The Commodification of Breast Milk and the Breast Milk Industry By Barbara Ann Vocisano, B.A. Hons Carleton University, 2011 A thesis submitted to the Faculty of Graduate and Postdoctoral Affairs in partial fulfillment of the requirements for the degree of Master of Arts In Legal Studies Carleton University Ottawa, Ontario © 2011, Barbara Ann Vocisano Library and Archives Bibliotheque et Canada Archives Canada Published Heritage Direction du Branch Patrimoine de I'edition 395 Wellington Street 395, rue Wellington Ottawa ON K1A0N4 Ottawa ON K1A 0N4 Canada Canada Your file Votre reference ISBN: 978-0-494-87894-1 Our file Notre reference ISBN: 978-0-494-87894-1 NOTICE: AVIS: The author has granted a non­ L'auteur a accorde une licence non exclusive exclusive license allowing Library and permettant a la Bibliotheque et Archives Archives Canada to reproduce, Canada de reproduire, publier, archiver, publish, archive, preserve, conserve, sauvegarder, conserver, transmettre au public communicate to the public by par telecommunication ou par I'lnternet, preter, telecommunication or on the Internet, distribuer et vendre des theses partout dans le loan, distrbute and sell theses monde, a des fins commerciales ou autres, sur worldwide, for commercial or non­ support microforme, papier, electronique et/ou commercial purposes, in microform, autres formats. paper, electronic and/or any other formats. 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Canada ii ABSTRACT The opinions expressed about breastfeeding and the nutritional values of breast milk have become polarized. This thesis examines the impact current tension and dialogue surrounding the practice of breastfeeding and breast milk in Canada has had on a woman's autonomy and infant nutrition choices. It is posited that although the 'breast is best' slogan is widely known and often referenced when people discuss infant nutrition choices, there is now a newly emerging focus, namely that providing breast milk to babies is the only option. The way in which we discuss infant nutrition choices and the practice of breastfeeding has changed, and there is an increase in the moral regulation of women as a result. From a theoretical point of view, the theory of moral regulation is used as the main theoretical framework to illustrate the impact the 'breast is best' rhetoric has had on infant nutrition choices, and the way in which mothers perceive themselves. iii ACKNOWLEDGMENTS The idea for this project came from hospital staff following the birth of my first child. Without realizing the impact they would have on my thesis topic, the case room nurses began to lecture me the moment I mentioned I would be formula feeding my new born. The criticisms and suggestions they offered inspired me to look deeper into why a stranger would question so vehemently the infant feeding choices of an educated adult woman in her late 30s. I am grateful to my husband who supported me along my journey and encouraged me when I wanted to give up. I owe a special debt of thanks to my parents who looked after my children, drove me to the library, and provided me with support during particularly stressful periods. I am grateful to my professors who have always taken an interest in my work, and my many co-workers at the Graduate Student's Association at Carleton University. Thank you to Professor Hunt for the discussions on moral regulation and help with writing style, as well as for the many articles he noticed in the media and sent to me for my review. There are a number of good friends I also wish to thank that have made my time at Carleton University a special one. I would also like to acknowledge the many friends I have outside of my academic world that have provided me with support and friendship during the past few years. The School's administrative staff, specifically Andrew Squires and Barb Higgins, deserves special mention for all of their time and help. In particular, Leslie in the Research and Ethics Department was especially helpful and supportive during my research; she helped me through the bureaucratic nightmare I experienced with an outside Research and Ethics Board. Leslie went above and beyond the call of student duty so that my research could be more complete. iv TABLE OF CONTENTS Page ABSTRACT ii ACKNOWLEDGEMENTS iii CHAPTER I: THEORY OF MORAL REGULATION AND APPLICABILITY IN BREAST FEEDING DISCOURSE 1 Introduction 1 Section A: Theory of Moral Regulation 3 Section B: Aim of Thesis 10 CHAPTER II: LITERATURE REVIEW 12 Literature 12 A Woman's Experience 16 Commodification of Other Bodily Fluids 17 CHAPTER HI: METHODOLOGY 19 CHAPTER IV: BOOB, BUST AND ECHO 23 Aspects of the Controversy 23 Breast is Best Discussion 24 Formula Powered 25 How Infant Nutrition Culture Changed in Canada 27 Language 27 Public Reaction 29 New Phenomenon 31 CHAPTER V: INFANT NUTRITION CULTURE CHANGED IN CANADA: WHY THE MOOOOOVEMENT? 35 Medical 35 Medical Literature 35 Demedicalization of Child Birth Practices and the Organic Movement... 36 Misinformation 38 Legislation 42 International Law 43 Mass Media 46 Access to Electronic Communication 47 Social Networking Sites 48 CHAPTER VI: IMPACT: OVER THE SHOULDER STAKEHOLDERS 53 V Business: Milking the Rewards 54 Lifestyle Industry 54 Niche Market 54 Fetish Lifestyle 58 Entrepreneur Breast Milk Economy 60 Donor/Trade Economy 70 Cross Nursing 73 Milk Banks 75 CHAPTER VII: CONCLUSION 78 LIST OF ILLUSTRATIONS Illustration 1- Cyclical relationship diagram of Breastfeeding Industry, Moral Regulation and Initiating the Practice of Breastfeeding Illustration 2- Old Navy "onesie" Illustration 3- "She's a Star" campaign poster from Britain Illustration 4- Ad for Evenflo baby bottles c. 1976 Illustration 5- Ad for "My BrestFriend" nursing pillow Illustration 6- Home page for Nestle baby Illustration 7- Home page 'pop up' for Nestle baby Illustration 8- About.com Pregnancy and Childbirth Section Illustration 9- Home page for Compendium of Breast Milk Substitutes LIST OF APPENDICES Appendix A- Questionnaire used in primary research Appendix B- Results of Questionnaire Question Number 5 Appendix C- Results of Questionnaire Appendix D- Results of Question 1 of Questionnaire Appendix E- Results of Question 8 of Questionnaire BIBLIOGRAPHY .82 CHAPTER I: THEORY OF MORAL REGULATION AND APPLICABILITY IN BREAST FEEDING DISCOURSE Since prehistoric times, how babies should be fed has been a constant for our species, which is one of the more than 4,600 varieties of milk- producing creatures collectively known as mammals. Each mammal produces its own unique milk, and thus feeding a baby something other than breast milk will always be a deviation from the biological norm for our species. Indeed, breast milk is the only truly universal food uniting all 6 billion of us, irrespective of geography and culture. J. Akre (Akre, 2000, p.549) You will be able to nurse the baby. Never think of anything else. Nursing the baby yourself is the 'one best way' Dr. Helen MacMurchy (Nathoo & Ostry, 2009, xi) Introduction Opinions from strangers, family members, friends and co-workers about the benefits of breast milk and breastfeeding are widespread in conversations with expectant parents and mothers. Equally clear is that expectations of right and wrong with respect to infant feeding have shifted over time. Opinions that are expressed regarding the breast milk vs. formula debate have become polarized. Furthermore, many in Canada expect women to use breast milk to nurture an infant regardless of circumstance. For example, my research uncovered that in some instances adoptive parents are encouraged to provide their infant with breast milk from an outside source. Adoptive parents who were interviewed felt that they had failed their adopted child nutritionally and emotionally when breast milk and the act of breastfeeding was not made available. One adoptive parent who participated in primary research felt morally regulated to provide breast milk, rather than formula feed. The 'moral element in moral regulation involves any normative judgment that some conduct is intrinsically bad, wrong or immoral (Hunt, 1999, p. 7). In this thesis the normative judgment involves the conduct of bottle feeding. My research further uncovered that in the past it was generally accepted that a breast milk substitute (such as cow's milk based formula, soy formula, high calorie formulas) (Fraser Health Authority, 2002) would suffice for an adopted infant. Rather than "unite all 6 billion of us," (Akre, 2000) the nature and value of breast milk and the practice of breastfeeding are part of a discussion that divides mothers into two camp groups: good mothers and bad mothers; that are, mothers who use breast milk and mothers who do not, respectively. Today, a mother who chooses not to nurse her baby often meets with professional and social disapproval and may be labelled as a bad mother (Kedrowski & Lipscomb, 2008, p. viii). The professional and social disapproval imposed on women who choose to bottle feed indicates that a form of moral regulation exists. Critical to this thesis and within the discussion surrounding breast feeding and use of breast milk lies the theory of moral regulation.