Adolescent mothers and breastfeeding
Post by Kimberly Jamie
In 2014, I was awarded a grant from Cancer Research UK as part of their scheme focused on cancer prevention in ‘harder to reach’ groups. Along with colleagues from Queens’s University Belfast and Bristol University, and with research assistant support from Dr Hannah Bows, I focused on adolescent mothers as a group who aren’t necessarily ‘harder to reach’ but are certainly overlooked in health research. Even though adolescent mothers can have health and development issues common to all young people, when young women have babies, practitioners’ attention often shifts away from them to the health of their children. Similarly, epidemiological research is much more concerned with the long-term health outcomes of children of teenage mothers rather than the teenage mothers themselves.
Our research, then, focused attention on adolescent mothers themselves. We were particularly interested in the ways that decisions about health are made in the context of everyday life. For example, while the guidelines around taking enough exercise are well-known, decisions about going for a run or going to the gym aren’t made in this context of government advice but are, instead, about how much time we have, how far away the gym is or whether someone can look after our children. These everyday decisions about health are also related to broader social issues like socio-economic deprivation or inequality. For example, can you afford gym membership? Can you afford appropriate gym clothes? Is your neighbourhood safe to jog in?
Through photo elicitation and focus groups, we placed adolescent mothers’ voices at the centre of our research and analysis. During focus groups our participants described the importance of their early decisions about infant feeding which, essentially, boiled down to breastfeeding or bottle feeding. Even participants who opted not to breastfeed talked in some depth about their decision. This was somewhat surprising finding as we didn’t set out to study infant feeding decisions.
Sociologists have focused extensively on the moral minefield of infant feeding which is laden with contradictions and paradoxes. On the one hand, breastfeeding is well-known to be the nutritionally optimal method of infant feeding and so women who breastfeed are understood as ‘good mothers’. On the other hand, breastfeeding can be conflated with sexuality and women are stigmatised for breastfeeding, particularly in public even while women’s breasts are highly visible in public in magazines, in film, on billboards etc. We found that for adolescent mothers, traversing this contested landscape is even more challenging as they also have to negotiate a 'spoiled identity’ which is associated with having a child at a young age.
To make sense of this, we used Elizabeth Murphy’s idea of deviance related to infant feeding. Murphy (1999) argues that given the link between breastfeeding and maternal morality, formula-feeding leaves women open to charges of deviance which they must account for. While Murphy’s framework is a useful starting point we found that for our participants it is breastfeeding, not formula-feeding, which is understood as deviant and requires accounting for. In our paper ‘I just don’t think it’s that natural’, we argue that breastfeeding is constructed as deviant at three ‘levels’ - it was considered (i) a deviation from broad social norms about women’s bodies, (ii) a deviation from local normative mothering behaviours, and (iii) a transgression within micro-level interpersonal and familial relationships. In our paper, we show how breastfeeding is constructed in these ways and that adolescent mothers account for the deviance by locating breastfeeding as a selfish act (through an adapted ‘breast is best’ discourse), by minimising anti-breastfeeding discourses and by questioning the dominant norms which anti-breastfeeding constructions are based on.
Our second paper focuses on relationships with healthcare practitioners around infant feeding. Throughout our focus groups, participants also talked about their strained relationships with healthcare professionals where they often felt stigmatised and not properly listened to. These strained relationships became particularly problematic for participants when it came to infant feeding as participants described needing additional support, empathy and warmth. In this paper, we used Shim’s notion of cultural health capital (CHC) which looks at the ways higher cultural capital is mobilised in healthcare contexts for health benefit. In our paper, we argue that young mothers’ infant feeding decisions are impacted by an intersection of inequalities. In other words, we suggest that while their age may have an impact on adolescent mothers’ decision to breastfeed or not, so too might their lack of cultural health capital.
There is still lots to explore in our data!
Kimberly Jamie is an Assistant Professor in the Department of Sociology at Durham University.
Views and opinions expressed on this blog site are solely those of the authors and other contributors. They do not necessarily represent those of Durham University, its Department of Sociology, nor all members of the Health and Social Theory research group.
Image credits: Kimberly Jamie; NHS Start 4 Life.