Shame is integral to the contemporary lactivism movement.
Indeed, it is so integral that there’s actual a blueprint on how lactivists can shame other mothers. Entitled Watch your language it was written by lactation consultant Diane Wiessinger and published in the Journal of Human Lactation in 1996. It is a primer on how to mobilize language to shame women who bottle feed.
Wiessinger identifies the problem for those wishing to shame mothers. Merely telling them that “breast is best” leaves open the possibility that you can still be a good mother if you formula feed (also known in Wiessinger’s parlance as artificial feeding):
When we … say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, “So what?” Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy and thus safety and adequacy-of artificial feeding…
So what if that’s the truth and women deserve accurate information in order to make informed decisions? We shouldn’t allow the truth to get in the way of manipulation:
Artificial feeding, which is neither the same nor superior, is therefore deficient, incomplete, and inferior. Those are difficult words, but they have an appropriate place in our vocabulary.
Actually, they are ugly, shaming words and Wiessinger is just getting started:
Because breastfeeding is the biological norm, breastfed babies are not “healthier” artificially-fed babies are ill more often and more seriously. Breastfed babies do not “smell better”; artificial feeding results in an abnormal and unpleasant odor that reflects problems in the infant’s gut.
[pullquote align=”right” color=”#ef6aa7″]The shaming of mothers for the ostensible benefit of babies benefits only those who profit from the shame.[/pullquote]
Wiessinger has the temerity to insist:
When we fail to describe the hazards of artificial feeding, we deprive mothers of crucial decision-making information. The mother having difficulty with breastfeeding may not seek help just to achieve a “special bonus”; but she may clamor for help if she knows how much she and her baby stand to lose. She is less likely to use artificial baby milk just “to get him used to a bottle” if she knows that the contents of that bottle cause harm.
Since when is deliberately inducing shame a form of decision making information? It has never been before, and it isn’t now.
Why would anyone undertake shame as a deliberate effort to promote breastfeeding. For Weissinger, it isn’t about babies or mothers it’s about promoting a “breastfeeding culture.”
We cannot expect to create a breastfeeding culture if we do not insist on a breastfeeding model of health in both our language and our literature.
And:
All of us within the profession want breastfeeding to be our biological reference point. We want it to be the cultural norm; we want human milk to be made available to all human babies, regardless of other circumstances. A vital first step toward achieving those goals is within immediate reach of every one of us. All we have to do is…watch our language.
Maybe that’s what those who profit from lactivism want, but it’s not what those in the health professions want. We want babies to be healthy, fed to satiety and not left to cry in hunger. We want mothers to be healthy and not in pain or struggling to manage a fraught breastfeeding relationship while dealing with new motherhood.
Over the past 20 years Wiessinger’s dream of using shaming language to browbeat women into breastfeeding has succeeded. The breastfeeding initiation rate has reached a 100 year high. And the impact on infant health has been … negligible to non-existent.
In contrast, the impact on maternal mental health has been profound. Simply put, there is an epidemic of guilty mothers who are ashamed that they cannot breastfeed exclusively.
The authors of a recent paper, Shame if you do – shame if you don’t, explain:
The message frequently summarised as ‘breast is best’ reflects scientific knowledge on the nutritional and immunological benefits of breast milk for infants as well as carrying moralistic dimensions. In many cultures, breastfeeding is synonymous with ‘good mothering’. When mothers make a decision not to breastfeed, they may experience guilt, blame and feelings of failure. Taylor and Wallace, in their theoretical framework aimed at understanding maternal responses to infant feeding, argue how formula feeding mothers may experience shame (as opposed to guilt) through ‘failure’ to live up to ideals of womanhood and motherhood…
Shame is considered to incorporate affect (e.g. fear, anger, humiliation, self-disgust, anxiety, low self-esteem, depression), cognitions (e.g. feelings of rejection, inferiority and inadequacy) and actions (e.g. withdrawal and isolation or retaliation). Although shame is often used interchangeably with guilt, these are considered to be two distinct emotions. Shame is believed to occur when there is a breach between the cognitive evaluation of the ideal self and that of the actual self. The self-evaluation giving rise to shame emerges through an awareness of a deficiency or feelings of not being good or good enough: a global negative feeling about the self in response to a goal not reached, or some shortcoming…
Just what Wiessinger was hoping for!
Interestingly, the sense of shame was precipitated or intensified by exposure to those who were supposed to provide breastfeeding support:
The quote[s] below suggests that what professionals may view as a positive approach may in fact augment the experience of shame due to the inherently judgemental nature of language used:
I got fed up of people telling me I was doing a good job. […] I wanted somebody to help me and actually find a solution to the problem I was facing. I think it is underestimated how vulnerable you feel and how much of a failure you feel and that is not really the right thing to say to people.
Some of the women who formula fed from the early post-natal period or after a period of breastfeeding also reported marginalisation through a lack of support:
When you bottle-feed you don’t get as much help. I did try so hard [to breastfeed] I kept blaming myself that I couldn’t do it. […] it was too painful and however much I tried I couldn’t get him on, and wasn’t feeding properly. […] But when you decide ‘I don’t want to do it anymore’, it seems the support goes out the window. […] It did get me very very down, it felt like they turned against me because I was bottle-feeding.
Restrictions or inhibitions on discussing substitute feeding methods (both on the post-natal ward and in the community) left women feeling dejected and isolated:
Bring the choice back for god’s sake, when breastfeeding doesn’t work, bottle feeding is a good alternative. I didn’t have a clue what I should be using.
The enforced dependency of mothers on the medical model was also in evidence when women experienced incapacity to breastfeed, perceived or otherwise:
They wouldn’t allow me to cup feed her, so I had to wait for a midwife to be free […]. I did ask as it was distressing that I couldn’t feed my child.
In The concept of shame and how understanding this might enhance support for breastfeeding mothers, Leeming and Marshall note:
Previous discussions of the potential for breastfeeding promotion to cause distress for women who do not breastfeed or who struggle to do so have tended to assume that the problem is guilt. In response to this a frequently made point has been the importance of recognising that apparent ‘failures’ to breastfeed are not best understood as the mother’s omission or ‘choice’ but instead as a consequence of the many barriers to breastfeeding in Western societies… However, as Taylor and Wallace point out, women’s emotional responses may be more complex than has sometimes been assumed and for many mothers who struggle with breastfeeding or turn to formula milk, shame may be as much if not more of an issue than guilt.
… When we are ashamed we experience ourselves as inferior or flawed before a more powerful critical ‘other’, whether this is an actual person we perceive as devaluing us or a sense of a generalised ‘other’ in front of whom we are inadequate and lesser. With shame the focus is on a sense of a damaged and unable self, rather than on specific actions. Therefore an example of shame would be a mother whose distress about feeding difficulties arises from the possibility to her that these difficulties mean she is fundamentally flawed or inadequate as a mother, and possibly exposed as such before critical others…
So if babies don’t benefit in any measurable way from breastfeeding promotion through shaming and mothers are actually harmed by it, who does benefit?
Lactivists benefit and they benefit in a variety of ways.
First, lactation consultants benefits by increased employment and income. If every women is shame into attempting breastfeeding, and shamed if she attempts to stop, and shamed if she combo-feeds with formula, and shamed when she is seen bottle feeding, there will be greater need for lactation consultants.
Second, lactivists benefit in the same way that those inflicting shame on others always benefit, by enhanced self-esteem through feeling superior to the shamed.
Finally, lactivists benefit by enjoying ugly behavior that is usually forbidden but is actually encouraged in the case of formula feeding. There is simply no limit to the cruelty of lactivists toward women who don’t or don’t want to breastfeed, and no limit to the delight that lactivists experience in sanctioned cruelty to other mothers.
Wiessinger’s blueprint for lactivists, promoting careful choice of shaming language in order to browbeat women who choose formula is an ugly document, and the result, inevitably, has been a rise in ugly feelings of shame among those mothers.
So now the rest of us need to ask ourselves if we have been duped into harming women for the benefit of a lactation consultants and lactivists who have been preying on them. Wiessinger was on the mark when she pointed out that “breast is best” leaves open the possibility that you can still be a good mother if you formula feed and that our personal experiences tell us that optimal is not necessary. We need to make it clear, in the strongest possible terms, that formula is an excellent substitute for breastmilk, that you can definitely be an excellent mothers if you formula feed, and that the shaming of mothers for the ostensible benefit of babies benefits only those who profit from the shame.
