Professional Documents
Culture Documents
Breastfeeding has been the subject of social policy, concentrating on the bodies of women and infants and the ways they interact between each other and the greater social space. Although concentrating its effort with an ideal of the productive body, it goes beyond economic spheres in its search towards adequate and secure livelihoods, although also as a space where social and economic development converge, where tensions between individual decision-making and household/community interests arise, where boundaries between the natural and the modernly artificial are debated, and coming along an imagination of a hygienized, fit and healthy citizen subject. This has meant the development of a system that frames human milk as a public/social good. However, given its particularities it conflicts with other provisioning systems that imagine goods as the result of an industrializable production process. This is first paragraph is not clear you need to make a the statement that breastfeeding appears a natural private process but within the modern state / economies/ breastfeeding has become the subject of public interest and concern in relation to biopolitical concerns around security hygiene food breastfeeding is subject to different imaginaries and policies around the modern citizens You need to position yourself and your interest in it theoretically and politically Is this your introduction to the RP your problem statement can you clarify that Use some quotes, pictures, get some interest in here from the start
Food and nutrition policies, and food and nutrition security (FNS) policies in particular, have become the space in which breastfeeding (BF) policies are currently located in Bogata?. The extent of which such a statement is true will be illustrated through certainexplored in an analysis of debates embedded in the 2007 FNS of Bogota (the capital of Colombias capitalColombia) and its history time frame?. The RP looks at how the concerns of security are played out in public policy and the resistances and tensions between global worries about risk and the local responses and challenges. Security has become a major concern of public policy, especially at a global level, where risk and probability have become the new lingua franca. However, the global power transmission mechanisms are met with local power networks that incorporate their messages only partially and with resistance. The implementation of securitization of human milk poses a gendered resistance where spaces of possibility [outside the neoliberal loci] emerge. This RP will explore relevant policy-making of global governance institutions (which are?) and the conceptualization of [the political economy of] the baby food market (defined by big business, consumers, governments. It will then ask how the promotion of a universal body (what do you mean?) came to play a role in such a context. With insights from teratology and the perverse I will
argue that the body was framed to incorporate risk narratives into the natural body, leaving out other bodily accounts. With this framework in mind, the discursive translations from the global into the histories of F(NS) policy at the local (Bogota) will be traced. In particular, it will focus on the exclusions and resistance during implementation that lead to the incorporation of local resistance in local policy. (the actors ?) This text will continue by analysing whereRP will map out how BF policies are placed into Bogotas FNS policy, then exploring the conditions of BF policy as biopolitics of BF in Bogato and in the globall market. and finally the insertion of BF inside the globalized market. The BF policies tend towards discrimination but not necessarily to individuation or essentialization. They are less deterministic due to the dynamic framing of metabolism and hormones, also connected to the fluctuating conception of the female. These last sentences are not clear what are you referring to conceptualising bodies? Female essentialism? The mapping of individual body onto the social? Vice versa? Refer to your theoretical framework what inspired and interested you, why you chose this approach
Merit good is a term revived from 1970s debates after the coining of the term by Musgrave (1957). The development of de/merit distinction of goods contributed significantly to the justification of policies such as food stamps, although the 1970s would marginalize the concept for some years to the neoclassical schema of externalities. 3 These categories are shared with the dominant FAO food security framework although Colombias national policy differs in the last terming using utilizacin while in Bogotas it is aprovechamiento. A
2
this dimension that the policy places BF, broadening nutrition to the cares during pregnancy and early age.5 This framing sets an epistemic (?) change with a history of local policy making that privileged medical discourse. In contrast with policy from a century ago, the emphasis is now on the pleasurable instead of centring on the avoidance of death.
Comment [AS1]: Can this be interpreted a an hedonistic turn of the time-space compression in the age of Empire? The use o translation strategies to resist or even overturn powers from the macro only arise from within its own possibility space.
Comment [AS2]: The focus of current reproductive policy anxieties has changed towards giving life, debating pre-birth comin into-being leading to debates around abortion.
broad distinction can be made turning to their latin roots: the first goes back to profecto meaning truly, really, indeed, while usus signifies use, experience, skill, advantage, profit. 4 The word in used in the Spanis original is goce from the Latin gaudeo: to rejoice, take delight (University of Notre Dame 2013) 5 Los cuidados durante la gestacin y la edad temprana entre otros, son aspectos que modulan el aprovechamiento de los alimentos y determinan el estado de nutricin de los individuos (CDIAN 2007:22) 6 In England these institutions were named Milk Depots. In some respects, these places resemble current milk banks.
Figure 1. The front pages of the works by Troconis (1912) and Pardo (1920) The first municipal agreement concerning infant feeding was named By which aid is given to the Drops-of-Milk institution established in Bogota (Consejo Municipal de Bogota 1919) and based its first consideration on the high infant mortality rate of the nation (Art. 1). The first estimates of infant mortality rates in Bogota appeared at the dawn of the 20th century inside the medical (academic) establishment. One such early estimate comes from Troconis (1912)7. In a pre-demographic transition society8, addressing lactation as a strategy towards modernity was a novel import, adding to the hygienic and eugenic discourses prevalent in the Colombian medico-political establishment9. They imported the French anxieties of declining and (re)vitalizing populations (as motivated by late 19th century depopulation concerns10). Comparing local statistics to French ones, Troconis affirms that Bogotas are insufficient and makes the case of the quantitative importance of infant mortality affirming that the latter ones prove the point for the former case.
Comment [AS3]: The recurrent use of French (medical) scholarship and policy in th early stage is an example of the coloniality o power. Check on Castro-Gomez
These are the earliest estimates I have found. Further archival work could be useful, especially the citys official statistical bulletin Registro Municipal. Troconis (1912:13) complains about the lack of official data, especially by emphasizing available ones elsewhere. His permanent references are, notwithstanding, French. 8 According to CEPAL (???) Colombia reached the phase of demographic transition near the middle of the 20th century. Standardization of life/death statistics through the consolidation of measuring systems are a basis to the current understanding of the demographic transition. The French Loi Roussel of 1874 implemented the first efforts to make infant mortality statistics uniform and national, as a response to earlier estimates of declining birth rates. It is through the Law 48 of 1924 (Congreso de Colombia 1924: art.10) that infant birth and mortality statistics become mandatory at the municipal level an centralized at the national. 9 Castro-Gomez (2007) shows how hygienists, physicians and lawyers positioned these advances in science in the policy-making sphere and how they shape the (capitalist) production of subjectivities during the years 1910 and 1930, the time he considers Colombias industrialization beginnings took place. 10 Declining birth rates during the second half of the 19th century in France became a matter of concern that as were materialized in the 1874 Loi Roussel. Jacques Bertillon, physician turned statistician and incubator of an international system for the classification of the causes of death, was a founding member of the Alliane National pour lAcroissement de la Population Franaise. Offen (1984) links geopolitical change, mainly the decline of France as world power during the Ancien Regime, to the ordering of hegemony in terms of population at the interior of patriarchal medical and political discourse to the framing of debates on womens reproductive role or the French thought on the woman question (p.652).
7
Figure 1 Estimates of infant mortality in Troconis (1912:15-16), Bogotas are presented on the left and French ones on the right.
These types of comparisons are recurrent in Troconis text. His analysis will lead him to state misery and ignorance are the two overarching factors of infant mortalitys etiologyaetiology (p.37) similar to (BertillonXX?). After discussing infant mortality and depopulation by cause of death he reaches four main conclusions (p.37) of which I will centre on two 1) that respiratory infections, gastroenteritis and stillbirth are the main contributors of infant mortality and 2) that food related illnesses follow. On his section on illegitimacy (p.16-17) he compares the municipal laws that deal with (unsupported claims of raising11) infanticide to the French Roussel Law of 1874. In pages 26-27 he stresses the importance of breastfeeding practices with the irrefutable arguments of Variot. He also makes claims about Bogotas mothers with syphilis (mothers as vectors) and stillbirths based on the statistics reported by Fournier, Julien and Le Pileur (p.23-24).
Infanticide
Legitimacy is the moral context by which infant mortality is first understood. Generally, Troconis argues, the mother and the child are both abandoned by the father, thus forcing the former to work for both their cares. Illegitimacy thus derives in either the absence of a natural food source or in infanticide. This is said to be the consequence of mothers taken away from a natural condition and from their natural duties, further suggesting that governmental response should be framed into paternalistic institutions. Private charity, the also private Hospital de la Misericordia and the public Hospicio (poorhouse) are presented (p.37-39) as the sole institutions that address infant mortality. It is the third one that the author considers to implement prophylactic measures against infanticide (p.38)12. It is the public institution that faces the heinous crime (p.17). Despite a positive stance about saving many children from death, [it also acquits] adults from their responsibilities, it does not tackle the root of evil and Troconis does not doubt for one moment of the powerful influence of illegitimacy on infant mortality (p.17). Calderon (1920:20) frames the problem similarly referring to the mothers perverse feelings resulting from a cruel misery that drowns maternal sentiment and Being a question of the quantitative kind, the author states later (p.17) that the information is under reported and lacking. He again assumes the universal nature of foreign (European) estimates to state the relevance of infanticide in accounting infant mortality. 12 It is to be noted that local newspapers reporting on infanticides moved the municipal government into policymaking. However, Pardo (1920: 20) also notes the media fixation with these deaths eight years later. Studying the rhetoric of such press articles is outside the scope of this text.
11
resorts to institutional response, this time making the case for the already existing Drops-of-Milk. It is in this last text where the class component is made most explicit, when Calderon exalts the importance of these places as corrective of the perverse and criminal behaviour of poverty. It is the misery they find themselves in, he continues, what drives women (and not their agency) to attempt abortion and infanticide, because the hunger and nakedness that threatens them entails an uncertain future. Calderon (1920:24) is convinced that a majority of Bogotas women are capable of concupiscent love only, which lead him to conclude that the love they can profess as mothers is only selfish; professing only amoral manners, they can only consider their child as disrupting their liberty. The nature of woman is therefore wicked and in need of re-education. Such an account denies women as active subjects and marginalizes them from any public debate This contrast with infanticide as recounted by Spicker (2000), where feminine slaves in the Viceroyalty of New Granada practiced it as a means of resistance.
Gotas de Leche
Troconis deploys all his knowledge in pediatrics as learned in Europe to explain infant mortality, bringing infant feeding as the central theme. A mothers breast milk is argued as the best baby food of the lot, over artificial feeding and wet nursing. The Drops of Milk, a private initiative of individual doctors and associations of them, were inaugurated throughout the country (as was the Latin American trend) and funded initially through (the higher class and clerical) charity, and with national government support since Law 48 of 1924 (Congreso de Colombia 1924). The Colombian Congress (1928) decreed the (financial)
encouragement of these centers at the national level13. The national example followed Bogotas transposition of the French invention. They were perceived by the public as promoting bottle feeding in the absence of motherly care (which was indeed done), but to inform, protect, and invigilate (pregnant) women on bearing/rearing normal and healthy organisms, specially through breastfeeding, was their prime goal (Pardo 1920:18).
Vicious milk
Syphilis is portrayed as a sub registered cause of infant mortality due to the moral stance that sexually transmitted diseases had (Troconis 1912:23-24). The discussion, however, does not end there. Pardo (1920:48) comments on the cases which, like this one, breastfeeding is contraindicated. Milk coming from a non-healthy/non-hygienic body becomes a matter of concern. Degenerate bodies here are linked once again with the consumption of the poor. Of all things, physicians and politicians converge on the problems of consuming chicha, a fermented beverage made out usually from maize. Blood impurity was and race degeneration were transmitted through the milk of degenerate mothers. The discussion on substitution is brought up. The slave origins of the nutrix. Wet nurses as evil and giving classist-racist value to breast milk.
Artculo 2 Auxliase con la cantidad de veinte mil pesos ( $20,000) anuales, durante el trmino de tres aos, la construccin del edificio destinado al funcionamiento de la Gota de Leche de Bogot, que proyecta llevar a cabo en esta ciudad, en el lote que ha comprado para el efecto, la institucin denominada Patronato de Gota de Leche de Bogot. La cantidad asignada le ser entregada al Patronato de Gota de Leche de Bogot, previo el visto bueno del seor Director Nacional de Higiene. Artculo 3 Aumntase en tres mil pesos ( $3000) el de la Salacuna que funciona en el barrio de Las Cruces, de la ciudad de Bogot (Congreso de Colombia 1928). 14 Cows as the mayor input for Bogotas consumption worked both for the meat and for the milk market. The former was widespread while the latter was destined primarily for small cattle-raisers. State intervention was needed to associate small milk producers into a supply force capable of coping with the increasing demand for cow milk. Also from the State were the hygienic processes of standardization that shaped consumption practices. (Brigitte Baptiste et al Carne????? 2009???)
13
Technical betterments in production and consumption of cow milk intensified earlier disdain for human milk. At the same time it did also with in the opposing breast milk side. Cow milk was becoming a symbol of nutritious and hygienic and therefore physically and morally desirable. Bad food and nutrition habits of mothers, especially when their work environments were related to antihygienic (dirty) or anti-ethical (poor and symbolizing socio-economic failure). More generally, the way in which corporal fluids were perceived was changing due to the social, cultural and environmental consequences of technical and scientific imports, in particular from the biology-medicine discourses that supported the European expansionist project. Human milk, as other practices of human reproduction, was inserted into a public practice as caption through nationhood where once it was part of private/communal ideals. If global commerce as pioneered by Europeans in the 16th century compressed time and space through their particular risk-taking inclination as suggested by Sloterdijk (2005), milk-banks propose a risk alleviation strategy by establishing a market economy free of debtor/creditor binomials (disregarding state-led investments). But can it be rendered global, the materiality of human milk, transported, distributed, exchanged outside the volunteers communitte?
THE INCORPORATION OF BREASTFEEDING BY FOOD AND NUTRITION SECURITY The current international legal framework
The rhetoric of rights introduced through the second half of the 20th century by global governing institutions. UNICEF, FAO and WHO as main players of baby food international policy. Other organizations outside the UN system such as Save the Children, WABA and IBFAN. Joint WHOUNICEF 1989 Declaration (Baby Friendly Hospital Initiative), Innocenti Declaration, the International Code of Marketing of Breast-milk Substitutes and absence of UNIFEM/ONUWOMEN.
also associated with the (patriarchal) medicalization of the maternal body (but also of the infant body). The building of the female and infant body by medical discourse admitted the breast-feeding as the best practice (for infants, not the mother) although diminished motherly/female knowledge on how to realize it, it emphasized the difficulties of breastfeeding without scientific appropriation and ended up creating disincentives for lactation in a time when bottle-feeding was more readily available (Van Esterik 2002). Other discourses overtly proposing other diets as better than breastfeeding also became available inside medical institutions. There are undocumented histories of resistance and compliance that helped shaped medical practice. This has been accompanied by a shift from the communal to the individual practice, especially through a modern hygienic imperative, as it is best exemplified by the ghost of AIDS and the vertical transmission problem. The use of wet nurse services became a rarity as other cheaper substitutes became available, such as access to water, milk, certain foods, but also the use of commercialization strategies by the growing industries. Although the objects addressed by breastfeeding policy are named all over, there has not been a wide focus on what they, the objectified subjects want. Certain psychoanalytic works and from child psychology have tried addressing the question of what pre-spoken language babies experiment and desire. Anyhow, this is not usually the case with policy. What mothers, caregivers in general, and women in general want is usually not put into consideration for what social policy has to say about them. The case has been (briefly) made that breastfeeding policies have primordially focused on women as a subordinate of the child as the future-productive-entity. The policies rely on a small set of policymaking disciplines (such as nutrition, medicine, especially obstetricians and pediatricians, public health, clinical nursing, health education, epidemiology, and economics) which have traditionally preferred quantitative over qualitative research. A set of measurements have been constructed seeking to govern subjects. The only national level indexes have been measured according to initiatives from international organizations, by Profamilia, an NGO promoting sexual and reproductive rights (the most important one of its kind), through the Demographic and Health Surveys sponsored by USAID and whose purpose is to gather quality information to plan, monitor and improve population, heath, and nutrition programs(Measure DHS ). Since the 1990 to the 2010 surveys there have been changes in the way maternal lactation has been termed. While in 1990 breastfeeding was understood as an important variable for reduced exposure to pregnancy due to postpartum amenorrhea and was measured through three indicators (initiation, complementary foods, and duration), the 2010 survey frames the practice as relevant for babies and its immunologic properties and other health related benefits and now compiles seven sets of indicators. It must be said that government entities now participate importantly with funding and that ICBF now funds a new survey on nutritional status that also includes lactation indicators. Although these are not the only actors in the debate and recognizing breastfeeding has gained complexity in its depiction, breastfeeding as policy has not been usually framed as a complex process shaped by environmental and sociocultural forces. Breasts, children, breastfeeding rates, complementary feeding, child and maternal mortality and morbidity, infant and maternal health, mind-motor development, and so on appear throughout lactation policy documents. What social policies address is concerned with life, death, and productivity.
Translating policy
The adoption of enlightened French policy-making in the beginning of the 20th century was in line with the celebration of a century of independence from Spain, the expansion of water supply and sewerage services, innovations in milk pasteurization and the emergence of a milking and baby-food industry, developments in pediatrics and immunology. The nascent state was willing to enter
modernity and the policy-making elites sought English/West-European fashions. As noted, transpositions from the French medical establishment were made adamantly in regards to vitalizing and populating concerns. Embedded in broader biopolitical government practices of the early 20th century, milk was instrumentalized for the maximization of national fitness through hygienic and eugenic strategies. The former consisted on adding an individualized attention to the habits of subjects to the earlier hygienic concern with securing the external conditions of health through town planning, sewage systems and the like while the latter meant to improve the body politic and to relieve it of the economic and social burdens of disease and degeneracy in the future by acting upon the reproductive decisions and capacities of individuals in the present (Rose 2001:3-4). Following Pedraza (??Zandra), the hygienization of milk is in line with the pursuit of moral cleanliness starting through physical and social hygiene. The biopolitics of the first half of the 20th century, both in its ne/hygienist and in its eugenic form, involved more than the idea that, other things being equal, healthy individuals were more desirable than those who were unhealthythe political rationalities of our present are no longer inspired by the dream of taking in charge of the lives of each in the name of the destiny of all in this new configuration, the political meaning and salience of health and disease have changed. In this domain as in so many others, the images now are of the enabling state, the facilitating state, the state as animator. On the one hand, the state retains the responsibility that it acquired in the 18th or 19th century / the precise timing varying across national contexts / to secure the general conditions for health> regulating the sale of foodstuffs, organizing pure water and sewage disposal, sometimes mandating the addition of health-promoting elements into the diet vitamins, fluoride in water and the like. On the other hand From the places where breastfeeding is enunciated there exists a tension in translation, from an organ-based framing of a practice to one centered in a fluid, from breast to milk, breastfeeding vs. lactation. From the international multilateral organizations, where global policies take shape, to the national framework, where they are brought into the local and from where they are contested with other policies at other levels, different actors are putting policies into practice and making the former out of the latter. In Colombia, the disparities describing the connection between the bodies of women to those of babies are framed in the tension between English-dominant international multilateral organizations or NGOs and a Spanish-speaking government/activism, and their particular administrative narratives. Of course, there are translation problems other than [written] policymaking English-Spanish to the [spoken], everyday practice of not-necessarily Spanish-speaking practitioners (e.g. indigenous communities). From the latin lac, milk, and lactare, to contain or give milk, (University of Notre Dame 2012) Colombia's policies term the practice referencing a fluid, while international policies appeal to a [usually non-implanted women] breast. This is not to say it is a Colombian initiative. UNICEF, WHO, and FAO spoke/wrote of lactancia in their own Spanish versions of policy-recommendation/making, and it is also from such inheritance that Colombian policies speak. The epistemic order seems to be always English first, Spanish second. For Malaysia-based World Alliance for Breastfeeding Action (WABA) Latino members, the translation of the English spoken years slogan into the Spanish/Latin American version is always an end-of-the-year email-based discussion consolidated in Costa Rica. However, Spanish has its own inner struggles. In an intent to capture left out meanings, certain Spanish-speaking lactivism has retermed lactancia as amamantamiento, turning the focus from physiology to mama, not just a mammalian gland, but the mother, to women and to love. This gives space to breastfeeding/lactation as a biocultural process in a more complex fashion than the one depicted by strictly medical engineers. A shift from mothers
milk to human milk, although both used as medical jargon, has been used by social movements as a decentering of infant nutrition from the mother-as-unique-caregiver17. The creation of a web-based Spanish speaking breast-milk promoting community began as a consequence of the connectivity already fostered by international/regional conferences. The particular take of the FAO (1996) FNS framework into Bogotas policy. Decoding global and local lactivism infiltrated into
Psychiatrization of infanticide
The fear of infanticide was ever present in a thread of emails I started receiving on Sep 9, 2013, that gave me a first-hand example of the relation between monstrosity and food security and the different policies that mediate among such poles. The imprint of motherly instability in the likelihoods of postpartum depression (PPD) and postpartum psychosis, and the risk of infanticide. The puerperal state as a moment of instability of motherhood blurs the divide between the psychological and the physiological. Drug administration, from Biperidene to Oxytocin-substitues. The life-giver/life-taker monstrosity of this mater potestas is inscribed into a legal instability framework that contrasts with the Roman patricius held pater potestas. The Colombian Penal Code recognizes/legally frames infanticide as a crime in its article 328 with a lenient penalty, in at least the sense that it is made comparable as less in the amount of years of incarceration. The killing by a mother of an offspring resulting from violent sexual intercourse, abusive or non-consented artificial insemination, given that it occurs during the eight days after birth, will be penalized with arrest of one to three years18. This taxa of homicide does not name the crime as infanticide (as is the case in other Latin-American law) and restricts the unmotherly to three horror-images. This sets it apart from the previous shame rhetoric used to justify infanticide, where dishonour was the prevalent motive, as an inheritance from French/Helvetic law.
Comment [AS4]: Check if it does not distinguish it from parricide (meaning that t same considerations are made even if the killing is of a child not her own)
The term leche (milk) has been depicted as both materna (maternal) and humana (human), while lactancia goes along with materna and natural. In both cases the terms have been incorporated occasionally into written and practiced policy. 18 La madre que durante el nacimiento o dentro de los ocho das siguientes matare a su hijo, fruto de acceso carnal violento o abusivo o de inseminacin artificial no consentida, incurrir en arresto de uno a tres aos
17 19
Figure 4 Left side: Cover of October 22, 2010, Magazine of El Mundo. Right side: Fouquet (1452) Madonna Surrounded by Seraphim and Cherubim Recap on distancing between production and consumption. Milk banks vs commercialization. The framing of milk banks in Bogotas policy. The incorporation of the International Marketing Code of Breast-milk Substitutes in the text through programmed (budgeted) surveys of its violation. The holes of the Code, The Icecreamists human milk ice cream, the neoclassical take on incentives for a human milk market (Waldek 2002) between Roman Charity and galactophilia. Original text in Spanish: dicho artculo atenta contra la salud pblica y contra organismos oficiales tan serios como la OMS y el UNICEF e incluso contra la humanidad
20
CONCLUSIONS
Food and breastfeeding policies share the common in their origins the fears of death through ingestion and nutrition, the constitution of a fit citizen-subject of a nationalist endeavour towards productively machinic. However, the discourse has shifted into what Rose (2001) calls risk politics.
REFERENCES