In contrast to medical care, which is focused on the individual patient, public health is focused on collective health. This article argues that, in order to better protect the individual, discussions of public health would benefit from incorporating the insights of virtue ethics. There are three reasons to for this. First, the collective focus may cause neglect of the effects of public health policy on the interests and rights of individuals and minorities. Second, whereas the one-on-one encounters in medical care (...) facilitate a compassionate and caring attitude, public health involves a distance between professionals and the public. Therefore, public health professionals must use imagination and care to evaluate the effects of policies on individuals. Third, the relationship between public health professionals and the people who are affected by the policies they design is characterized by power asymmetry, demanding a high level of responsibility from those who wield them. Against this background, it is argued that public health professionals should develop the virtues of responsibility, compassion and humility. The examples provided, i.e. breastfeeding information and vaccination policy, illustrate the importance of these virtues, which needed for normative as well as instrumental reasons, i.e. as a way to restore trust. (shrink)

In the United States, roughly 1 out of 4 births takes place at a hospital certified as Baby-Friendly. This paper offers a multi-disciplinary perspective on the Baby-Friendly Hospital Initiative (BFHI), including empirical, normative, and historical perspectives. Our analysis is novel in that we trace how medical practices of “quality improvement,” which initially appear to have little to do with breastfeeding, may have shaped the BFHI. Ultimately, we demonstrate that a rich understanding of the BFHI can be obtained by tracing how (...) norms of gender/motherhood interact with, and are supplemented by, other normative, historical, and institutional realities. We conclude with suggestions for practical revisions to the BFHI. (shrink)

Drawing on feminist theories of parenting and the welfare state, I analyze experiences of diaper need as a case of how gender, class, and race inequalities shape the social organization of caregiving and limited policy responses. Data from in-depth interviews with 70 mothers who experienced diaper need and 40 diaper bank staff revealed obstacles low-income mothers face in managing lack of access to children’s basic needs and how gendered assumptions of parental responsibility thwart public diaper support efforts. I use this (...) case to theorize gender policy vacuums: These occur when gender disparities and ideologies prevent systematic responses to structural problems. Empirically this study contributes to understandings of diaper need as a problem of the gender structure that cannot be solved with alternative diapering methods that assume middle-class, white, androcentric privileges. Theoretically it illuminates key mechanisms by which feminized care labor is devalued and rendered invisible and how this erasure rationalizes lack of redress for gendered inequalities and creates policy gaps around caregiving. (shrink)

Many ethics instructors turn to peculiar examples and cases to highlight ethical concerns about autonomy and collective goods. While these efforts are respectable, they lamentably reinforce the valorization of independence and the opposition of individuality to collectivity that are too prevalent in ethics today. Attending to the event of pregnancy would help overcome these troubles. By concentrating on pregnancy, we can better appreciate the dependence that is integral to the human experience, the discrete value of each individual, the possible noncompetition (...) between individual and society, and the importance of appreciating the sources of our existence. Religious ethicists would do well to think more about pregnancy, a condition which is sui generis and yet also illustrative of the fundamental interdependence of human beings. (shrink)

Breastfeeding has become a subject of moral concern as its benefits have become well known. Encouraging mothers to breastfeed has been the goal of extensive public health promotion efforts. Emmanuel Levinas makes absolute responsibility to the Other central to his ethics, with giving food to the Other the paradigmatic ethical act. However, Levinas also provides an important critique of the autonomous individual who is taken for granted by breastfeeding promotion efforts. I argue that the ethical obligation to feed the hungry (...) child must be recognized as coextensive with meeting the needs of women, especially given the current absence of important social and economic supports for breastfeeding. Under a Levinasian framework, each of us is ethically responsible for feeding children; this responsibility is not limited to mothers. This ethical responsibility needs to be expressed through improving social and economic supports necessary for those individuals who wish to breastfeed, instead of attempting to convince women to breastfeed. This ethical responsibility must also be understood in a broader context of a politics of hunger, which provides access to quality food for all, and goes beyond mere nutrition to include the importance of culture, touch, and intimacy in the enjoyment of food—what Levinas calls “good soup.”. (shrink)

Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopment advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice.In a letter sent out to 2600 hospitals across the country they [Public Citizen] demand that healthcare facilities “immediately discontinue the distribution of commercial infant formula manufacturer discharge bags,” claiming it undermines women’s success at breastfeeding. What they failed to explain is (...) why a woman’s decision regarding her own tits is anyone’s fucking business but her own.Clearly, policies to promote breast-feeding.. (shrink)

This article is a discussion of the recently emerging critique of pro‐breastfeeding discourses in academic literature, and what this means for midwives and other professionals who find themselves promoting breastfeeding because of professional expectations or indeed workplace policies. Various strands in the debate are explored, starting with dominant and familiar ‘evidence’ and descriptions of breastfeeding and breastmilk that are carried through to international policies that advocate breast over formula feeding. We then consider evidence predominantly from social science literature that has (...) found some women's experiences of infant feeding to be at variance with the dominant pro‐breastfeeding ideology. We argue that midwives and others delivering maternity care are the means to deliver the policy aspirations contained in the World Health Organization (WHO, 2018) Baby Friendly Hospital Initiative document that makes selective positive claims about breastfeeding without adequately considering its potential drawbacks. We conclude that although the benefits of breastfeeding tend to be exaggerated in promotional material, on balance the weight of evidence still favours breast over formula feeding. We challenge the charge that breastfeeding jeopardises women's financial position by arguing that it is not breastfeeding per se that impacts negatively on women's economic prospects, but rather the way in which society is socially organised. (shrink)

References to the ‘natural’ are common in public health messaging about breastfeeding. For example, the WHO writes that ‘Breast milk is the natural first food for babies’ and the U.S. Department of Health and Human Services has a breastfeeding promotion campaign called ‘It’s only natural’, which champions breastfeeding as the natural way to feed a baby. This paper critically examines the use of ‘natural’ language in breastfeeding promotion by public health and medical bodies. A pragmatic concern with selling breastfeeding as (...) ‘natural’ is that this may reinforce the already widespread perspective that natural options are presumptively healthier, safer and better, a view that works at cross-purposes to public health and medicine in other contexts. An additional concern is that given the history of breastfeeding in the USA, ‘natural’ evokes specific and controversial conceptions of gender and motherhood. (shrink)

Environmental chemicals accumulate in all human bodies and have the potential to affect the health of men and women, adults, and children. This article advances “precautionary consumption”—the effort to mediate personal exposure to environmental chemicals through vigilant consumption—as a new empirical site for understanding the intersections between maternal embodiment and contemporary motherhood as a consumer project. Using in-depth interviews, I explore how a group of 25 mothers employ precautionary consumption to mediate their children’s exposure to chemicals found in food, consumer (...) products, and the home. Most of the mothers in the study situate their children’s chemical “burdens” within their own bodies and undertake the labor of precautionary consumption as part of a larger and commodity-based motherhood project. In actively expanding the sphere of responsible motherhood to include managing children’s body burdens, these mothers navigate multiple and overlapping contexts that hold women accountable for children’s futures and value the agency of the proactive consumer. Yet, as the sphere of responsible mothering expands, women without financial resources, time, and family stability are pushed to the margins of normative motherhood. (shrink)

Background: Breastfeeding is currently strongly recommended by midwives and paediatricians, and the recommendations are based on documents provided by the World Health Organization and public health authorities worldwide. Research question: The underlying question is, how are non-breastfeeding mothers affected emotionally when informed that breastfeeding is the safest and healthiest option? Research design: The method used is an anonymous web-based qualitative survey exploring the narratives of non-breastfeeding mothers, published on Thesistools.com. The aim is to achieve qualitative knowledge about the emotions of (...) non-breastfeeding mothers. Participants and research context: Participants were based in Sweden, the United Kingdom and the Netherlands and were selected through a purposeful sample. Ethical considerations: The online survey anonymizes responses automatically, and all respondents had to tick a box agreeing to be quoted anonymously in scientific articles. The study conforms to research ethics guidelines. Findings: Respondents describe how they were affected, and the following themes emerged in studying their descriptions: depression, anxiety and pain, feeling failed as a mother and woman, loss of freedom/feeling trapped, relief and guilt. Discussion: The themes are discussed against the background of the ethics of care and a theory of ethically responsible risk communication. Conclusion: Three conclusions are made. First, the message should become more empathetic. Second, information should be given in an attentive dialogue. Third, information providers should evaluate effects in a more inclusive way. (shrink)

Breastfeeding advocates and global health agencies have been sounding alarms about the dangers of digital marketing practices of the formula-feeding industry. This study comprised a feminist discourse analysis of materials produced (blog, social media posts, comments) in a paid partnership between baby formula brand Enfamil and an influencer, Marilou Bourdon from Trois fois par jour. Our analysis reveals a sophisticated marketing campaign that co-opts feminist critiques of breastfeeding promotion discourse while carefully avoiding explicitly violating the International Code of Marketing of (...) Breast-milk Substitutes. Underlying this campaign is a rhetoric reliant on pathos to assuage maternal guilt and shame for feeding formula. (shrink)

State-sponsored breastfeeding promotion campaigns have become increasingly common in developed countries. In this article, by using the tools of liberal political theory, as well as public health and health promotion ethics, we argue that such campaigns are not justified. They ignore important costs for women, including undermining autonomy, fail to distribute burdens fairly, cannot be justified neutrally and fail a basic efficacy test. Moreover, our argument demonstrates that breastfeeding campaigns are a rare case that bridges the fields of public health (...) ethics and the ethics of health promotion campaigns. This demonstrates the need to consider the ethics of state promotion of both voluntary and coercive behavioural change that benefits third parties. (shrink)