What Is Natural Is Best: A Qualitative Exploration of Women’s Engagement in Attachment Parenting

Attachment Parenting is a form of “intensive parenting” and involves a set of caretaking practices that are perceived by proponents of Attachment Parenting to nurture a strong maternal–child bond. Based on semi-structured interviews with 15 women who self-identified as Attachment Parents and observations of La Leche League meetings, this study investigates the ways in which parenting behaviors are understood and rationalized in relation to the philosophies of Attachment Parenting and the wider parenting culture. Study findings illustrate how the women in this study account for their parenting practices through both an appropriation and rejection of Attachment Parenting expertise and engagement in a discursive appeal to “what is natural is best.” Given a wider sociocultural environment characterized by multiple forms of expertise and risk, the ways in which Attachment Parenting serves as an interpretive frame and moral road map for the women in this study are discussed.

Geodemographies of Breastfeeding Support

Background Mother-to-mother breastfeeding support organizations provide important information and guidance for helping mothers initiate and maintain breastfeeding, postpartum. However, the availability of this support is limited by a constellation of barriers, including race, culture, socioeconomic status, and geography. Research aims To identify the geodemographic composition of communities where breastfeeding support was available from the mother-to-mother support organizations Breastfeeding USA and La Leche League, identify underlying issues of equity, and highlight locations where more support resources may be needed. Methods The locations of mother-to-mother support meetings were collected by ZIP code ( N = 180) and were combined with a geodemographic database and exploratory spatial data analysis to explore the compositional characteristics of communities served ( N = 1,173). Results Significant gaps in the geographic distribution of breastfeeding support existed. While many metropolitan areas benefited from numerous mother-to-mother support groups and peer counselors, the geographic footprint of this support favored communities that were white, affluent, and suburban. Conclusion Spatial analytics combined with geodemographic analysis provide a unique perspective into the diverse landscape of mother-to-mother breastfeeding support groups at a local level. Our results highlighted inequities in the distribution of support provided and prescriptive guidance regarding where more resources may be needed.

Being There: The Development of the International Code of Marketing of Breast-milk Substitutes, the Innocenti Declaration and the Baby-Friendly Hospital Initiative

Margaret Isabirye Kyenkya (photo) grew up in Uganda with five bothers and six sisters. Her Bachelor of Arts was in Social Work and Social Administration (Makerere University, Uganda), and was followed by a Masters in Sociology, (Nairobi University), and a Certificate in Mother and Child Health (International Child Health Institute, London). Her PhD focused on Hospital Administration inspired by the WHO/UNICEF Baby Friendly Hospital Initiative. She has worked as a researcher, the founder of Non-Governmental Organizations, a Senior United Nations Officer (New York Headquarters and several regions), a Manager in the United States Agency for International Development-funded National Health and Nutrition Projects, and a governmental Health and Nutrition Adviser. A certified trainer in a number of health and nutrition areas, a breastfeeding counselor, and a retired La Leche League Leader, Dr. Kyenkya has significantly influenced the course of lactation support and promotion globally. She stated, “My most precious and valued occupation is that of a mother [of five] and grandmother [of eight].” Dr. Kyenkya currently lives in Atlanta, Georgia, in the United States. (This interview was conducted in-person and transcribed verbatim. It has been edited for ease of readability. MK refers to Margaret Kyenkya; KM refers to Kathleen Marinelli.)

Jan Riordan: An Oral History

While conducting my dissertation research on the professionalization of breastfeeding support, I identified key “founders” of lactation consulting. I focused on the people involved in the formation of the International Board Certified Lactation Consultant, as certified by the International Board of Lactation Consultant Examiners and represented by the International Lactation Consultant Association. Jan Riordan was at the top of my list. As the editor and co-author of the first text on breastfeeding and human lactation for non-physicians, Dr. Riordan shaped the professional body of knowledge for International Board Certified Lactation Consultants and others providing clinical breastfeeding support. She was a La Leche League leader and founding member of the Kansas La Leche League International Chapter, served on the first International Board of Lactation Consultant Examiners Board of Directors, and served on the first editorial review board of the Journal of Human Lactation. She was a professor of nursing at Wichita State University for 23 years. I met her at an International Lactation Consultant Association conference in San Antonio, Texas in 2010, just after she had retired from Wichita State, and I interviewed her by phone on August 10, 2010. This is from a taped interview. (AE = Aimee Eden’s initials; JR = Jan Riordan’s initials). The University of South Florida IRB approved the full study.

Back to Bed

Chapter 1, “Back to Bed: From Hospital to Home Obstetrics in the City of Chicago” analyzes the home obstetrics training practiced at the Chicago Maternity Center alongside the emergence of what would become an international breastfeeding organization, La Leche League. One focused on the inner-city’s working-class population, while the other catered more to the suburban white middle-class. Both the Chicago Maternity Center and the La Leche League relied on the promotion of home birth, but for very different reasons. Under the CMC, home birth provided essential training for obstetrical students, while under the LLL, it enabled mothers to breastfeed and bond with their babies. The different rationales underscored the extent to which race, class, and context shaped ideas about home birth. Taken together, these two examples reveal the complex origins of what would become a contested yet increasingly popular practice by the 1970s.

Middle-Class Midwifery

Chapter 2, “Middle-Class Midwifery: Transforming Birth Practices in Suburban Washington, D.C.,” investigates the individuals and organizations that began to promote home birth in the 1970s. Many of the D.C.-area women attribute their “calling” to midwifery at least in part to their experiences as mothers, La Leche League leaders, and childbirth educators. When they opted to take the further step of becoming midwives, they enabled the transition of home birth as a practice primarily supervised by doctors to one facilitated by midwives. Aware of the significance of this shift, these women carefully positioned themselves as responsible, educated, middle-class midwives, representing the least threatening version of the midwife to organized medicine. With the establishment of the area’s first nurse-midwifery program at Georgetown University in 1974, many trained and worked with established doctors and hospitals.

Breastfeeding Videos as a New Training Tool for Malaysian Breastfeeding Peer Counsellor Program in Empowering Breastfeeding Communities

The Malaysian Breastfeeding Peer Counsellors (MBFPC) is the pioneer of non-governmental organization (NGO) of trained breastfeeding peer counsellors in Malaysia initiated in 2010. The training was done in a systematic way using a developed syllabus that was adapted from and endorsed by the La Leche League International (LLLI) to suit our local population. Training materials used throughout the program were presentation slides, demonstration tools, mantas and role-plays. Materials and methods: In 2015, MBFPC partnered with Global Health Media Project (GHMP) to incorporate breastfeeding videos as training tool to further enhance the delivery of current breastfeeding peer counsellor trainings to the participants, emphasizing on helping breastfeeding mothers. The new training tool was evaluated in 38 participants, who underwent 21 hours of training. Participants were required to do pre and post-assessments to complete the MBFPC Modules, view 8 videos and do practical sessions within a 2 month period post training. Participants’ field experience survey and focus group discussions were conducted among the participants and the trainers to look at the practicality of the videos in our training. Results: All participants felt that the videos made the training more effective and helped change their understanding and approach. The trainers agreed that the videos had covered all key topics need to be delivered in the training modules and helped them to deliver most important topics in helping breastfeeding mothers in a more practical way. Conclusion: GHMP Breastfeeding Videos are suitable as educational and training tools in helping breastfeeding mothers in our training.

The Life and Legacy of Niles Polk Rumely Newton: Breastfeeding Researcher, Advocate, and Mother, 1923-1993

In the 1950s, researchers devoted very little time to understanding breastfeeding, physicians and nurses learned almost nothing about it in their training, and even those mothers who showed an interest in breastfeeding often found the lack of information and support for doing so to be overwhelming. In this period, Niles R. Newton stands out for a number of reasons. Born in 1923, Niles went on to marry, have four children (all of whom she breastfed), earn a master’s degree and a PhD, and carry on a successful research career as a specialist in the psychology of childbirth, breastfeeding, and childrearing. Her unique work in the psychology and physiology of breastfeeding shed precious light on many of the most common problems that mothers faced when they set out to breastfeed their infants. Her research quickly became the cornerstone of the back-to-the-breast movement and was snapped up by breastfeeding advocates, mothers, and La Leche League, in particular, who helped popularize and disseminate Newton’s ideas to an eager audience. This article examines Newton’s life and works in more detail and argues for the central place she holds in the history of modern breastfeeding.