The Bottle, the Breast and the State: Oakley review

Maureen MinchinBook Reviews, Bottle Feeding, breastmilk, Child Health, Commentary, epigenetics, General News, Infant Formula, Infant Health, Lactation, Lactivism, Maternal Health, Microbiome, Milk Hypothesis, Milk Matters, Reviews by MM

 The Bottle the Breast and the State. The politics of infant feeding in the United States. 

By Maureen Rand Oakley. (Lexington Books 2015)

I like this book, which should be  read by those in mother support, breastfeeding advocacy and feminist academia with the time to do so. I  support Oakley’s approach, as I welcome any book which urges feminists to work for change in a broad-ranging coalition on infant feeding.

What this piece of my writing is, and isn’t. 

This is only partly a review of the book. It is also a commentary on some of the issues the book raises or discusses. Quotation marks and italics indicate excerpts. It will be obvious when I am expressing my own views on topics; I do so at some length because I suspect the book will not be as widely read as it deserves to be. Another review from a different perspective can be found at https://onlinelibrary.wiley.com/doi/full/10.1111/jftr.12180

What does the book cover?

The back cover blurb reads as follows. The book “explores the ways in which breastfeeding is both promoted and made difficult in the United States. It also examines how the use of formula is often shamed and yet encouraged by many standard medical and government practices. Using both qualitative and quantitative methods it explores the politics policies and individual experiences surrounding infant feeding. Oakley shows that a failure to separate the issue of breastfeeding rights and support from problematic approaches to breastfeeding advocacy, in both academic scholarship and public discourse, has led to a deadlock that prevents groups from working together in support of breastfeeding without shaming drawing on a feminist ethic of care, Oakley develops a caring infant feeding advocacy. This approach values the caring work done by parents and recognises the benefits of this work for society. It promotes policy supportive of parenting in general and breastfeeding in particular, in order to remove barriers that present a challenge to women who wish to breastfeed. Caring infant advocacy also works to promote the development of better alternatives for those who do not breastfeed.”

 So what’s in the book?  it does “explore some of the ways that US culture and policy promote and undermine breastfeeding and how feminist mothers and activists respond to this paradox.”Oakley’s “approach to supporting breastfeeding promotes both governmental and non-governmental policies that invest in early childhood as a public good regardless of infant feeding choice. Expanding options to offering paid maternal or parental leave, making banks milk more available, providing funding for medical research on primary lactation failure follow-up, and improving infant formula, are all needed to provide the best context for infant feeding. This would not only make breastfeeding a realistic possibility for the many women who desire to do it, but find it difficult for a variety of reasons, but would provide greater societal support to parenting in the early years regardless of feeding choices or parental work situation.”

The summary outline

The author summarises the book early on. Chapter 1 is a sketchy outline of US infant feeding history;  chapter 2 explores the debate within [largely US, not global] feminism about breastfeeding advocacy; chapter 3 explores women’s experiences with breastfeeding; chapter 4 provides an overview of state breastfeeding laws, policies and programs, and analyses their effect on rates; chapter 5 explores the advocacy of breastfeeding as a public health issue by the  American Academy of Pediatrics (AAP) and the US Department of Health and Human Services (HHS) via their policy statements, including the trend towards the use of risk language over benefits; chapter 6 looks at the activities of grassroots activists for breastfeeding and formula feeding and suggest ways to “build a more sustainable movement focused both on breastfeeding as a civil right, and a caring activity that needs to be valued and broadly supported by social policy”. 

Content Chapter by chapter

The chapters are as outlined above. In the first brief historical outline, the author rightly includes her own history as a formula fed child of a mother actively discouraged from breastfeeding – because she would not cope with a two year old as well as  breastfeeding a baby! (Even though that mother had successfully fed Oakley’s sibling for three months.)  Elsewhere Oakley discloses that she breastfed her own child, and her lactation consultant advised formula at one stage when her milk was insufficient. I was very pleased that she did all this, as I believe such disclosure is essential to understanding and allowing for the author’s context and potential conflicts of interest. Vested interests are not all financial, and our opinions are shaped by what we experience, and what our mothers tell us. As I make clear in all my work, my survival of horrendous breastfeeding problems was largely thanks to the fact that my mother had been poor in Australia and so breastfed in the 1940s, together with my discovery of Dr Mavis Gunther’s work. (The first in my family to attend university, I am a classic example of postwar social mobility thanks to societal change and scholarships won – I believe thanks to exclusive breastfeeding for almost 9 months.)

Chapter 1 outlines the medicalisation of birth and childrearing, but places them in the broader societal context. A number of medical advances greatly improved health, lowering infant mortality rates during the entire 20th century. Oakley mentions antibiotics and vaccinations – sewerage systems and water supplies are even more important! – and rightly says that “with these changes taking place any declines in health due to a reduction in breastfeeding rates may have been masked by the positive trends from these other advances.” (An obvious fact that formula fantasists ignore, citing the time coincidence between declining child mortality and rising formula use as proof of the safety of formula feeding.) Parents and health professionals alike saw formulas as among the scientific advances, especially as women looked to a life beyond the home. Oakley points out that the relationship between working and breastfeeding has shifted over time, place, and class. The role of the childbirth movement of the 60s and 70s, and the global infant feeding controversy including the WHO Code, all increased media attention to infant feeding issues. Federal government actions and legislation related to breastfeeding are briefly mentioned along with the formation of the US Breastfeeding Committee in 1998. But much is necessarily omitted from this US-based sketch.

Chapter 2 is an extremely useful overview of feminist perspectives on infant feeding. It is however largely confined to North American authors, though Marilyn Waring and Judith Galtry make it into the bibliography. Elizabeth Helsing, Gro Nylander and other Scandinavian feminists, NCT and UK authors such as Mary Renfrew, Heather Welford and Sarah Wickham, were overlooked.  Even my ground-breaking book Breastfeeding Matters : what we need to know about infant feeding is not referenced, although it created major change, as the Royal College of Midwives acknowledged in the first edition of their 1989 booklet, Successful Breastfeeding (given to every UK midwife). This is a shame, as many women within the mother support organisations were no less feminist than those in academia, and clearly saw no need for division on the subject of breastfeeding advocacy. La Leche League is discussed, but non-US breastfeeding organisations are not mentioned. There is a useful outline of some court cases and legislation in relation to breastfeeding discrimination and the rights of women. As she points out, “embodied men and women both deserve to move freely in public space and combine work and parenthood without attempting to change or deny part of their biology” and  “Feminists have disagreed about the extent they should get involved in promoting policies to support breastfeeding because of their association with breastfeeding advocacy which are sometimes taken a naturalistic view of women. This has led to a tendency in the academic literature to critique traditional breastfeeding advocacy and to call for an improved social context for breastfeeding without really advancing any mechanism by which to do this.”  She goes on in subsequent chapters to argue for an alliance to “ transform the public space and workspace into a welcoming place for all women regardless of how they feed their infants.”  Indeed.

In Chapter 3 women talk about all manner of topics: their decisions on feeding, breastfeeding in public, their experiences with healthcare providers, views on advocacy and feminism, attitudes towards other women’s feeding practices: all of which will be very familiar to those working with mothers anywhere. There is an interesting discussion about the use of risk language and breastfeeding advocacy. Permeating that conversation at every point is the complete confidence of breastfeeding mothers in the adequacy and safety of infant formula in America. (This is later discussed at length in chapter 5, which again strongly reflects American culture) The practical challenges to breastfeeding cited were also very familiar. In some cases father’s desire to help with feeding was less than helpful, creating additional work for the recovering mother, or even potentially sabotaging breastfeeding by giving a bottle of formula instead of waking the mother, so that she set an alarm to breastfeed or pump. Perhaps all too typically, one mother, who found her husband’s ability to help with bottlefeeding was an advantage, commented that, “I think he liked it, but not in the middle of the night.”  Help when you need or want it isn’t the same as “help” someone else wants to give, when and for as long as it suits them to give it….

Chapters 4-6 “explore some of the current efforts that do exist to try to affect breastfeeding rates and infant policy in the United States.”  This covers  the reality of influences on US state legislation relating to breastfeeding, the different approaches to breastfeeding advocacy, and maternal activism for both breast and bottle feeding.

Chapter 5 covers medical and public health approaches to breastfeeding advocacy. There is a cogent and sustained discussion of the risk versus benefits approaches in breastfeeding advocacy which I think should be read by everyone involved, as I can’t cover it fully here.  As Oakley points out, American Academy of Pediatrics statements assert that the breastfed infant is the normative standard, but then talk of the decreased risks associated with breastfeeding, rather than the risks associated with its absence, and with the presence of formula feeding (those two are not the same.) She is right to say that “this language [of benefit] feels the most natural to those researching and writing about the topic because it reflects the actual experience in the United States, where the actual norm in practice is to see an infant with a bottle, not an infant at the breast.” “Insisting on a norm one would like to see, even if it seems most biologically appropriate, does not create a norm; people breastfeeding for substantial length of time creates a norm, since human beings are cultural and social creatures, not just biological ones. We may be mammals, but we are mammals who invented and have been using bottles and formula with great frequency for quite some time.… Using the formula fed infant as the baseline just feels appropriate.” And  “almost every woman I interviewed reacted negatively to the risks of formula language… They felt it would make women feel guilty, and that this might make them angry to the point where they might reject the advice altogether”…

Oakley hits the nail on the head when she says, “Most of the women interviewed could not even understand why one would use the term risky to describe the use of infant formula in a developed country.”  And that lack of understanding really is the problem. Thanks to a combination of regulatory failures, industry marketing, and societal pressures (all discussed in my book, Milk Matters: infant feeding and immune disorder) infant formula is seen as totally safe and completely satisfactory, even, it would seem, by Oakley herself. Anti-formula-industry activists have long swallowed and regurgitated the clever industry line that the problem is not the products in themselves, and their unavoidable biological effects, but poverty and sanitation, lack of clean water supplies, maternal ignorance, and so on.

Even were that the case, poverty is everywhere, not least in the United States. Many communities even in highly developed WEIRD nations still lack power and clean water, and it takes massive US government investment in providing free infant formula to prevent catastrophic child morbidity and mortality rates. Yet when toxic water scandals erupt, whether in Flint Michigan or Minnesota, few raise concerns about, and almost no research follows the outcomes for, exposed formula fed infants drinking a litre or more a day. (Instead, tabloids focus on the risk to the breastfed child, who will consume less water, and only after it has been filtered by an adult female body.)

Fortunately, so long as they are fed, most children survive and grow. Given that only 22% of US children were ever breastfed by 1972, the clear evidence for even outdated formulas’ non-lethality is the survival of the US population, grown on evaporated milk in large part, and defective formulas now outmoded, which would be strongly condemned were they to be revived.

But survival is not proof of the absence of harm from formula feeding. America’s massive 20th century health problems support the belief that formula feeding makes for unhealthy survival across all demographics. In the 1960s my friends and I were amazed by obese middle class Americans’ dependence on allergists and pyschologists. A generation or two later, Australians are replicating that obesity and dependence, and middle class Asia is beginning to, as artificial feeding increases there. What is more, and this is where Oakley needs to read more widely, scientific measurement is now showing that every child not breastfed will be affected to a lesser or greater degree by their nutrition, and rarely if ever will the formula-fed be advantaged by comparison with the breastfed.

Nutrition is the single biggest postnatal factor affecting normal human development and health. In the critical neonatal period, nutrition programmes development for life, affecting gene expression and physiological development across all parameters. That there are measurable differences in brain and reproductive tissue and genetic material in infancy is frightening to anyone thinking about longterm consequences. Risk is real, and universal. (As any reader of Milk Matterswill appreciate)

So, as I have been saying for decades, and Oakley says in this book, it is the wider public that needs education. And not about breastfeeding alone. Where there is an absence of breastmilk, there is (usually) the presence of formula. Both absence and presence have negative consequences. The society-wide myth of formula safety and equivalence to breastmilk needs to change. Using risk language can be unacceptable or counter-productive in certain clinical situations, but society-wide it is precisely what is needed. It is needed both to motivate and sustain the practice of breastfeeding, and to reduce needless supplementation with infant formula. (Different campaigns!) I agree with the author that there is a need for better formula, but the sheer impossibility of coming within a mile of breastmilk is not widely appreciated. A living tissue cannot be replaced by a dehydrated powder. AS an aside, it strikes me as astonishing how few of the many people concerned about the impact of processed foods never see infant formula for what it is, probably the most highly processed of all processed foods in general use. (For most formulas, ingredients have been created or processed before they come together to be combined and processed into infant formula.)

Yes, as the author says, people breastfeeding for substantial lengths of time will create a new norm. But that may never happen if American complacency about infant formula continues. And that complacency leads to unnecessary risk and harm for infants being formula-fed, as well as propping up a culture in which mothers cannot make informed infant feeding choices, or carry them through once made. As a senior FDA official said to me in 1984, “we have to reassure parents that formula is safe because American society depends on bottle feeding.”  Deconstructing such a society and recreating one where the 80% of women now choosing to breastfeed will not have to stop after a few weeks or months will require concerted and united effort. To date this has been hampered rather than helped by the US brand of feminism, with its strong focus on women but not their infants – as though any mother can be happy when her baby is not. And it must involve informing parents of real risks, not to children they do not identify with in some distant place, but risks and harm to themselves and their children.

It may be that America is not ready for innovative advertising campaigns that graphically emphasise risk, though it is certain that industry lobbying should not be permitted to determine that (as it famously did with the NBAC campaign).

It is true that talking about risk with parents can be confronting and difficult, and can even be inappropriate in certain circumstances.

It is however true that all scientific publications need to frame what they say appropriately, when it is the intervention that increases risk and the physiological norm is what that risk is calculated from. Media reporting needs to reflect that truth as well, however unpopular that may be. To talk of a 50% reduction in the risk of SIDS has much less impact than saying “being formula fed doubles the baby’s risk of SIDS”. The statistics are the same, the impact is very different. Health professionals are negligent if they do not communicate what may be involved for the child, when parents are considering infant feeding. Awareness of the intergenerational impacts on health conditions makes such education ever more important – there is ample evidence that current epidemics of inflammatory disease are directly linked to the harms of past artificial feeding. My book collating that evidence has received no negative criticism, even from industry personnel given copies for that purpose.

Health professionals are readily silenced by emotion-laden talk of them bullying women, when they are doing their job of promoting healthy behaviours. Their managers need to understand that the identical hospital encouragement to breastfeed is readily interpreted in two very different ways, depending not on what was said, or how it was said, but the outcome of breastfeeding success or failure. When women have the right support and succeed, they say “the midwives were great, they really stressed how important it was and helped me persevere through the hard bits.” When women do not succeed, for lack of skills or support, they say, “The midwives pressured me to breastfeed and they shouldn’t have, my mother wasn’t able to, and I knew I couldn’t.” What was suggested was the same. But it is the negative voices that will be heard.

Chapter 6is entitled Breasts, bottles and maternal activism. It documents “the various ways that activism on the part of mothers has brought attention to the issue of breastfeeding rights.” As Oakley says,  “Since society depends on mothers and all parents in the work they do raising children, that it is reasonable to expect policy to go beyond simply allowing women to breastfeed in public (a negative right), but to provide positive support for this endeavour.”  Rights need to be balanced with the responsibility of society to support the work of nurture, via for example acceptance of “public breastfeeding and state laws to protect the practice”.But as she concludes. “..while engaged citizenship can help change the culture to a degree, it does not address the substantive issues that can serve as constraints to breastfeeding, such as needing to return to work and not having access to one’s children or pumping facilities at work.” Thus she argues for the need to build wide-ranging coalitions to produce change in policies such as family leave, public breastfeeding laws, and workplace pumping.

However, the issue of family leave skates lightly over what I see as the emerging “us-too” problem of fathers’ feelings about breastfeeding. So many discussions of infant feeding seem to subordinate the mother and baby’s biological needs to the desire of the non-birthing parents for feel-good ‘bonding’ experiences. Parents need to understand that:

  1. both parents can bond emotionally with a baby using their different bodies in different ways
  2. babies are not dolls for grownups to play with: infant care should be responsive and respectful
  3. ingesting calories is not the only important aspect of feeding
  4. the female who has birthed has greater need for care than the other parent, whose role it is to care for her
  5. pumping creates extra work and affects milk supply
  6. partners do not have rights over the birth mother’s body or her milk – but it is arguable that the baby does!

The reality of maternal breastfeeding is made more complex and difficult by the need to pump milk, whether due to employment pressures, or partners’ desire to feed their babies: a marketing ploy from artificial feeding interests. Breastfeeding is for the baby (and the recovering female), not the baby for breastfeeding. The decision about whether, when, and how often to pump is the mother’s prerogative, as it is her body that must cope with the consequences. Getting the mother’s milk supply synchronised with the baby’s needs takes time, and is not helped by pressure from another adult to consider them before the baby.

The process of lactation is societally so valuable that it is worth considering whether breastfeeding women should be paid, with their future employment rights and superannuation protected for those who might then choose to be at home with their infant for some or all of the first two years after birth. Parental leave can facilitate breastfeeding, but it is clear from Norway’s experience that extending such rights to fathers in the baby’s first year will curtail breastfeeding duration. A cost-benefit analysis is needed before other countries follow suit. The breastfeeding dyad’s best interests should always take priority, and no mother should have to sacrifice her baby’s health to the need to keep food on the table and a roof over her head.

The Conclusion argues that  “breastfeeding is still not receiving adequate governmental, societal, and medical support in the United States, given the very strong statements on breastfeeding from the AAP and the HHS. In arguing for more feminist engagement with the issue of infant feeding, I am not asking feminists to engage uncritically in breastfeeding advocacy but for their voices to further inform current efforts to support women who do breastfeed”…without shaming women who  cannot or choose not to breastfeed.  Oakley sees the need for better support for all women feeding infants, however they are fed, and talks of the need for “better formulas or increased  access to milk banks.”  So Oakley wants “a broad coalition of interests working not only for improved social conditions for breastfeeding, but also for increased medical specialisation in human lactation and improved options when maternal breastfeeding is not possible.” As do I.*

 My conclusions and some thoughts about omissions

But then, Oakley’s approach is exactly what truly informed breastfeeding advocates have been promoting for decades.  Those who work at the grassroots with families are well aware of the fact that almost all mothers use formula at some stage of the baby’s first year, understand why that occurs, and do not condemn women doing thing differently, making different choices or being forced to, in the light of their own circumstances. If Oakley had read  Food for Thought (1982) or Breastfeeding Matters (1985) she would have seen that some of those aware of the risks of infant formula were also aware that increasing breastfeeding rates demands major structural change to enable breastfeeding, as well as to better regulate and police current infant formula feeding content and marketing. It was not a coincidence that “while many recognised that supportive workplace and public policies could help women breastfeed if they decide to do so, I found that only those few with connections to LLL and Attachment Parenting International spoke in terms of the need for fundamental changes in the structure of US society that would value caregiving in a substantial way.”  Virtually all breastfeeding mothers’ groups that I am aware of around the world have such a perpective, though they are often misrepresented.

The Mummy Wars?

Nor was it surprising to me, that in her interviews with breastfeeding women, Oakley found no evidence of “the mummy wars” so-called. If she had looked into this at depth, she may well have found that the mummy wars were little more than a clever, award-winning, global marketing strategy of US companies defending their declining WEIRD market share, paying for shills and gaining media space for formula feeding mothers protesting against alleged nastiness that was never common, and certainly not among informed breastfeeding advocates. (This protest helps to silence any talk of the risks and harms of formula feeding, for fear of giving offence.) Formula apologists often fail to realise that ALL mothers, breast or bottle feeding, are subject to public criticism and interference. For every formula feeding mother who feels someone gave her a nasty look or word, there are breastfeeding mothers told to feed in toilets or to leave premises or cover up their breast, so offensive when feeding a baby, even beneath advertising signs displaying far more skin.

Choice? What choice?

Women in communities where formula use is normal naturally defend formula feeding as a valid choice. And no sane breastfeeding advocate would want to impose breastfeeding as a duty- apart from the ethical issues, it is unlikely to work well where a mother resents feeling obliged! Yet talk of ‘choice’ is absurd in most situations. As Oakley clearly sees, pragmatic forces drive decision-making.  Breastfeeding fails or is insufficient for many reasons, few of them physiological, many of them to do with incompetent health professional practice. Maternal breastfeeding is not the best option in a few cases – fewer than Oakley thinks however, as only three of her (New York 2010) list of eight contraindications are still supported by the World Health Organisation (WHO). Women do need to use formula for many reasons, most of them outside their control. It doesn’t help of course, that massive century-long marketing campaigns have persuaded everyone, including the healthcare professionals caring for women, and even many breastfeeding advocates, that  the current “modern” formulas  are nutritionally equivalent, even superior to some women’s milk. For “some women”, read the average mother on the average western diet, and certainly those who are poor and unclean or ill. Class-ism and racism have been  common, and any examination of 20th century formula marketing materials would show how they have been used to promote the ersatz product and highlight how pathetic has been societal awareness of these obnoxious tactics. The formula industry was able to co-opt the heath care systems of WEIRD nations as marketing tools thanks to such lack of awareness.

Industry and politics

So I believe that this book about US politics affecting infant feeding does not adequately address the role of the infant formula and dairy industries. Industry said succinctly decades ago that promoting breastfeeding is the best way to sell more formula, because it is the initial breastfeeder who will formula feed for the whole of the first year or longer. (The aim is now up to four years of age judging by available products!) And every can of first formula says something like the old Wyeth slogan, “for use when breastfeeding fails or is insufficient.” When, not “if ever”, or “in the rare event that”….

For the formula industry, the most profitable option is short term breastfeeding followed by long term formula feeding. This is because some initial breastfeeding allows some gut development that might make the difference between tolerance of formula, and intractable problems and formula-swapping. And also, importantly, because both an early start at the breast (for the later formula fed) or early exposure to formula (for the later breastfed) reduces obvious outcome differences in research studies.

Who pays what?

There is some, but just not enough, in this book about the vast continuing protection, promotion, and support of infant formula by US government agencies. Half the infant formula used in the United States is in fact paid for by taxpayers and given to the the disadvantaged women of every colour whose babies most need breastfeeding for optimal development.  The product itself has benefited from governmental subsidies and protection at every level. Even when found guilty of misleading marketing, and fined millions of dollars by a court, a US company was allowed to pay much of that fine in product – promptly shipped at taxpayer expense to the emerging Eastern European market. The United States Department of Agriculture (USDA) has been and probably still is the world’s largest purchaser and supplier of the product. In 1980 it paid for 1/4 of the total world production of infant formula, then only $2 billion globally, but now over $56 billion. The current system of rebates for formula provided by the Women Infants and Children or WIC, program of food support for needy families, is certainly an improvement on paying full retail value to the companies – as was the case before competitive tendering (a process initially boycotted by some US companies; the entry of Nestlé into the US market with their purchase of Carnation in 1987, and Wyeth’s desire to increase their market share, ended that cosy arrangement.)  However WIC now depends on that tendering rebate system for its work, creating an inherent conflict of interest – as breastfeeding rates rise, funds to support breastfeeding women will decrease. The US government will need to pay more: will it, in the current climate?

As well, the serious lobbying interventions and influence of formula companies in Washington, both in congress and in agencies like the USDA and FDA, was something I expected to see detailed at length in a book about US politics and infant feeding. Industry has been pivotal in all discussions about infant formula regulations, and have created a situation in which the FDA does not approve any formula, merely asks for notification of its existence 90 days before it is marketed, and requests post-market surveillance reports: none of which existed when an independent agency requested them. Industry personnel have rotated in and out of federal agencies at critical times in regulatory processes. US companies have used the threat of complaint to the World Trade Authority to pressure national governments to make regulations broad enough to allow all US brands market entry. They typically trial new additives outside the litigious USA. Industry was able to stop the only campaign devised to make consumers aware that there were risks to formula feeding. At a time when a US company was pressuring another country (by refusing needed supplies) to accept a USD loan to set up a manufacturing plant for phenylalanine-free formula, a US president took cans of the product as a gift in support of that pressure. Formula companies have had friends in high places!

In a book about US infant feeding politics, these facts  deserve inclusion. The role of US governmental agencies in the 20th century has been in fact to urge breastfeeding as women’s job, while protecting, promoting and supporting formula feeding with billions of dollars of taxpayer funds. If WIC no longer provided free formula to poor families, the result would be the same malnutrition, morbidity and mortality that come where national governments cannot afford to subsidise formula. The harms of formula would be immediately apparent. (Harms would have been obvious from the 1960s had not government subsidies made it economic for companies to provide families with liquid ready to feed or concentrate, rather than powdered, product.) WIC personnel are now working hard to reverse the effects of decades of formula support, and it is in that demographic that breastfeeding rates are rising. But in the context of little maternity leave, low incomes, punitive welfare policies and practices, it will be initiation rates that rise, and so will early weaning to formula: as stated above, industry’s preferred option. As Oakley points out, societal change is needed. As I said in 1982, a societal revolution is required.

ENVOI

Despite these criticisms, I welcome this book, which is urging feminists – some seemingly blind to the urgency of the problem – to work for change in a broad-ranging coalition. Which I hope to see including demographers and economists, food policy experts, social equity interests, conservationists, animal welfare groups, and many others concerned about the future of the planet. For all that they care about is in some way adversely affected by the absurd experiment of using a dehydrated processed powder in place of a crucial  living tissue, or “white blood”,  as one culture rightly called women’s milk.  And it is Women’s Milk, just as the bovine product is rightly called Cows’ Milk.  Calling it that might emphasize the need to support its primary producers.

Maureen Minchin April 2019

 

* The 1990s coalition I helped create (with Greg Thompson of World Vision) was called ACOIF, the Australian Coalition for Optimal Infant Feeding, precisely because we wished to improve all feeding options. ACOIF was later wound up after organisational politics, personal vendettas, and vested interests made consensus impossible.