There is growing awareness of the importance of adopting breastfeeding as the social norm everywhere. Here’s what a blog called PhDinParenting says about it in a post called “Societal Barriers to Breastfeeding”:

“Attitudes and imagery: People will breastfeed if they see others breastfeeding. Peer pressure, feeling normal, having role models. Call it what you like, it is what it is. If the predominant image in public, in magazines, in movies, on television, is bottle feeding, then people will see that as normal. If it is not, then fewer people will breastfeed and those that do will be ostracized and discriminated against by the anti-nursing-in-public brigade. This is one of the reasons I think it is so important to breastfeed in public. This is why I think we need at least as many breastfeeding dolls as bottle feeding dolls.”

Here’s another blog entry showing how breastfeeding in public used to the norm, even in rich countries. The author is probably correct that the sexualization of the breast (combined with all the forces that caused artificial feeding to increase) was responsible for some countries losing this. This blog post discusses why there is such a negative response to breastfeeding photos. (Facebook aparently does not allow them, though they allow plenty of other revealing photos!)

Very brief review of some of what the scientific literature says about norms is below this post. Comments or additions welcome! My email address is below.

Bottle Feeding is portrayed as the norm, even in countries like Sweden where it no longer is

Of course the mass media should be able to portray bottle feeding when it’s appropriate. Not every woman on TV ought to be portrayed breastfeeding; that would not be realistic.

But we all can see that all media, presumably often unthinkingly, tend to equate babies with bottle feeding. Here’s an example from Sweden, a child-friendly and woman-friendly country. It’s from the front cover of the 1994 Stockholm telephone catalog. No doubt the staff who placed it there simply thought it was a cute and amusing picture–a woman finding a way to feed her baby while painting. But of course the “normal” way to do that in most of the world is to have the baby in a sling, swung around the front, and breastfeeding while the mother’s hands are equally free.

Here’s another, from a Swedish department store ad (Sweden’s no worse than any other Western country; I just happened to live there for 20 years). What an idyll! Imagine getting to have a baby but not have to pay any attention to it–or not even touch it! And of course this illustrates one clear reason for portraying bottle feeding as the norm: there’s something to sell. It is possible to cash in on breastfeeding too (pumps etc) but so far at least that’s a much smaller market and the products involved are usually familiar only to breastfeeding women.

Breastfeeding is portrayed in non-normative ways

We also see examples of breastfeeding portrayed in ways that are “non-normative.” It’s not always easy to choose an image for breastfeeding that IS normative. At one end of the spectrum, it is not uncommon to see breastfeeding as part of a picture illustrating misery, poverty, and malnutrition. 

Click here for another example, from the industry-friendly nutrition journal Nutrition Today from the early 70s, when breastfeeding in the industrialized world was on the verge of dying out. The editors may only have intended to illustrate the challenge nutritionists felt they were facing in those hippy days. But of course, for most people, including the formula company executives clapping their hands in glee, it was saying, “Are YOU the kind of person who would do THOSE things with your baby?” or “Is this ‘back to nature’ thing really such a good idea?” Fortunately, this journal had no impact on international norms and they DID change, sending breastfeeding rates up over the next 10-20 years all over the industrialized world.

At the other end of the spectrum, many of the pictures of breastfeeding used by infant formula companies that I have seen over the past 35 years show a woman doing it who is clearly wealthy. But isn’t that a good thing, we may ask; don’t we all strive to be like rich people? Actually, research within the fashion industry suggests that most of us do not; we strive to be like someone we perceive as similar to us, but slightly higher on the social scale. As milk companies have no doubt been informed by marketing gurus, images of clearly wealthy and privileged women breastfeeding may make many feel, “Yeah, okay, breastfeeding is great if you can afford not to work, to have good health care and to eat an expensive diet.” Similarly, illustrating breastfeeding with a woman with very large breasts may increase fears among others that they may have difficulty or an inadquate milk supply.

Breastfeeding is left out of children’s books

An excellent post on this can be found here on the Australian Breastfeeding Association website.

Progress is being made on the use of language

Diane Wiessinger is the first person I read who pointed out clearly that we need to stop saying “breast is best” because it’s not, it’s just normal. Formula is inferior. In a more recent letter to JHL (24(4): 369, 2008) she calls on them and other journals to be honest. (And in JHL’s instructions to authors, they are.) We wouldn’t say that clean air was responsible for lower rates of cancer! She calls on the APA to live up to their own statement that exclusive breastfeeding is the norm, as apparently, the American Academy of Family Physicians does. This call for better use of language is being taken up by others.

Of course saying bottle feeding is harmful subjects one to attack because we accused of scaring people who use formula or making them feel guilty. It is remarkable how powerful and pervasive this argument has been and it may have done as much harm as the infant food industry itself. In 1975 Cornell University published the first academic monograph documenting how infant formula was promoted and how the health professions were involved. In researching it, I was struck by the fact that content analysis suggested that infant feeding literature for parents (brochures, etc) from US and NY state governments was no better than that from infant formula companies, while one from Johnson and Johnson (which at that time sold no products relevant to infant feeding) was much better. Years later I received a letter from the author of a US government brochure given by congressmen to new parents in their districts. He was a pediatrics professor at U Pittsburgh and asked what was wrong with his booklet. I cited each passage that gave it demerits, resulting in a letter back with his earlier humility replaced by ridicule. He saw no clear scientific evidence that breastfeeding was any better (the data at that time WERE weak; my content analysis was based on what La Leche League said was needed to support breastfeeding mothers). He mentioned that his wife was unable to breastfeed and his main goal in the booklet was to help such mothers avoid feeding guilty.  

How important is it to portray breastfeeding as the social norm?

Is all this a big deal? Is it something worth making a huge effort to try to change?

Here’s a thought. If we don’t define for society what the norm should be for fathers’ increased involvement in child care, someone else will. Indeed, they’re already doing it: click here. And if you don’t think images from ads will exert much influence, here’s one from a regular newspaper article.

Every day on Twitter a few people comment that someone breastfed in front of them. Some express disgust or anger; some, confusion or mild discomfort. On that same day, a substantial proportion of the world’s population, probably the majority, also saw someone breastfeeding and simply didn’t pay attention. Click here for ”proof.” This is a tourist post card I bought  in 1987 in Lesotho, a small country in southern Africa. I doubt any of us who have been brought up in a bottlefeeding culture could guess what the explanation of the picture is on the other side–”Woman weaving a basket.” Presumably the photographer, publisher, etc either did not notice, or pay attention to the young child in a school uniform kneeling next to her mother for a snack–I’ve watched them do that on the way home from school in Ghana as well, a decade earlier.

Is this child abuse, perversion, disgusting? Or are our norms a bit off?

Should everyone be pressured to breastfeed till their children start school? Of course not. To be positive and supportive of someone who does? Well, that’s probably not a realistic goal. 

But maybe, with time and help from the mass media, we could achieve a society where people did not pay much attention to who was breastfeeding whom because, after all, that’s the norm.

So what can be done? Let’s do some research to find out what will work!