Breastfeeding as intangible cultural heritage

The act of breastfeeding has been a widespread cultural practice from the beginning of mankind. However, the manners and the choice of breastfeeding is culturally specific and it has evolved through time. Breastfeeding must be considered as a cultural phenomenon. It has produced a variety of oral histories and traditional knowledge that has been transmitted from generation to generation. It is an important element of the intangible cultural heritage of Europe and of all mankind.

The food-production industry has undergone massive developments over the last decades. Today parents can obtain nutritious food that is specifically suited to every stage of a child’s development. Breast milk as a life-giving substance for infants is no longer essential in the western society because it can be replaced by artificial formula milk. However, the World Health Organization recommends that women breast-feed their infants for the first six months and if possible for the first two years along with other food.[1] Health scientists today believe that even with the improvements of formula milk it is better for mothers to feed their infants with breast milk. There has been much debate about whether breast-feeding is more of a cultural phenomenon than a natural one.  What makes the cultural definition complicated is the overlap that breast-feeding has with public health, and the ideas that people have about breast-feeding being more natural than feeding the infant with artificial formula milk products. It is still widely believed that the human being is a mammal and the breasts of women are made for the production of milk for their infants. It may appear obvious to classify breast-feeding as a natural phenomenon, but, as other natural phenomenon that concern human kind, it should be reminded here that culture is what defines what is natural. What is defined as natural in one culture may not at all be considered natural in another culture. Culture has a formative influence on breast-feeding as well as other basic human practices concerning birth, death, food procurement, and sanitation.

Breast-feeding is a personal and often intimate act. It connects the mother to her infant. Real life stories from mothers reflect that understanding. [2] Breast-feeding narratives contain advice for women to use for themselves or to convey to others. They serve to provide support to the mother, to build their self-confidence, and to cope with the complications that can come up during breast-feeding.[3] These personal narratives can also be used to discourage mothers to breast-feed their children. Irish women have described that they feel shame if they are seen breast-feeding in public. There are numerous examples of a feeling of rejection by breast-feeding mothers in other countries and cultures. Since the use of formula milk has been introduced in the Western world in the second part of the 20^th century, it is common for young women to have never seen a child being breast fed, so they do not have role models and in this regard the transmission of the practice is impeded. [4] Although breast-feeding is a very personal act that can vary between individuals, groups, or communities as a whole, it does have common traits that are passed on to other groups and to future generations that become part of a shared cultural heritage. Fathers also participate in this cultural heritage, because they have a possibility of voicing their opinion on the act and how they experience it. Midwifes and other professionals that service the mother during and after birth can be very influential in how breast feeding a child is performed.

Osama Shukir Muhammed Amin Old-Babylonian fired clay plaque of a standing nude woman nursing (breastfeeding) her infantIt is these shared personal experiences that shape, change and remake breast-feeding as intangible cultural heritage. Academic influences can be formative on the act of breast-feeding. The American scholar Orit Avishai has researched the topic in the perspective of the social and cultural influences on breast-feeding women. He believes that breast-feeding should be regarded as a cultural phenomenon but not a natural one because, according to him, it always has a connection with culture, history, and politics.[5] Every community from all times has to deal with socially accepted norms and issues of morals with regard to breast-feeding. These social norms dictate when and where women are allowed to breast feed. He points out that breast-feeding is a culturally sensitive issue because the women’s breasts play a dual role, as a source of nourishment for the child but also as a sexual organ. To study breast-feeding as intangible cultural heritage offers the possibility of considering it from a historical, social and cultural perspective rather than simply from the point of view of nutrition.

The history of breast feeding

Breast-feeding can be documented as far back as 200 B.C..[6] As early as the 2^nd century, the Greek scholar Soranus published a paper on gynecology containing precise and strict guidelines for women who were breast-feeding. They should eat healthy foods, be free of stress, abstain from sex and not physically exert themselves. Beginning in the 16^th century there are numerous sources that give insight on the beliefs and the practices of breast-feeding in most parts of Europe. In the year 1513 a first book was published in Germany by Eucharius Rösslin dealing with childbirth and breast-feeding. Translated into many different languages, the book states that breast milk can easily go bad and can be unhealthy for the infant. In keeping with his Greek predecessor, the author cautions women to be have a healthy lifestyle and to avoid sex during pregnancy. Sex was considered to make the mother’s milk go bad. It remains difficult to precisely evaluate the impact of these teachings because during this early modern period there are no statistics available on the evolution and the geographical distribution of the occurrence of breast-feeding in Europe.[7] Throughout history breast milk has been considered as an extremely delicate substance which could go bad easily. Mothers were cautioned not to breast-feed if they had to do manual labor or if they had mental health problems. In such cases, they were advised to get a wet nurse to conduct the feeding. If there were no other possibilities, it was considered better to use cow´s or goat’s milk to feed the child.[8] The European scholars of the 18^th century, such as Van Helmont and Brouzet even stated that breast milk was not necessarily the best for infants and in a civilized and progressive society one should distance oneself from nature. One way to do that was to find something better than milk to sustain the coming generations of infants.[9] Breast-feeding was also connected to social status.[10] In the 18^th century it was not uncommon that wealthier families would get wet nurses to conduct breast-feeding for fear that the natural mother’s milk might not be good for the child. Around the middle of the 19^th century this perception changed and the noblewomen began breast feeding their children themselves.[11]

Paul Nandar and his nurse 1856.The Icelandic manuscripts contain information regarding breast-feeding. For example, in the Icelandic law book Grágás from the 13^th century, women were expected to breast-feed their children for at least two years, during which time they were exempted from fasting.[12] At that time, Icelandic scholars and priests perpetuated the same ideas about breast-feeding as in Europe. Women were advised not to have sex while breast-feeding as well as to avoid hard physical work and stress. During the latter part of the 18^th century and the beginning of the 19^th century, the idea that breast milk is bad for infants is preached religiously. Doctor Jón Pétursson gives the advice to mothers that they should not give breast milk to infants if they are not well fed. Björn Halldórsson, in his publication, Atla, of 1778, states that psychological deficiencies of mothers can affect the breast milk. Iceland actually maintained the idea that breast milk could be bad for infants much longer than other countries. The result of these ideas is that Iceland had a much higher rate of infant mortality than other European countries until the end of the 19^th century. It´s not until around 1870 that Icelandic women start giving their children breast milk again. [13]

The number of breast-fed infants has remained low in Iceland throughout the 20^th century. In 1985, only 67% of Icelandic women breast-fed their children at the age of 3 months. Although the number is up to 83% in 1990, and 86,1% in 2008[14], it remains lower than those of Canada situated at 89,4% in 2012. However, it is higher than the rates in the UK (80%) and Ireland (only 55,4%). [15] It is clear that the practice can vary greatly from one country to the other even though the populations of these countries share a common western cultural heritage.

Opportunities to look at breast feeding in a cultural context

Feminist scholars have researched breast-feeding to investigate the social and political implications of the practice, to see to what extent it has contributed or hindered women’s rights. There are different opinions on this subject matter. [16] In recent years, it is more often stated that breast feeding empowers women and that they should be free to decide how long they want to breast-feed, that it should not be only a question of following social norms. Their work has contributed in many ways to considering breast-feeding as a community practice transmitted from generation to generation and therefore as a form of intangible cultural heritage.

Þórunn Kjartansdóttir

[1] World Health Organization, Counselling women to improve breastfeeding practice, 2018.

[2] In the book Gjafabók, Reynslusögur íslenskra kvenna af brjóstagjöf, Aðalheiður Atladóttir, Dagný Ósk Ásgeirsdóttir and Soffía Bæringsdóttir (eds.), 2010.

[3] Hildur Sigurðardóttir, “Sjálfsöryggi og brjóstagjöf: prófun mælitækja”, Rannsóknir í Félagsvísindum XI, 2010 p. 106.

[4] Virginia Thorley, Is breastfeeding ´Normal‘? Using the right language for brastfeeding, Midwifery, 2019, p. 41.

[5] Orit Avishai, “Managing the Lactating Body: The Breastfedding Project and Privileged Motherhood”, Qualitative Sociology, 2007 p. 138,

[6] Oligicia Milankov. “Breastfeeding Through the Centuries”, Medicinski pregled, 2018, p. 51.

[7] Helgi Þorláksson, “Óvelkomin börn”, Saga, 1986, p. 84.

[8] Helgi Þorláksson, “Óvelkomin börn”, Saga, 1986, p. 115.

[9] Ian G. Wickes, “A history of infant feeding”, Archives of Disease in Childhood, 1953. p. 334

[10] Helgi Þorláksson, Helgi. “Óvelkomin börn”, Saga, 1986, p. 104

[11] Ian G. Wickes, “A history of infant feeding”, Archives of Disease in Childhood, 1953. p. 337.

[12] Gunner Karlsson, Mörður Árnason, and Kristján Sveinsson, Grágás : Lagasafn íslenska þjóðveldisins, 1992, p. 33.

[13] Garðarsdóttir, Ólöf, “Brjóstagjöf og áhrif hennar á lífslíkur ungbarna á Íslandi 1910-1925”, Ljósmæðrablaðið, 2005, p. 100-101.

[14] Directorate of Health in Iceland, Infants exclusively breastfed 2004-2008, 2011.

[15] Virginia Thorley, “Is breastfeeding ´Normal‘? Using the right language for brastfeeding”, Midwifery, 2019, p. 42.

[16] Jacqueline Wolf, “What Feminists Can Do for Breastfeeding and What Breastfeeding Can Do for Feminists”, Signs Journal of Women in Culture and Society, 2006, p. 398.

Bibliography

Atladóttir, Aðalheiður, Dagný Ósk Ásgeirsdóttir and Soffía Bæringsdóttir. Gjafabók: Reynslusögur íslenskra kvenna af brjóstagjöf. Reykjavík: Iða, 2010.

Avishai, Orit. „Managing the Lactating Body: The Breastfedding Project and Privileged Motherhood.“ Qualitative Sociology 30 (2007): 135-152.

Directorate of Health in Iceland. Infants wxclusively breastfed 2004-2008. 2011. <https://www.landlaeknir.is/tolfraedi-og-rannsoknir/tolfraedi/heilsa-og-lidan/naering/>.

Garðarsdóttir, Ólöf. „Brjóstagjöf og áhrif hennar á lífslíkur ungbarna á Íslandi 1910-1925.“ Ljósmæðrablaðið 83 (2005): 19-27.

Karlsson, Gunnar, Mörður Árnason and Kristján Sveinsson. Grágás: Lagasafn íslenska þjóðveldisins. Reykjavík: Mál og menning, 1992.

Milankov, Olgicia. „Breastfeeding Through the Centuries.“ Medicinski pregled 71.5-6 (2018): 151-156. <http://doi.org/10.2298/MPNS1806151M>.

Sigurðardóttir, Hildur. „Sjálfsöryggi og brjóstagjöf : prófun mælitæki.“ Rannsóknir í Félagsvísindum XI 11 (2010): 106-114. <http://hdl.handle.net/1946/6764>.

Thorley, Virginia. „Is breastfeeding ‘normal´? Using the right language for breastfeeding.“ Midwifery 69 (2019): 39-44. <https://doi.org/10.1016/j.2018.10015>.

WHO, World Health Organization. Counselling of women to improve breastfeeding practices. 2018.

Wickes, Ian G. „A history of infant feeding. Archives of Disease in Childhood.“ 1953. MBJ Journal. 22. mars 2019.

Wolf, Jacqueline. „What Feminist Can Do for Breastfeeding and What Breastfeeding Can Do for Feminists.“ Journal of Womwn in Culture and Society 31.2 (2006): 397-424. Signs Journal of Women in Culture and Society 31(2):397-42.

Þorláksson, Helgi. „Óvelkomin börn.“ Saga 24 (1986): 79-120.

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