[Update]: This conversation on the complications that I believe stem from this new-found establishment, as well as some thoughts on forging more justice in this area, will be examined in greater detail in my upcoming webinar of the same title, happening at the end of August, 2014!
The sections in this post are various short excerpts from a essay I wrote in an anthropology theory course. Its main focus is to examine the intersections of whiteness, geography, dominance, subjectivity, power, gender, education, history, biomedicine and more in the context of breastfeeding professionalism, specifically as it relates to the rise of the International Board of Lactation Consultant Examiners and the burgeoning of International Board Certified Lactation Consultants.
I have seen such a push by various advocates on what they believe is the important role of lactation consultants. Many people rave of them. I often also hear various Black lactation advocates discuss their desire for a greater representation of IBCLCs in our community, and many talk about the imbalance that is prevalent that they believe stems from social inequality and the rigorous steps it takes to obtain the title. The lobby is often in favor of getting more people who ‘look like us’ on board — who receive this specific education — and who are culturally aware, in order to offer congeniality and trust and to help combat the staggering infant mortality rate in our community, as well as increase our overall health — something more breastfeeding can do. I can understand that. We all want better outcomes, and to help decrease SIDS, ear infections, allergies, as well as contribute to the health over the life of the child. But with that being said, I believe the opposite is true with the eruption of more breastfeeding professionals. I believe the International Board of Lactation Consultant Examiners and International Board Certified Lactation Consultants especially, are really only situated in ‘blind spots’ that obscure a much larger picture of the implications that exist from this and there are a multitude of consequences to the increase — not only in Black communities, but this modern form of structural violence can be seen throughout communities overall — locally, nationally and globally.
First there is the issue of dominance, governance and the way people are controlled, but people often view local and global supremacy, globalization, and ways to assert power in contexts other than a biological site like breastfeeding. But global sovereignty, leadership and dominance by one group over another, and attacks on cultures here and worldwide don’t always come in the form of a bomb from a military source. Sometimes they’re much more subtle.
Towards the latter part of the 20th century, the increasing awareness and so-called empirical and scientific data highlighting the various health benefits of human milk (that women’s impulse and inherent tendency had operated upon for hundreds and thousands of years prior) as opposed to artificial infant formula, which was greatly promoted instead of breastfeeding at the time, is what led to what we now see as the great desire to highlight these benefits through more mainstream and visible ways. To heighten this interest, medical professionals [emphasis on institution] began working with breastfeeding advocates with an effort to increase the population’s understanding and mothers’ participation to breastfeed, as well as offer hands-on assistance. In 1985, International Board Certified Lactation Consultans (IBCLCs) — who many deem the ‘Gold Standard’ in breastfeeding education and lactation management — became the product of this initiative — since a rigorous set of criteria which included enrolling in formal education classes in anatomy and physiology, biology, nutrition and others instituted by the overarching entity is required in order to obtain this esteemed title. This is what relegated these clinical professionals to the top of the lactation hierarchy. IBCLCs are employed in various settings such as hospitals, government nutrition offices, as well as work independently in the public and private sphere.
The IBLCE’s headquarters are located in Virginia, United States, and their vision to be ‘valued worldwide [emphasis mine] as the most trusted for certifying practitioners in lactation and breastfeeding care,’ which is increasingly coming into fruition. For nearly the past three decades, there has been a surge in the amount of people who have successfully completed the requisites outlined via their different pathways, and globally, there are more than 25,000 Certified Lactation Consultants in nearly 100 countries (ibcle.org, 2012). This number may not seem very significant given the global population, but what is most profound is that over half are in the United States alone, with a notable amount in Canada –and I have a hunch that these are not People Of Color. This number increases each year, as there was just another surge in the most recent certification. The IBLCE website states their exams are translated in various languages, signifying that the United States — a country whose flag drips with the blood of citizens here and throughout the world — is the marker upon with each country is measured. This other significant impact is that the US continues to be a purveyor of Western ideas and ideals, and a marker upon which other countries (and cultures, even on a local level) are measured. The message that ‘West Is Best’ remains embedded into various social fabrics, as views from this side are imposed onto various places on a global basis. I can only gather how this standard largely disregards various other cultural contexts, especially traditional knowledge as well as the role of family and community members in assisting with lactation, for example. Some people see this as biopower, others call it global sovereignty. But all of it means control.
Next, commodification becomes commoditization and monetization becomes stratification, and all of this underscores the way breastfeeding is now an object fixed with a price that is bought and sold. In societies that are already overrun with inequality, the presence of Lactation Consultants further perpetuates this. During my trip to Canada earlier this year to help my friend with her baby, she told me the story of how hard it was for her to nurse, and what effort it took to get breastfeeding initiated. She told me about the difficulties she had, and I even remember the day that I asked an IBCLC friend of mine for some pointers to send her way. She inevitably ended up hiring one nearby. My friend is a human rights lawyer, so she, of course, has much more money in her bank account than I do, I’m sure, because in that same conversation I told her that even with all of the work I do/have done/will continue to do to support breastfeeding, I couldn’t even afford to hire a Lactation Consultant right now if I needed one. A paradox she couldn’t help but ackknowledge.
Each day I get more and more dismayed at the way breastfeeding has become stratified and is a marker of status — meaning that it can gauge one’s social position. If we look historically at the eruption of infant formula and how that was used as an instrument to measure and ‘display’ information about someone’s economic status, since being able to purchase it meant you had money, then maybe it will allow us to see that the ‘explosion’ of breastfeeding professionals are not very far form this ideology. I’m not saying that there are breastfeeding professionals who don’t ‘donate’ their services — but even that is quite insignificant in the grand scheme of things. There is a truth here about being charged to feed a baby from your own body. Our instinct is usurped by the overarching entity, whose knowledge is produced via a linear scope, and women are made to pay for this through the various fees charged by hospitals and private sector firms — underscoring the primary tenets of an economic system that is controlled by private owners for profit, and selling our bodies back to us!! This not only forms competition and friction, but it creates fetishization of the breasts. I’m unsure if going into great detail about this is necessary, since commodification creates a steady and sturdy pathway to a fixation on something. I often hear people speak of issues with the way people fetishize breasts, but I can’t think of a more profound way that breasts become an object of worship than the use of breastfeeding professionals. In this case, they are looked upon as something distinguished from the rest of body, and mounted, within the framework of being a raw material.
Colonization of ‘Basic Instinct’ and dispossessing us from our own selves. Lactation Consultants are ubiquitous in various formal and informal settings, and one of the greatest influences can be found in hospitals, since this is where the majority of women give birth. After a woman has birthed, a consultant usually visits the mother and baby and immediately offers her assistance in positioning the baby and offers numerous additional strategies in order to get the baby to successfully initiate breastfeeding. If you know anyone who has ever had their baby find their food source on their own then you will know that a baby needs no assistance. A baby’s sucking reflex is biologically the strongest reflex for survival, and given the opportunity, with minimal intervention from outside sources, it can find its way to its food source, unassisted. This unassisted method is referred to as the ‘breast crawl,’ where a baby is placed on its mother’s abdomen and makes its way to her breast, which is a clear indicator of the interdependence of the mother-infant dyad, yet the presence of breastfeeding professionals greatly interfere with this.
Breastfeeding As Coercion (?) This is a very difficult one for me — mainly, because I don’t think getting someone to breastfeed is bullying. However, we are far removed from the paleolithic era when we lived in caves, and most of us aren’t part of a hunter-gathering society so things inevitably are much more complicated when issues of race, sexual orientation and other intersections in a society that is highly arranged to be more beneficial to some instead of others. Is it possible to ‘coerce’ someone to breastfeed? Given the social climate, without working to challenge issues of injustice that I am convinced are at the epicenter of low breastfeeding rates?
Black people and Lactation Consultants? When I first began my breastfeeding ‘journey,’ I really thought I wanted to become an IBCLC because I was hell bent on doing whatever it was I could to help end the astonishing amount of inequity that exists among Black breastfeeding. I started working towards that goal initially and took a course and planned on taking others, and if you search the very beginnings of this blog you can read about this part of my endeavor. But it wasn’t until later on is when I realized that it was the furthest thing from what I actually wanted to do, since as I said before had I remained on it I would be cheating myself and the community members I want to work with since that is not where I feel called. Nor is it how I feel I can make the greatest impact. I also know that whiteness has worked to remain in control by operating in multifarious ways towards dominating and subjugating Black people and all POC, and the rise of breastfeeding entities with their methods and methodologies, ways of explaining things, bodies of knowledge and physical hands on women’s breasts, I believe, is only another aspect of this — something I will be writing much more about in a future post.
I know this area is a sensitive one — especially for some groups much more than others, and I’m not saying that I don’t believe there are issues that exist that would appear to require outside intervention. I also personally don’t believe that at the individual level IBCLCs have any intention on being in the profession except for a desire to assist with a healthy, nurturing relationship and get more babies to the breast. Yet good intentions don’t always lead us to a path of social justice, equity or healing. It sometimes causes a cycle of violence that is too easily overlooked, because it manifests under the guise of ‘nurturing,’ without allowing us to see the operation of the overarching structure.
There are various other things I would like point out, but I would rather start a dialogue with my readers instead.
What do I believe of any continued use of Lactation Consultants? I’m not totally certain at this point. The issue is definitely complex, and I would never claim to have all the answers. But to begin with, it does require taking a closer look at the way global injustice is perpetuated in this way; when people are dispossessed, depoliticized and, removed from their biology, intuition and instinct they are easy to regulate and control. I also believe this is why we must place greater efforts at working towards breastfeeding sovereignty and create ways to increase our knowledge of the subject at hand in our community at the local level — by organizing, and making more people involved and aware, because we are all responsible. And should all be in the know. And then we can return the power to the people — which is where it belongs.