breastfeeding week comes into play - ‘Set up for breastfeeding – educate and support’ has so many layers to it. Dissecting it methodically, we arrive at the realization that much of the discontent towards breastfeeding arises from the psychological inhibition towards public display of affection. Carl Jung and Sigmund Freud discovered that emotionally repressed societies birth several unnerving phenomena – for instance, castration anxiety and penis envy. This exposition aims to look at societal discontent towards breastfeeding in the same light. Public display of vulnerability and unpacking of power dynamics, such as the infant-mother dependency is something that goes against the conservative notion of power trapping.  

The redressal should therefore be framed with this contemplation in mind. For starters, the predominantly economic measures summarized above aren’t ‘useless’; rather they should be supplemented with a tacit understanding of power dynamics. For example, a support group can go far in its ability to nurture those women who are doubting of breastfeeding – semantically, of course, but socially - definitely. Whilst financial schemes are mostly Governmental, the social response can only be bolstered by the Government, should at all it wishes to do something. 

Considering what citizenship truly means, an individual taking up responsibility for their health and that of those around them is the best way forward. How exactly can this be achieved? An individual’s body is something that they can definitively claim rights over; movements in the past have always arisen from such fundamental revolutions – an Individual’s right over what they perceive to be ‘them and theirs’. The potential for something that was so natural in the past to occur once more cannot be overstated – the social consciousness arising out of ownership is the only thing that can elevate the status of breastfeeding; such can be made possible through the same means above discussed – propagation of information and enabling participation.

Here we arrive at a satirical realization – individuality leading to increased public display of compassion, establishing a self-sustaining loop of healthy behaviour.