Breasts have a purpose and it is not male entertainment! have no qualms about feeding Amanda in public. NONE. I was given a "hooter hider" at the baby shower, but promptly lost it. I found it a week ago in the linen closet (she is 4 1/2 months). Which left me thinking that it is a beautiful piece of cloth, but why would I hide my beautiful baby under it?! I did one of my final projects in nursing school on breastfeeding in public and feel it's worthy to include here. Yes it is long, but just scan the subtitles for the interesting parts. The end gets all nursing intervention-y so you could skip that. I'd edit it shorter but I have a cute baby asking for attention in her pterodactyl voice....
Women who Breastfeed Publicly and the American Obsession With Breasts
The Vulnerability of Women who Publicly Breastfeed in the United States
Breastfeeding is the ultimate form of nourishment for an infant. Not only is it superior for digestion, it also offers rich antibodies that protect the infant from illness throughout the breastfeeding period. However, in spite of widespread research proving breastfeeding is the healthiest way to feed almost all infants, fewer than 18% of mothers who initiate breastfeeding do so for the American Academy of Pediatrics recommended six month minimum (Wolf, 2008). While some bottle-feeding is due to aggressive advertising by formula companies, the absence of visual depictions and live examples of breastfeeding in the US certainly does not suggest that breastfeeding is a vital practice and should be an attractive and viable option for almost any woman (DeJager Ward, 2000; Hall Smith, 2008).
Many mothers’ lack of enthusiasm towards breastfeeding in the US is not only due to a passive lack of role models in mainstream culture, but is fueled by active criticism, disdain, and even disgust towards the mother who nurses in public venues. Breastfeeding is defined as the feeding of a child with direct breast to mouth contact (Lawrence & Lawrence, 1999). Public breastfeeding is not a forbidden sexual activity, however the American obsession with sexualized breasts has led to the American cultural belief that nude maternal breasts are unacceptable. This is especially problematic, since “a lot of people view this as a personal rights issue for mothers, but it’s not just a mother’s right, but a child’s right too” (Cook Bauer, 2007).
A mother who strongly desires to give her infant the healthiest meals from the breast may have to rearrange her entire schedule to incorporate breastfeeding if she cannot feed her infant in a public setting. “If women are made to feel uncomfortable with public breastfeeding, breastfeeding becomes difficult, if not impossible to sustain….So, many women give up breastfeeding early on and opt for the bottle” (Wolf, 2008: pp. 2). This is unacceptable and demands examination of the cultural importance of breasts throughout history, historical changes in breastfeeding, cultural factors that contribute to resilience and health enhancement and a model for providing quality nursing care to women who publicly breastfeed.
Cultural History of Exposed Breasts in Public
The nude breast in public has been covered, revered, painted, sculpted, eroticized, criticized, monopolized, and commercialized. In ancient civilizations the breast had to be given frequently to ensure child survival, and evidence of nursing goddesses, mother goddesses and fertility goddesses are found in bare-breasted bone, stone and clay female figurines and idols (Blum, 1999; Yalom, 1997). These sacred depictions include mother goddesses that breastfed future pharaohs to ensure their thrones (Lawrence & Lawrence, 1999; Blum, 1999). Depictions of female breasts were nude and realistic prior to the founding of Greek civilization, but by the 5th century BCE the introduction of wet nursing coincided with the patriarchal mandate that Athenian women wear head-to-foot clothing. In paintings, Greek women’s breasts are never exposed (Yalom, 1997).
The bare-chested Madonna feeding her infant Jesus was a prominent feature in 1200-1400 BC European paintings (Lawrence & Lawrence, 1999). The female body was celebrated as a giver of life, while also becoming eroticized by new dress styles that prominently featured the breasts and turned them into objects of desire (Yalom, 1997). In medieval European societies, “the breast had a singular importance: it was the sign of attachment between mother and child, the link from one generation to the next … the mother was actually defined as the one who puts forth her breast to feed the child” (Yalom, 1997: pp. 36). The breast was held sacred, and actively discouraged from being sexualized.
However, the breast took a turn away from practical in the fifteenth century at the precise moment when “the mistress of the king of France … [was] painted with one breast uncovered … a voluptuous globe bursting out of the bodice” (Yalom, 1997: pp. 49). While viewers were used to seeing naked breasts used for feeding, this breast was “served up like a piece of fruit for the delectation of an observer outside the picture, and certainly not for the baby seated placidly within the frame” (Yalom, 1997: pp. 49). This particular painting was referenced by Anne Hollander as “the moment when the single bare breast became … a reference to pure pleasure. Stripped of its relation to the sacred, the breast became the uncontested playground for male desire” (Yalom, 1997: pp. 49). This new perspective continued and gained speed during the Renaissance, when female courtesans or paid companions became acutely aware of budding public connection between pert breasts and youthful attractiveness because when their breasts began to sag they no longer had any commercial value (Yalom, 1997). Courtesans and prostitutes also began to use make-up on their breasts, and “they were seen at their windows displaying their bosoms and making amorous signs to entice customers inside” which associated any bare breast with prostitution (Yalom, 1997).
The breast then became a political symbol in the twentieth century, beginning in France during World War I, and leading to American caricatured propaganda which “used blatant sexual imagery to rally American men against the potential rape of their country, symbolized by a vulnerable female” (Yalom, 1997: pp. 132). World War II GI magazines featured pull-out posters of well-endowed pin-up girls that capitalized on cultural beliefs about femaleness (Yalom, 1997). The 1950s saw heavy eroticization of the breast in America, from Marilyn Monroe to Playboy magazine (Olson, 2002). This developed into the American idolization of young full breasts, which were subsequently utilized to sell everything from soda pop to cars (Lawrence & Lawrence, 1999). In the 1980s pornography became mainstream, and Madonna pushed the envelope with open onstage female sexuality (Yalom, 1997). Due to the recent sexual and erotic history of the breast in the US when breasts are seen in public they are layered with cultural symbolism.
Cultural History of Breastfeeding
The 5th century BCE, the introduction of wet nursing coincided with the patriarchal mandate that Athenian women wear head-to-foot clothing. In the Bible fertility was celebrated as a gift from God and when Sarah, the elderly wife of Abraham, gave birth to a son and was able to breastfed him as if she was a young woman (Yalom, 1997). The goddesses are also referred to as wet nurses to the gods (Yalom, 1997). During the Middle Ages breast milk was a holy substance, like Christ’s blood and the two were combined in hopes of miracles, although a vial of Mary’s milk alone could cure blindness. Paintings of that time frequently portray Mary nursing her son with religious onlookers (Yalom, 1997).
From 1500 to 1700 breastfeeding among wealthy English women declined sharply due to opinions that breastfeeding would ruin their figure or simply because they could employ someone to do it for them (Lauwers & Shinskie, 2000; Lawrence & Lawrence, 1999). They opted for wet nurses or artificial feeding (Lawrence & Lawrence, 1999; Riordan, 2005). In Renaissance France “lower-class” breasts were those of peasant women who nursed their children compared to “upper-class” breasts for male pleasure (Yalom, 1997).
During the witch hunts of the 1600s an elongated nipple “which looked as though it had been recently sucked” was sufficient evidence to convict a woman of witchcraft (Yalom, 1997: pp. 60), demonizing breastfeeding women. Modern medicine, science and technology dramatically changed child feeding practices during the 17th and 18th centuries. The improvement of bottle and nipple design coincided with increased availability of cow’s milk and popularized bottle feeding (Lauwers & Shinskie, 2000), that were embraced to combat high infant mortality rates (Riordan, 2005). However, at the same time scholarly writing appeared about the potential of infection by bottle feeding, with clear indication that there was an unknown quality in breast milk that protected infants (Lawrence & Lawrence, 1999).
The use of wet nurses was common in early 19th century France and Europe, while in America women breastfed their children for at least a year to reduce the high likelihood of mortality. Yalom (1997) explained that in the US “the good breast was understood to be the nursing breast….it was even permissible to breast-feed in such public places as parks and railroads” (pp. 126). However, soon wet nursing became popular in the US, with use of peasant women, and later Black slaves, to feed the children of wealthier women (Golden, 2001). The 19th century was full of many changes in medicine, one of which was the movement of birthing to hospitals, which increased separation between mothers and babies, and decreased breastfeeding initiation (Lauwers & Shinskie, 2000; Riordan, 2005).
Bottlefeeding skyrocketed from 1940 to 1970 due to the creation of breast milk substitutes promoted by medical professionals and the milk industry (Yalom, 1997; Lawrence & Lawrence, 1999). La Leche League was founded in 1956 and served as a counterforce to the bottle feeding culture, educating women about how to breastfeed and supporting them in their efforts (DeJager Ward, 2000; Golden, 2001).
The 1960s bra-burning women’s liberation movement marked a resurgence in the popularity of breastfeeding that continued through the 1980s (Yalom, 1997; Lawrence & Lawrence, 1999; Simpkin, Whalley & Kepler, 2001). Breasts were also medicalized through lactation services and products. To ensure supply, the milk glands must be stimulated, which in absence of a child necessitates a pump. Breast pumps are used to assist mothers in providing maternal milk to their infants while continuing to work, but use can be problematic when it comes to workplace conditions and politics. The US Constitution supports public breastfeeding as a fundamental right of both mothers and children, although laws vary by state. Even so, many mothers do not breastfeed their children because of the mass media’s portrayal of female breasts as objects of desire, not sustenance that should be seen in public (Lawrence & Lawrence, 1999).
Unfortunately, breastfeeding does not always receive positive attention. When the media does cover breastfeeding it is usually in a negative light, such as in 1997 when a young US mother was accused of murdering her infant who she had been breastfeeding. Due to a previous breast reduction despite constant nursing her infant did not receive sufficient milk, and her access to Medicaid came too late to save her infant (Wolf, 2001).
Women living in the US are starting to see evidence that public views on breastfeeding are beginning to change. This year celebrity Angelina Jolie, voted one of the “Sexiest Women Alive” by People Magazine was featured on the cover of W Magazine breastfeeding one of her children (C. Mount, Personal Communication, October 2008). During World Breastfeeding Week synchronized breastfeeding occurs around the world, with the current Guinness World Record held by Manila, where in 2006 3,541 mothers simultaneously breastfed (Cook Lauer, 2007).
The value placed on these female breasts must be of sustenance, the ability to sustain human life during the most vulnerable years. Breastfeeding can be normalized as a labor of love. “American obsession with breasts has consequences most Americans fail to consider: ready access to human milk is vital to babies’ short-and long-term health” (Wolf, 2008: pp. 2). Currently breastfeeding in the US is intimately tied to the cultural interpretation of breasts purpose.
Current View of Breast: Sexual Identity-Maker
The words used in the US to describe breasts do not respect their original purpose. Words like “tits, jugs, hooters, bazookas” sexualize breasts (Tamaro, 2005). Breasts have become disembodied, signifying motherhood, but viewed as sexual objects separate from their biological role (Blum, 1999). In doing this women are socialized into feeling that their breasts exist for the enjoyment of others. In the US breastfeeding in public elicits a reaction from the viewer because of the current cultural meaning of the female breast – sex.
The media drives American popular beliefs about female breasts and the acceptability of public breastfeeding. Beginning in the 1950s, virtually all breasts portrayed by the media have been sexualized, focusing on the American ideal of the perfect breast- large, perky and young (Olson, 2002). “Women’s breasts emerged as the physical icons of American popular culture, the sina qua non of eroticism and beauty” (Olson, 2002: pp. 111). The ideal breast is youthful, and American women go through great efforts to keep their breasts appearing youthful through surgery, creams and enhancing garments. Based on the American cultural model, having breasts defines the American woman as female, and solidifies her sexual identity (Jones, 2001).
Americans have placed a value on female breasts, one of sexual pleasure, not of functionality and sustenance (Bauer Maglin & Perry, 1996). “Americans think breasts are primarily for enhancing sexual activity, which results in widespread discomfort when they are reminded that breasts go into babies’ mouths” (Wolf a, 2008: p. 1). This sexualization has been part of the US culture for generations. Men are simply not accustomed to seeing mothers’ breastfeeding their children because it is not common in the US. Men are women’s friends, partners, lovers, husbands, brothers, fathers and grandfathers. They are not opposites, but fellow humans with the complimentary reproductive capacity that are influenced by the breasts they encounter from childhood through adulthood, predominantly in media images.
American men are targets, and patrons, of the media’s commercialization of breasts. Due to this they may feel that breastfeeding in public is indecent or immoral (Tamaro, 2005) and may react to the sight of the maternal female breast in the public domain. “From the outside, the breast represents another reality, and one that varies in the eye of each beholder. Babies see food. Men see sex. Doctors see disease. Businessmen see dollar signs” (Yalom, 1997: pp. 275).
With a breastfeeding child some men may feel that their territory is being infringed upon (Challman, n.d.), that their ‘toys’ are being taken away (Tamaro, 2005) if their partner chooses to breastfeed. Others do not know that breastfeeding is healthy and normal, seeing no difference between bottle feeding and breastfeeding (H. Mass, Personal Communication, November 2008). Men who were bottle-fed may argue that they turned out fine.
Many American men’s feelings are ties to their lack of knowledge about women’s breastfeeding rights. “I heard two salesmen on an airplane discussing whether they should turn a woman in for breastfeeding. ‘Is it legal?’ one said to the other, then pulled out his reading material for the long flight. Yes, of course, it was Playboy” (Tamaro, 2005: pp. 286). Men also suffer from American stereotypes of public breastfeeding and may not know that in many countries a woman feeding her child in public is a normal event that does not merit the attention of a single man. Although many men do fall for the media’s depiction, there are those who overcome stereotyping breasts as strictly objects of sexual desire and see them as life-giving.
Educational websites like 007 Breasts explain why breasts are not solely sexual objects, but “baby feeders” as well. Men who frequent this site leave comments such as, “Hi I’m a 22 year old male…I have grown up in the US with its cultures and traditions. I think of breasts as sexual objects. That’s just what they have always been to me and it may take awhile to change that…However, losing the breasts as an object of sexual interest is not a real loss for anybody, they will remain just as beautiful” (Breast Obsession, n.d.). In this statement the young man acknowledges that the foundation of his beliefs about breasts is rooted in his life experiences, while respecting that they have another purpose and what must be overcome to reduce barriers to public breastfeeding.
Barriers to Breastfeeding in Public in the US
“Breasts are exposed everywhere, in television, films, magazines, and constantly in advertising; yet nursing in public is only grudgingly condoned, and mothers have been harassed at restaurants, malls, and movie theaters for breastfeeding their babies” (Blum, 1999: pp. 18). Mothers today grew up in a culture that taught them their breasts existed for the evaluation and pleasure of other (Jones, 2004). Self-consciousness with showing their maternal breast contributes to mothers’ choosing not to breastfeed in public.
Other Cultures Views of Breastfeeding in Public
The American obsession with breasts is unique and puzzles many people from other cultures where public breastfeeding is normal and accepted (Wolf, 2008: p. 1). In many cultures women wear their child at the breast to guarantee that feeding can occur easily as needed. “In Saudi Arabia it is not uncommon to see a totally veiled woman baring her breast to feed her infant in public with no one taking notice- except, perhaps a foreigner” (Riordan, 2005: pp. 719). In contrast to this a woman in France would have no hesitation about baring her breast at the beach, but if breastfeeding in public would cover herself if breastfeeding in public (Riordan, 2005).
In the author’s experience in Latin America mothers do not experience shame at breastfeeding in public because all women do it and the men do not furtively sneak glances because they have seen it before. A woman nursing on a bus or while having a conversation in the street is a normal experience of everyday life. Latinas living in the US often feel limited in their ability to breastfeed outside of their homes because of the embarrassment they experience when stared at. In their countries women publicly breastfeed and in the US they feel it is only appropriate in their homes, which isolates them (I.S., Personal Communication, November 2008).
A student traveling in Samoa told a woman that American men like to suck on women’s breasts, the woman replied “Do American men like to pretend they’re babies?” demonstrating the sole purpose for breasts in Samoa (Wolf, 2008: 1). The same interaction occurred between an anthropologist and women living in Mali, Africa, where women do not conceal their breasts in daily life and constantly feed their children. However, with these women the idea of a man being fascinated with breasts was humorous, so much so that the women laughed so hard that they collapsed on the floor (Breast Taboo). Many cultures do not understand the American obsession with breasts because for them breasts’ purpose is to feed babies, not entertain men. It is difficult for both US-born mothers and foreign-born mothers to breastfeed in public because they feel vulnerable to the ridiculing eyes of others. To better understand the experience of publicly breastfeeding mothers it is helpful to examine the overlapping systems that regulate human 4behavior through a theoretical model.
Theoretical Model to Provide Nursing Care For Publicly Breastfeeders
Imogene King’s theory focuses on individuals as personal systems connected to interpersonal systems of two or more people. These are found within boundary systems which regulate behavior, values, and roles as social systems. In order to understand interpersonal systems communication, role stressors and transactions must be considered, while with social systems power, authority, organization and status are crucial components to examine (Erci, 2008; Frey, 2002).
In the context of King’s theory, publicly breastfeeding women are personal systems and to understand them, their perceptions, self, body image, personal space, coping, and growth and development must be examined. The interactions of these women within US social systems influence their personal and interpersonal systems and effect their behavior, attitudes, customs, and values (Frey, 2002). Breastfeeding moms’ personal systems involve their roles as females, mothers, partners, sisters, friends, and daughters. Body image is important due to its central role in US culture. American society regulates roles, behaviors, values and roles and serves to define the normal boundaries for mother in the US. The perceptions that publicly breastfeeding mothers experience as a result of their surroundings in turn influence their behavior (Erci, 2008). The American obsession with breasts is problematic for mothers who desire to breastfeed in public because the experience leaves them with negative perceptions of the experience.
Interactions within and across personal and social systems influence American mothers’ public breastfeeding behavior. According to King’s theory the goal of nursing is for individuals to interact with their environment in the ideal manner with which to achieve a state of health and includes performing their societal roles (Erci, 2008; Frey, 2002). Public breastfeeding would be a goal directed behavior promoted by nurses with the goal of improving health outcomes and interactions within personal and social systems (Frey, 2002).
The goal of nurse-patient interactions would be to educate the mother about her breastfeeding rights, the importance of breastfeeding in maternal and infant health and to encourage public and private breastfeeding that would move toward the goal of 6 months minimum breastfeeding, while promoting the normalization of non-sexualized breasts in the social system. It is nurses’ duty to work toward ongoing changes in breastfeeding practice and education to attain the goals of maternal and child health that will increase their current resilience and empower them to combat vulnerabilities.
Nursing Implications for Public Breastfeeders
Reducing Vulnerabilities
Breasts are a normal part of the female body. They come in all shapes, sizes and colors, but media images make women insecure about various aspects of their breasts. A large part of helping mothers become comfortable with breastfeeding in public in changing the way they view their own breasts. Girls in the US grow up believing that their breasts need to look like the ones they see on television and in the movies. Referring women and girls to websites, such as 007 Breast where hundreds of normal women have posted photos of their breasts can increase self esteem and show them that their breasts are normal and nothing to be ashamed of (Breast Obsession, n.d.).
Nurses must begin to educate young girls about the development of their breasts, that all breasts are different and not one type is better than others. By further explaining the biological purpose of the breast at an early age the de-sexualization of breasts can begin with future generations. There is no age at which it is too early to begin teaching because children begin learning about gender roles at a very young age.
Children must also learn about milk. Not that they should drink it, but the many places it can come from, and what animals drink what kind of milk. Currently children support the formula feeding culture when they pretend to feel their dolls bottles. By educating children nurses can begin to erode the American breast obsession, helping make future generation of both men and women more accepting of maternal breasts in public, which would diminish the embarrassment many mothers are afraid of experiencing. Embarrassment is an important factor in reducing a mother’s concern about breastfeeding in public. Breasts are present in media everyday, but mothers can feel embarrassed if they expose their breast in public (Lawrence & Lawrence, 1999).
Blogs and online support groups are places where mothers can communicate about their public breastfeeding experiences and be supported by others like them. This builds community and resilience by connecting women at risk for social isolation. The internet has become a tool to disseminate information and experiences that show women they are not alone.
In response to these need more discreet feeding many businesses make clothing that makes public breastfeeding easier, through the use of tank tops made with straps that clip off, shirts with hidden nursing openings, and baby slings to carry infants who require frequent feedings (C. Mount, Personal Communication, November 2008). The invention of the nursing bra made it easier for mothers to discreetly feed their children, while the breast pump made it possible for them to express milk while away from their child (Riordan, 2005).
Enhancing Resilience
The importance of breastfeeding is well documented and organizations exist that are dedicated to supporting a mother’s right to breastfeed in public. Since the 1950s La Leche League has been educating mothers about the importance of breastfeeding and forming local chapters across the US to provide support through mother-child groups and literature (DeJager Ward, 2002). The American Pediatrics Association recommends breastfeeding exclusively for the first six months and partially breastfeeding for at least a year. The US’ Healthy People 2010 goals have included ones for breastfeeding, with the hope that the 75% of mothers who initiate breastfeeding will still be breastfeed at the six month mark, with 25% continuing until at least one year (Chang & Spatz, 2006).
The nurse must strive to help the new mother connect to resources like La Leche League where she can find support and acceptance and connect with women who breastfeed in public. Being a new mother is a stressful experience and through the support of her nurse and other mothers she can be solid in the knowledge that by breastfeeding in public she is supported by both the medical profession and women like her. In addition to medical professionals a mother need support from her peer group. Mother-baby groups have become popular and many new mothers find them to be a life line when a difficult situation arises (C. Mount, Personal Communication, July 2008). By initially breastfeeding with other mothers a new mother can gain the confidence she may need to breastfeed in public on her own. Without a support network it is difficult for a mother to sustain breastfeeding if she encounters discrimination.
It is imperative that prior to childbirth pregnant women are educated about their right to breastfeed in public. They must know what their rights are in their state. This information needs to be available in pamphlets on all postpartum hospitals floors and all mothers should receive a wallet-sized card that clearly outlines their breastfeeding rights and contains phone numbers to contact for support if she experiences discrimination.
Educating women about federal and state breastfeeding laws can help begin to create an environment that supports them as mothers seeking the best for their children and shows them that the law is on their side. For many women being asked to leave the establishment or be more discreet while breastfeeding in public is a valid fear. It has happened to many with some filing discrimination lawsuits or banding together to stage “nurse-ins” at businesses such as Applebees, Starbucks and McDonalds (Breast Taboo, n.d.; Cook Lauer, 2007). “By educating families about the laws in their state and helping them to understand their rights, nurses can help mothers feel more empowered and reduce their feelings of nervousness and vulnerability about breastfeeding in public” (Chang & Spatz, 2006: pp. 227).
The problem with the current negative attitude toward breastfeeding in public is that it is the foremost contributor to continued formula feeding and low breastfeeding rates, despite health promotion that “breast is best.” Breasts exist in private and social systems at the same time, which in recent American history has maximized public breastfeeding mothers’ vulnerability through media images that portray breasts as purely sexual objects. To reduce this vulnerability that directed affects the health of both mother and infant, the nurse must first educate the mother about the American culture’s breast obsession that is the root of her public discomfort, that her breasts create the ideal food for her child, and direct her to peer and professional resources that will support her. By joining a system that champion’s breastfeeding she will know her rights and grow in her conviction that her child deserves the best food possible regardless of where feeding takes place, and in doing so will increase her resilience and act in a manner that brings about her and her child’s ideal health state.
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