The Dance of Nurture Negotiating Infant Feeding, 1st Edition
Visit the link below to download the full version of this book:
https://medipdf.com/product/the-dance-of-nurture-negotiating-infant-feeding-1st-
edition/
Click Download Now
Contents
Acknowledgementsvii
Introduction1
Part I. Challenges
Chapter 1. Recovering Nurture 9
Chapter 2. Studying Nurture 23
Part II. Contexts
Chapter 3. Tracing the Human Story 45
Chapter 4. Entering the Commensal Circle 73
Copyright © 2017. Berghahn Books, Incorporated. All rights reserved.
Part III. Diversities
Chapter 5. Customizing Nurture in Southeast Asia 109
Chapter 6. Modernizing Nurture: A Global Shift 137
Part IV. Interventions
Chapter 7. Mastering Nurture: Trying to Get Nurture Right 159
Chapter 8. Negotiating Nurture: Yesterday’s Lessons, Tomorrow’s Hope 193
References223
Index245
Esterik, Penny Van, and Richard A. O'Connor. The Dance of Nurture : Negotiating Infant Feeding, Berghahn Books, Incorporated,
Copyright © 2017. Berghahn Books, Incorporated. All rights reserved.
Esterik, Penny Van, and Richard A. O'Connor. The Dance of Nurture : Negotiating Infant Feeding, Berghahn Books, Incorporated,
Acknowledgments
What began as a book about breastfeeding became a book about anthropology
and the human condition. It was inspired by the work of all the networks and
blogs hosted by people who have a scientific and empathetic commitment to
breastfeeding and the nurture of the next generation. It would be impossible
to list all the people and experiences that informed our work since so many of
them live online. We are particularly grateful to the series editors of the Food,
Nutrition and Culture series at Berghahn, Rachel Black and Leslie Carlin, who
championed the project as a subject of interest to the broader community in food
studies. Thanks to the anonymous reviewers who saw flaws and strengths in the
manuscript in time to let us improve the book.
Penny: Nurturing practices can be scarce in academia; friends and colleagues
nudged us to finish this work and provided generous assistance at those moments
when it felt like the task was overwhelming, in particular I thank Cecilia
Tomori, Alison Linnecar, Julie Smith, Dian Borek, and Naomi Duguid. The
Copyright © 2017. Berghahn Books, Incorporated. All rights reserved.
ideas expressed in this book were born from decades of experience watching
and, whenever possible, helping the ongoing work of WABA (World Alliance for
Breastfeeding Action) and IBFAN (International Baby Food Action Network).
The hardworking individuals in these global networks who wear multiple hats
play extraordinarily diverse roles in making it possible to nurture the next
generation. I thank them for tolerating an anthropologist in their midst. My
work has been inspired by the life and accomplishments of Dr. Michael Latham,
International Nutrition, Cornell University, who taught me the importance of
integrating research and advocacy.
Richard: Some books take on lives of their own. This one did. Exciting as a
newborn and demanding as a child, its adolescence was—well we survived that,
barely—and now it goes out into the world trailing debts deeper than words. For
your heartfelt support and kindnesses, thank you first and always to Carolyn, and
Esterik, Penny Van, and Richard A. O'Connor. The Dance of Nurture : Negotiating Infant Feeding, Berghahn Books, Incorporated,
viii Acknowledgments
to my kids and their spouses—John and Kellie, Daniel and Kathy, Amorn and
Harrison. And to the kids of my kids—Liam, Stella, Lewis, and Maeve—thank
you for enlivening my life and keeping me alive to why this book matters. I am
grateful to Sewanee for its institutional support, colleagues like Dan Backlund,
and fine students who believe in their teacher and his projects. And thank you
Penny and John for the many visits that birthed this book.
To John Van Esterik and Carolyn O’Connor who have nurtured us for so long
in so many ways, our heartfelt thanks.
Copyright © 2017. Berghahn Books, Incorporated. All rights reserved.
Esterik, Penny Van, and Richard A. O'Connor. The Dance of Nurture : Negotiating Infant Feeding, Berghahn Books, Incorporated,
Introduction
VVV
Broken Links
I began advocating for breastfeeding a couple of years after the birth of
my daughter, Chandra, and later, began writing about breastfeeding for
advocacy groups and academic audiences. Elsewhere (Van Esterik 1989:
20–27) I explained how my breastfeeding experiences influenced my
interpretation of the infant-feeding controversy, and shaped my personal
biases. Chandra’s hospital birth was uncomplicated but unpleasant. My
dominant memories are of being too cold to hold my newborn, and being
ravenously hungry, but left unfed for many hours. I was not breastfed,
but given lactic acid milk mixed with corn syrup. My mother was unable
to help me with breastfeeding. In fact, she was more enthusiastic about
the new convenient ready-to-feed infant formula samples we received,
standard marketing practices in the 1970s. She thought I was breast-
feeding to save money. As a foreign graduate student studying in the
Copyright © 2017. Berghahn Books, Incorporated. All rights reserved.
United States, I had minimal health insurance covering only one day in
the hospital after my daughter’s birth. The nurses were no help with
breastfeeding, flicking Chandra’s cheek to try and make her latch on, and
I left the hospital before Chandra was breastfeeding properly. But I had
an unusually supportive pediatrician who assumed I would have no prob-
lems with breastfeeding, and practical help from the wife of a fellow
graduate student who was a La Leche League leader. When I complained
that I had no milk on the third day, she took Chandra and breastfed her
while her experienced six-month-old baby latched on to my engorged
breasts forcefully and showed me how it was done. My friend helped me
deal with engorgement, let down problems, and Chandra’s tongue-tied
latch. Looking back, I see that the support I needed to succeed with
breastfeeding happened by chance, and the story could easily have gone
the other way (which would have made my mother happy). Breastfeeding
Esterik, Penny Van, and Richard A. O'Connor. The Dance of Nurture : Negotiating Infant Feeding, Berghahn Books, Incorporated,
2 Introduction
Chandra taught me to nurture; my mother nurtured me but never breastfed
me; there was very clearly a broken link between the generations, and
I had no embodied experience of being breastfed. As all mothers do, I
adapted to the contingencies of my life as a graduate student by using
personal and social resources to fill the gap left by the broken link. Only
in retrospect can I see the commonalities between my experiences and
those of other women. For example, reading Annette Beasley’s (1996: 53)
book reminded me of similar difficulties I had with Chandra favoring one
side, and clicking her tongue with every swallow. (PVE)
The story of this broken link drew my attention to the importance of viewing
breastfeeding, infant feeding, and nurture as links across generations. Forty
years of advocacy work around breastfeeding provided endless numbers of stories
about the complexity of breastfeeding and breastfeeding activism, some of which
are included here. I wanted to use my past experiences in breastfeeding advocacy
work to raise the arguments explored in this book. And I looked to anthropology
for help.
Breastfeeding experience and advocacy work were not sufficient to develop
the argument in this book, although it prepared me for addressing infant-feeding
activism from the perspective of both NGOs and bilateral bureaucracies. It was
clear to me that anthropology informed some of the best research in the field of
infant feeding, but less clear why breastfeeding questions were also at the heart
of anthropology. That is where Richard comes in to the story.
I admire Penny’s activism. That is not easy in anthropology. Although the
discipline has a long tradition of intellectual activism, we eagerly want to
change what people think. We shy away from changing how they live. That
temerity rightly honors cultural relativism. Yet what is a civic-minded scholar
Copyright © 2017. Berghahn Books, Incorporated. All rights reserved.
to do when a culture’s everyday doings crush its enduring values? That happens
sometimes with breastfeeding and always with anorexia. That got us involved
as anthropologists. We figured knowing how culture works would equip us
to see and challenge how today’s culture works against itself. We know other
professionals battle these same problems. We wish them well. We do, however,
worry when a profession’s Cartesian logic creates the problems it sets out to
solve. That, in a nutshell, is why eating disorders frustrate treatment and why
breastfeeding is regularly misunderstood and wrongly politicized. Getting out
of these traps is not easy. So we ask your indulgence as readers. Hang in there
with all the theoretical and methodological moves. We have to go back to
basics to do better. We hope the rethinking repays your efforts. (ROC).
Since Richard had already worked out arguments concerning why anorexia
was an important case for anthropology, our collaboration was an opportunity
Esterik, Penny Van, and Richard A. O'Connor. The Dance of Nurture : Negotiating Infant Feeding, Berghahn Books, Incorporated,
Introduction 3
to add another case study. We already knew that we attended to the same things
in anthropology long before we began formal collaboration on From Virtue to
Vice (2015) and The Dance of Nurture. Fieldwork in Thailand was foundational
for us both. Although we carried out different ethnographic projects over the
years, we both used Thailand to educate ourselves about other times and places.
Consequently, we are both influenced by Thai concepts of nurture, an approach
widespread in Southeast Asia. This is a shared narrative voice; when we speak
separately, it is in notes followed by our initials.
Why use eating disorders and breastfeeding as instances of nurture or the
failure of nurture? Both processes are activities that function as wholes and
that interact with a person’s unique constitution and with cultural scripts that
organize modern life. Both subjects require holistic thinking, not reductionist
binary oppositional thinking. Dividing mind from body, reason from emotion,
public from private, and individual from society makes both eating disorders
and breastfeeding incomprehensible. Both topics are difficult to study ethno-
graphically. Both have uneasy relations with feminist explanations, and require
what we call a relaxed feminist analysis. The path to breastfeeding and eating
disorders are both long causal chains reflecting complex motivations entangling
both reason and emotion.
Breastfeeding support is one of the most financially efficient interventions for
reducing infant morbidity and mortality, but no interventions can force a mother
to breastfeed against her will, as the Nazis and Italian fascists discovered. Such
coercive interventions are rare and go against the logic and moral imperative
to nurture others. In spite of decades of efforts to promote breastfeeding, few
women follow the World Health Organization (WHO) recommendations for
exclusive breastfeeding for six months, a key part of the Global Infant and Young
Child Feeding Strategy.
The stories of anorexics detailed in From Virtue to Vice introduce us to North
Copyright © 2017. Berghahn Books, Incorporated. All rights reserved.
American women who are driven to succeed in many arenas of life; their self-
regulatory rules to never give up, and to try harder even if it hurts, may sound
familiar to breastfeeding mothers in Western societies. Mommy blogs introduce
Euro-American mothers who write of struggling to breastfeed, and how they
persevered in the face of pain and persistent problems. These progressive modern
women who treat breastfeeding as an extreme sport have few counterparts in
other parts of the world where nurture is still a dance, not a fight.
Why focus on nurture as an object of anthropological investigation? Because
it is important both theoretically and practically; it is part of both the little and
the large—global food security and grumbling stomachs. This book offers an
explanation for why nurture is so basic to the human condition. Everyone takes
it for granted that we must deal with the vulnerability of newborns, but we have
underestimated the foundational importance of that nurturing work. Its impact
stretches forward and backward, linking the generations.
Esterik, Penny Van, and Richard A. O'Connor. The Dance of Nurture : Negotiating Infant Feeding, Berghahn Books, Incorporated,
4 Introduction
An online publication in Nature (2011) identified the top ten questions that
are both foundational and transformative (and difficult) for social scientists to
tackle. Of course, nurture was nowhere to be seen. But the argument of our book
resonated with the top ten questions about how to persuade people to adopt
healthier behaviors, how to improve society’s ability to get the important things
approximately right, and how and why the social becomes biological. Nurture
addresses these questions. The profound interdependence and need for social
relatedness necessary to pass nurturing practices across the generations resides
in this social universal: mother–infant interaction. An anthropological exami-
nation of nurture opens up possibilities for new research questions about our
primate heritage, biocultural models in anthropology, and the limits of human
adaptability.
Our reviewers pointed out that we were not clear about the potential audi-
ences for this book; they were right. We want every reader to be as interested in
infant feeding and nurture as we are. In fact, we should be more specific. We
hope anthropologists, particularly medical anthropologists, will see breastfeed-
ing and infant feeding as a lens for understanding the human condition, and that
biological and cultural anthropologists will find that nurture as a biocultural
hybrid could be a basis for working together on human commonalities. We hope
that the New Ethnology will provide some guidance as to how to work across
differences. But we are very conscious of the fact that this book, and particularly
Chapter 3, is the result of two cultural anthropologists wading into the world of
biological anthropology selectively, trying to understand the vast research emerg-
ing on lactation and breastfeeding. Ours is not the reading of insiders. But if we
are to extend a hand across the subdivision divide, we must be able to understand
how others make sense of less familiar fields and risk the misunderstandings that
may result, or the integration we all seek will never happen.
Breastfeeding activists and those who work supporting new mothers in their
Copyright © 2017. Berghahn Books, Incorporated. All rights reserved.
infant-feeding practices will meet themselves on most pages. We hope they can
tolerate the anthropological framing throughout. Health care professionals,
particularly those working in public health and maternal and child health, may
share some of our concerns about the complexities of applying global health
policy in local contexts. We hope the subject of infant feeding will also be of
interest to development workers who struggle with many of the same issues.
Most of all, we hope readers will find a way to apply some of the ideas about
nurture in their own lives.
We both love to dance—to celebrate, exercise, and relieve stress. We never
noticed when or how it waltzed in to the book and became a guiding metaphor
for nurture.
Esterik, Penny Van, and Richard A. O'Connor. The Dance of Nurture : Negotiating Infant Feeding, Berghahn Books, Incorporated,
Introduction 5
Plan of the Book
Anthropology is well placed to answer the broadest of questions about the
human condition—in this case, nurture. In Part I, we document the challenges
to breastfeeding and nurture (Chapter 1), and to studying both processes real-
istically (Chapter 2). Part II explores two important contexts for understanding
nurture, first how breastfeeding is embedded in biocultural contexts (Chapter 3),
and then how infant feeding is embedded in systems of food sharing and com-
mensality (Chapter 4). Part III then examines the incredible diversity of nurture
by showing how infant feeding is embedded in regional systems, specifically
Southeast Asia (Chapter 5), and positioned in relation to modernity (Chapter 6).
Finally, Part IV shows how infant feeding is handled by modern bureaucracies
(Chapter 7) and negotiated by mothers and groups struggling to nurture the next
generation (Chapter 8).
Copyright © 2017. Berghahn Books, Incorporated. All rights reserved.
Esterik, Penny Van, and Richard A. O'Connor. The Dance of Nurture : Negotiating Infant Feeding, Berghahn Books, Incorporated,
Copyright © 2017. Berghahn Books, Incorporated. All rights reserved.
Esterik, Penny Van, and Richard A. O'Connor. The Dance of Nurture : Negotiating Infant Feeding, Berghahn Books, Incorporated,
VVV
PART
I
Challenges
The first chapter opens with the crisis orientation that draws attention
away from the importance of nurture and care in the development of
our species and all humans. Anthropology has an important role to play
in developing a biocultural model of nurture. We use the metaphor of
dance to avoid the dualistic thinking that has polarized and impover
ished the way breastfeeding is thought and talked about in popular,
feminist, and biomedical discourses. Chapter 2 develops the model we
use to shift the logic from distorting binaries to a unitary biocultural
perspective, and explains how we define and use key concepts like
culture, life cycle, and constitution used in the book. We end with a
proposal for the development of the New Ethnology.
Copyright © 2017. Berghahn Books, Incorporated. All rights reserved.
Esterik, Penny Van, and Richard A. O'Connor. The Dance of Nurture : Negotiating Infant Feeding, Berghahn Books, Incorporated,
Copyright © 2017. Berghahn Books, Incorporated. All rights reserved.
Esterik, Penny Van, and Richard A. O'Connor. The Dance of Nurture : Negotiating Infant Feeding, Berghahn Books, Incorporated,
CHAPTER 1
Recovering Nurture
VVV
The world is not doing well—poverty, disease, violence, pollution, terrorism,
hunger, and global warming producing floods, droughts, and typhoons, while
experts quarrel and leaders dither about how to solve these problems. We seem to
lurch from crisis to crisis, many of them interconnected, such as war and famine,
ecological disasters and refugee flows, financial collapse and poverty. Many
authors document the big picture that ties world politics and economics together,
finding the large patterns that identify a tipping point for world-changing crises,
and the collapse of civilizations (cf. Diamond 2005; Klein 2007; Graeber 2011).
Potential political, ecological, and economic catastrophes in our globalized world
are unpredictable, suggesting that extremes of turbulence threaten the limits
of adaptability, as societies become more complex and more rigid (cf. Homer-
Dixon 2006). From a global perspective, changes in complex systems can be
rapid and dramatic, leading to environmental degradation and climate change or
the collapse of financial systems. Human societies, disoriented following massive
collective shocks of war, terrorism, and natural disasters, are vulnerable to abrupt
Copyright © 2017. Berghahn Books, Incorporated. All rights reserved.
system failures, as well as to the global conspiracies that are complicit in free-
market economies that thrive on disaster.
Women are nowhere to be seen in these explorations of why past civiliza
tions failed, but technology is front and center. Much as we try, these problems
cannot be solved by technical ingenuity—a new vaccine, better fertilizers, or
so-called humanized cow’s milk, for example. Nor are they necessarily problems
of modernity: “Disease, pollution and disasters multiply with a potency that
cannot be consigned to the misguided epistemology of modernity” (Bessire and
Bond 2014: 446). The Western world developed technologies that allowed them
to dominate the modern world (Diamond 1997), but these technologies have
done little to solve interconnected synergistic global problems, and have often
made the situation worse, particularly in the context of corporate globalization.
Often the authors who write of the future of the world, look to corpora
tions and technology to solve modern problems, rather than looking to them
Esterik, Penny Van, and Richard A. O'Connor. The Dance of Nurture : Negotiating Infant Feeding, Berghahn Books, Incorporated,
