Philosophy professor Fiona Woollard has written a fascinating paper on the issue of breastfeeding and maternal duties entitled Is It Okay to Let My Child Be Stung by a Wasp?
New mothers report feeling shamed for not breastfeeding, and constantly having to defend their use of infant formula from strangers on social media or in public places like cafes. Coming at a time when new mothers are extremely vulnerable, such guilt and shame can have devastating consequences…
Something that might help would be if we recognised that the health benefits of breastfeeding give mothers a reason, but not a defeasible duty to breastfeed. Defeasible duties are associated with guilt, blame and requirements to justify our behaviour. If you have a duty to do something then you are required to do it; if you don’t, other things being equal, you should feel guilty and people with appropriate standing can blame you.
Defeasible duty is a technical philosophy term; colloquially we might call it a moral imperative. So the question becomes: do the purported health benefits of breastfeeding lead to a moral imperative for a mother to breastfeed? Woollard believes that the answer is “no” because not all reasons reach the threshold of moral imperatives.
[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]Is there a moral duty to do what is safest for a baby?[/pullquote]
Woollard notes:
We treat mothers and pregnant women as if they have a defeasible duty to perform each action that might benefit their child. That’s why we tend to act as if it follows from the fact that breastfeeding has health benefits that the mother has a defeasible duty to breastfeed. I call this a maximal maternal duty to benefit.
Most lactation professionals claim to believe, and craft their language to promote, the idea of maximal maternal duty to benefit. For them, the fact that breastfeeding has any health benefits is not merely a reason to breastfeed but a moral imperative to breastfeed.
But most of us, including lactation professionals, do not believe in a moral imperative to do anything that benefits a child regardless of other factors. For example, I doubt lactation professionals would claim that there is a moral duty to buy a Volvo, the safest car on the road.
If you do the math, the risk of a child dying in a car accident is far greater than the risk of being “harmed” by formula feeding, regardless of what magical benefits you ascribe to breastfeeding. But wait, you say. Volvos are expensive, many people cannot afford them and they might destroy the family budgets of even those who could scrape together the money. In other words, the benefits to the child can be balanced or even outweighed by the harms to the family. Therefore, while the fact that it is safer might be a reason to buy a Volvo, it does not lead to a moral imperative to buy a Volvo.
In other words, there is not a maximal maternal duty to benefit. Yet if reducing the greater risk of dying in a car accident isn’t a moral imperative, why would breastfeeding be a moral imperative?
The Volvo example is a bit outlandish but there are several situations a lot closer to breastfeeding that pose the same moral conundrum.
Is there a moral imperative to avoid co-sleeping with infants?
There is simply no question that co-sleeping increases the risk of sudden infant death. True, not every breastfeeding pair has the same risk but the risk exists for everyone. In other words, there is a measurable benefit to a baby to sleep outside its mother’s bed. Any theory of a maximal maternal duty to benefit creates a moral imperative for mothers to reject the practice of co-sleeping.
Most lactivists and lactation professionals are appalled at the thought. Co-sleeping makes breastfeeding more convenient, and although they would be the first to lambaste a mother who chose formula because it is more convenient, they rate their own need for convenience in breastfeeding very highly.
Besides, they claim, breastfeeding itself reduces the risk of sudden infant death. So what? If there is a moral imperative to breastfeed because of the health benefits, then surely there is the SAME moral imperative to reject the practice of co-sleeping.
How about homebirth? If a maximal maternal duty to benefit leads to a moral imperative to breastfeed, then the same principle creates a moral imperative to give birth in the hospital.
Homebirth in the US dramatically increases the risk of perinatal death. The best analysis to date, conducted by Judith Rooks, CNM MPH shows that homebirth with a licensed homebirth midwife increases the risk of perinatal death by 800%.
But wait, homebirth advocates say, homebirth provides benefits for the mother. So what? If mothers are morally required to do what is best for babies, regardless of the impact on themselves, then it doesn’t matter how mothers might benefit from homebirth. They have a moral duty to deny themselves those benefits in order to maximize the health and survival benefits to the baby.
Is there a moral imperative to vaccinate?
Every pediatric health organization promotes vaccination even more aggressively than breastfeeding. If they were forced to choose between them, they would undoubtedly choose vaccination as far more beneficial to babies than breastfeeding. Even their absurd claim that higher breastfeeding rates could save more than 800,000 lives per year pales into insignificance compared to the hundreds of millions of lives saved by vaccination.
Anyone who insists that there is a moral imperative to breastfeed because the WHO says it saves lives must acknowledge that there is a greater moral imperative to vaccinate because it saves far more lives. Yet millions of parent insist that what they personally believe about the benefits and risks of vaccination should carry greater weight than WHO recommendations. If that’s the case, then how can there be a moral imperative to breastfeed when many women believe the risks to their babies, themselves and their families outweigh the benefits?
Where does that leave us?
At a minimum, we must acknowledge that we do NOT believe in a maximal maternal duty to benefit. We don’t believe that mothers are obligated to drive Volvos or nothing else. Moreover, many passionate advocates of natural mothering do NOT believe that the fact that co-sleeping, homebirth, and refusal to vaccinate increase the risk of death means that mothers are obligated to avoid co-sleeping, homebirth and vaccine refusal. They recognize and respect that fact that there are other factors (convenience, finances, parental beliefs) that are involved.
Now they just need to recognize and respect that there is more involved with breastfeeding than benefits to babies.
