Breastfeeding in the Twentieth Century

breastfeeding

A review of Feeding Babies, Making Mothers: The Science, Practice and Meaning of Breastfeeding in the Second Half of the Twentieth Century, by Jessica Martucci.

In this thoroughly researched, beautifully written dissertation, Jessica Martucci explores the trajectory of the ideology of “natural motherhood,” and its role in the resurgence in breastfeeding in America during the second half of the twentieth century. The work forms part of an intellectual genealogy exploring infant feeding which has roots in sociology, gender studies, the history and philosophy of science, medical anthropology, social policy and beyond (see for example: Rima Apple, Mothers and Medicine: A Social History of Infant Feeding, 1890-1950 . Madison: University of Wisconsin Press, 1987; Linda Blum, At the Breast: Ideologies of Breastfeeding and Motherhood in the Contemporary United States. Boston: Beacon, 2000; Christina Bobel, The Paradox of Natural Mothering . Philadelphia: Temple University Press, 2002; Janet Lynne Golden, A Social History of Wet Nursing in America: From Breast to Bottle . Cambridge: Cambridge University Press, 1996; Jacqueline Wolf, Don’t Kill Your Baby: Public Health and the Decline of Breastfeeding in the Nineteenth and Twentieth Centuries. Columbus: Ohio State University Press, 2001.)

In her introduction, Martucci spells out her intention: “Ultimately, I ask the question of why — in the face of such widespread support (both scientific and cultural) for formula- and bottle-feeding and in the face of institutional and financial hurdles that continue to make breastfeeding one of the more complicated, if not more difficult, aspects of early motherhood — why did American mothers persist in trying to breastfeed their babies over the course of the twentieth century?” (p.3)

In short, she convincingly argues that the connection between “natural motherhood” and breastfeeding helped “bring breastfeeding back from the brink of obsolescence” (p.ix) after the Second World War, in constituting notions of appropriate maternal behavior endorsed by physicians, voluntary groups, policy makers, and mothers themselves.

The dissertation is divided into five chapters, which follow both a chronological and a thematic order. Chapter 1 discusses in greater depth the maternal ideologies at play in the United States mid-century. Martucci argues that:

In the immediate post-World War Two era, a significant shift in the practice, culture and construction of mothering took place, as the expert-centered ideology of “scientific motherhood” began to give way to an alternative construction, best described as “natural motherhood” (p.40).

“Natural motherhood” is described as “articulat[ing] a model of maternal identity that emphasized evolutionary tendencies and systems in the mother-child relationship that would not be learned but were believed to be innate” (pp.34-35). In describing the difference with “scientific motherhood” (a much more rigid, expertise-driven conception, as written about by authors such as Rima Apple), Martucci describes natural motherhood as one linked to trends such as the natural birth movement and the breastfeeding movement as well as its own kind of scientization (around instinct).

Chapter 2 explores the meaning that breastfeeding held for pediatricians, as a professional group. As Martucci says, traditionally this is a much-maligned group in the history of infant feeding, usually portrayed as having a vested interest in the promotion of formula milks to mothers. However, through her deft engagement with a range of sources (notably Pediatrics, the official journal of the American Association of Pediatrics), Martucci shows how breastfeeding was seen as an area of contested knowledge among a range of stakeholders (whom she discusses further below). Recognizing, for example, that mothers themselves were hungry both for expert-led guidance about how to “best” feed their children (under the rubric of scientific motherhood, by the precision of the bottle) and for information about breastfeeding, Martucci foregrounds the complexities of the doctor-patient relationship. Pediatricians therefore walked a line between appearing “supportive” of breastfeeding, while in practice leaving many women without adequate help to do so. The chapter overall, then, paints a more complex one that is typically portrayed:

The role of pediatrics in the post-war shift to breastfeeding, therefore, might be characterized as just one of the several important groups and bodies of knowledge that contributed, albeit in a complicated and often times ambiguous manner, to the reversal in breastfeeding trends that continues to take shape in America to this day (p.149).

The third and central chapter explores the cultural meaning and experience of breastfeeding for mothers themselves, primarily during the 1950s and 1960s. The chapter draws on material published in popular magazines, organizational records, infant care manuals and mothers’ letters to experts “in an effort to reconstruct the cultural environment in which women made the choice to breast- or bottle-feed and what the choice and its implications meant to them” (p.36). Martucci weaves in a discussion about gender, female sexuality and the role of the American family here, arguing that mothers navigated a complicated web of advice, expectations, identities and desires as they made their infant feeding choices (p.37 passim).  In posing the difference between scientific and natural motherhood along lines of sexuality, Martucci shows how the former was linked to bottle feeding, and the latter to breastfeeding, describing how the two “collided” in this era in differing ideas of feminine sexuality, and intimate accountability (i.e., to the partner, or to the child). This offers valuable insights “into what mothers and fathers thought about the consequences and meanings of the choice to breast or bottle feed and…also reveal[s] the presence of a private and ongoing conversation that was taking place within infant feeding discourse over the best way to structure the American family – was the mother-infant relationship to be central or should the husband-wife relationship come first? Was natural motherhood incompatible within a modern, egalitarian nuclear family? Breastfeeding advocates seemed to be very aware that the proposal of placing the mother- infant dyad at the center of the family was counter to what most Americans would find palatable” (p.186).

The oft-neglected role of nurses in the history of infant feeding is addressed in Chapter 4, which looks at letters and articles as well as archival records from the 1960s and 1970s, to argue that the nurse “has played a historically consequential role in mothers’ experiences with breastfeeding” (p. 37). The chapter looks at the different meanings that mothers and nurses brought to infant feeding (not neglecting the fact that many nurses were themselves mothers). As Martucci writes:

As historians and sociologists of medicine and nursing have shown, nurses have always had to negotiate a series of complicated relationships between themselves and the institutional constrictions of the hospital, of the medical hierarchy, of patients, and of the nursing field itself. Breastfeeding highlights the particular tension that existed between patients (specifically mothers) and nurses. The interactions of mothers and nurses were highly gendered – based on their sometimes shared, often conflicting assumptions, expectations, and experiences (or lack thereof) of motherhood. The nurse, a trained and avid believer in scientific medicine had been, for decades, an evangelist for the ideology of scientific motherhood. By the late 1940s, however, this construct of womanhood was being challenged by the emergence of an alternative maternal ideology, that of natural motherhood. (p.246)

The final chapter explores the way that nature, feminism and technology influenced the experience and meaning of breastfeeding from 1969 through the 1980s. The chapter looks at how “natural motherhood” intersected with wider ideas about feminism, observing, as many have done before, that “the natural” is a problematic ideology in terms of gender equality. Drawing on a range of archival material as well as her own interviews, Martucci writes:

I argue that the feminist struggle over breastfeeding was rooted in the recent historical connection between breastfeeding and natural motherhood, one which they needed to dismantle in order to re-define breastfeeding in a way that did not jeopardize the feminist vision of the unfettered, yet biologically and sexually fulfilled, woman. (p.38)

The conclusion of this dissertation points to new directions for research – around “cyborg motherhood” (through the medium of the breast pump, see Linda Layne, Sharra Vostral and Kate Boyer (eds.), Feminist Technology. Champaign: University of Illinois Press, 2010.) as well as further work around the enduring appeal of “the natural” in social life. This is a dissertation which has huge potential to complexify and complicate common readings of the history of infant feeding, both in the United States and beyond. Martucci concludes, perhaps appropriately, by drawing out the intimate, personal nature of infant feeding decisions, which must nevertheless be set against this historical landscape:

As the history of the science, practice, and meaning of breastfeeding has shown us, however, what breastfeeding is all about is a question that each mother (and family and generation) has had to grapple with on her own amidst an ever changing historical landscape of knowledge, expectations, and possibilities surrounding the institution of motherhood and its connection to breastfeeding in America. (p.321)

Charlotte Faircloth
School of Social Policy, Sociology and Social Research
University of Kent, Canterbury
c.faircloth@kent.ac.uk
http://kent.academia.edu/CharlotteFaircloth

Primary Sources

American Academy of Pediatrics, Pediatrics.
Boston Association for Childbirth Education Collection, Schlesinger Library. Radcliffe Institute for Advanced Study at Harvard University (Cambridge, MA).
Boston Women’s Health Book Collective, Schlesinger Library Archives, Radcliffe Institute for Advanced Study, Harvard University (Cambridge, MA).
La Leche League Collection, DePaul University Special Collections (Chicago).

Dissertation Information

University of Pennsylvania. 2011. 340pp. Primary Advisor: M. Susan Lindee.

 

Image: “International Breastfeeding Symbol” by Matt Diagle, Wikimedia Commons.