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The Moral Dilemmas of Nighttime Breastfeeding: Crafting Kinship, Personhood and Capitalism in the U.S

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The Moral Dilemmas of Nighttime Breastfeeding: Crafting Kinship, Personhood and Capitalism in the U.S The Moral Dilemmas of Nighttime Breastfeeding: Crafting Kinship, Personhood and Capitalism in the U.S. by Cecilia Tomori A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy (Anthropology) in The University of Michigan 2011 Doctoral Committee: Professor Gillian Feeley-Harnik, Co-Chair Professor Thomas E. Fricke, Co-Chair Professor Raymond G. De Vries Professor Marcia C. Inhorn Professor Elisha P. Renne DEDICATION I dedicate this dissertation to my husband, Kerry Boeye, who supported me in breastfeeding our children and in the many years of research and writing that led to this work, and to our children, Jakob and Adrian. ii ACKNOWLEDGEMENTS This dissertation emerged out of many years of interest and study of the embodied experiences of reproduction. My interest in breastfeeding was first peaked while working as a health services researcher at Northwestern University. During my research at an obstetrics/gynecology clinic staffed primarily by residents, I observed women express their breastmilk using electric pumps during their lunch breaks. I later sat through meetings with some of my colleagues there, which took place during these pumping sessions. I was intrigued by the women’s dedication, the equipment involved and the lactation process itself. I did not yet know that I would soon be joining these women’s ranks when I became pregnant with my first son, Jakob, in 2000. As a college-educated woman who worked in the health care setting and who had attended the recommended hospital-based childbirth education courses, I was surprised to find how little I actually knew about childbirth or breastfeeding. In fact, without support and encouragement from my husband, Kerry Boeye, I would have stopped breastfeeding within just days after my son’s routine, biomedicalized birth. Without my husband’s active participation and unfailing support throughout the years of breastfeeding our two children, neither breastfeeding, nor this dissertation could have been part of our experience. Although I knew that childbirth and breastfeeding were topics that interested me both as a mother and as a scholar, it took several years of four-field anthropological training to design and carry out my own ethnographic study of breastfeeding. At the University of Michigan’s Department of Anthropology, my wide-ranging interests were nurtured by Gillian Feeley-Harnik, Tom Fricke, Marcia Inhorn, Elisha Renne, Raymond De Vries, Judy Irvine, and A. Roberto Frisancho as well as by many other faculty members. I owe many thanks to Tom Fricke for seeing my interests as anthropological, despite never having taken anthropology during my undergraduate studies, and offering iii me a pre-doctoral fellowship at the Center for the Ethnography of Everyday Life. I was immediately attracted to learning about the craft of anthropology through the readings and discussions that took place in our very first seminar together. My research project on kinship, personhood and breastfeeding was conceived in Gillian Feeley-Harnik’s seminar later that year, which she co-taught with Thomas Trautmann. I have been aspiring to keep the many exciting dimensions of anthropology to which Gillian has exposed me in that seminar as well as in subsequent coursework and our discussions ever since then. The project began to take shape during my teaching Childbirth and Culture with Elisha Renne, who encouraged me to pursue my research on breastfeeding further. Finally, the lenses of kinship and personhood united fully with the anthropology of reproduction in Marcia Inhorn’s seminar on Intersectionality and Women’s Health. I am grateful to Marcia for introducing me to the anthropology of reproduction, for helping me shape the project that I later carried out, and for her continued enthusiasm and support for my work. After taking time off to give birth to and care for my second son, Adrian, I was fortunate to begin preparations for doing fieldwork. Through a fortuitous meeting set up through Lisa Kane Low, Raymond De Vries joined the committee during this time and added unique interdisciplinary insights from the diverse perspectives of medical sociology and bioethics. In addition to faculty, I am deeply indebted to Laurie Marx, who provided pivotal support throughout my years in the program. I thank The Alfred P. Sloan Center for the Ethnography of Everyday Life, the Population Studies Center at the Institute for Social Research, the Rackham Graduate School, the Department of Anthropology, and the Center for the Education of Women at the University of Michigan for providing the funding support for my work that was necessary to prepare for, carry out, and complete this research project. In addition to members of my committee and other faculty, I had many helpful conversations with midwife researchers Joanne Bailey and Lisa Kane Low, as well as with lactation consultants, midwives, childbirth educators, physicians, and doulas, whom I cannot name due to confidentiality reasons. I have learned a great deal from them and appreciate their support. I received some crucial encouragement in the final phases of the dissertation from the members of the planning committee as well as many participants of the Breastfeeding and Feminism Symposium at the University of North Carolina, Chapel iv Hill. Specifically, I would like to thank Miriam Labbok, Paige Hall Smith, Bernice Hausman, and Jacqueline Wolf for their interest in my work. I am grateful to Helen Ball for putting me in touch with her excellent student, Kristin Klingaman, who introduced me to this group. James McKenna’s, Helen Ball’s, and their colleagues’ work have been a source of inspiration throughout this project. Finally, in addition to my husband, I have been supported by a tremendous network of friends and colleagues. I am especially grateful to Britt Halvorson, Jessica Smith Rolston, and Laura Heinemann for reading my work and providing insightful and constructive comments. I cherish their friendship, generosity, and am inspired by their own outstanding work in anthropology. Jessica Robbins, Elana Buch, Vanessa Will, Kelly Kirby and Bridget Guarasci have nurtured this work with their friendship and excitement about my research. Sallie Han’s work as well as support has been a source of ongoing inspiration. I have been very fortunate to be supported in very concrete ways through excellent food and even better company from Fernando Andrade, Anna Shahinyan, Sergio Miguel Huarcaya, Maria Burbano, and their children. Most of all, I am grateful to all of my participants who have welcomed me into their lives and offered to share their breastfeeding experiences and dilemmas with me. I hope that I have stayed true to them in my accounts and that they will enjoy seeing the fruits that our time together has born. v TABLE OF CONTENTS Dedication………………………………………………………………………...ii Acknowledgements ……………………………………………………………...iii List of Appendices……………………….………………………………………vii Abstract …………………………………………………………………………viii Introduction ….………………………………………………………...….1 Chapter 1: Struggles over authoritative knowledge and (consumer) “choice” in breastfeeding and sleep in the U.S.……..………59 Chapter 2: Making breastfeeding parents in childbirth education courses …………………………...……………………………..……93 Chapter 3: Dispatches from the “moral minefield” of breastfeeding ….128 Chapter 4: Breastfeeding as men’s “kin work”………...………………153 Chapter 5: Breastfeeding babies in the nest: producing children, kinship, and moral imagination in the house…………..……………181 Chapter 6: Time to sleep: breastfeeding babies in capitalist regimes of temporality and personhood ……………………………….220 Conclusion ….………………………………………………………….254 Appendices ….…………………………………………………………………266 Bibliography ….………………………………………………………………..286 vi LIST OF APPENDICES Appendix 1. Semi-structured interview guide………………………………………….266 Appendix 2. Sleeping/feeding log………………………………………………………268 Appendix 3. Table of demographic characteristics of the couples involved in the study …………………………………………………………………………….270 Appendix 4. Biographical sketches of core participants ……………………………….271 Appendix 5. Figures of sleep equipment ………………………………………………283 vii ABSTRACT The Moral Dilemmas of Nighttime Breastfeeding: Crafting Kinship, Personhood and Capitalism in the U.S. by Cecilia Tomori Co-Chairs: Gillian Feeley-Harnik and Thomas E. Fricke This dissertation addresses the cultural construction and negotiation of moral dilemmas that arise from the embodied practices of breastfeeding and sleep in the U.S. I argue that the heated debates that surround both breastfeeding and infant sleep arrangements originate from the intertwined social histories of biomedicine and capitalism that have simultaneously led to a valuation of the properties of breastmilk for health and the erosion and stigmatization of breastfeeding’s intercorporeal praxis. I investigate the consequences of these conflicting cultural trends through a two-year ethnographic study of middle class parents committed to breastfeeding. In particular, I focus on the embodied moral dilemmas that stem from cultural concerns about personhood and the intercorporeal aspects of nighttime breastfeeding in parent-child kin relations that are amplified by contradictory medical guidelines for breastfeeding and infant sleep. First, I address the role of childbirth education courses for mediating these biomedical stances by situating them within different moral frames for kinship, personhood, and capitalism that parents consume and negotiate. Next, I explore the gendered embodied
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