“Women have been producing such a miraculous substance, breastmilk, since the beginning of human existence, yet they form the least wealthy and the least powerful half of humanity. …all over the world women are impeded from protecting their own and their babies’ health, and often surv ival, because of factors beyond their control.”
--Gabrielle Palmer, The Politics of Breastfeeding, Page 1.
After politics, religion, and money, I’m not sure if any topic of debate or even conversation is more fraught these days than those around health. Maybe that’s because nothing is more intertwined with politics, religion, and money than health. In The Politics of Breastfeeding: When Breasts Are Bad for Business, Gabrielle Palmer (a nutritionist, advocate, mother, grandmother, and teacher) does not shy away from these topics, but dives head first into the considerable politics and money that have meddled in the practice of breastfeeding babies across the globe. This is not a new book—the edition I read was first published in 2009 (Pinter & Martin), so many of the numbers are outdated and there may be new research on this topic. However, the questions Palmer attempts to answer are relevant today, and possibly talked about less than they were each time she published a new edition of her book, which was first published in 1988. In her own words, here are the questions she aims to answer (2):
- “Why, after about a million years of survival, has one of the principal evolutionary characteristics by which we identify ourselves as mammals become so damaged?
- Have women been freed from a time-wasting biological tyranny to lead nobler, more fulfilling and more equal lives?
- Why is it that whether we were breastfed ourselves, or breastfeed our own children, depends on our social and economic position?
- How is it that in many societies, 100% of poor, undernourished women all breastfeed easily, while in others, groups of privileged, well-nourished women believe they cannot?
- Why is the right to breastfeed fought for so vehemently by some women and rejected so forcefully by others, often according to their class, education or society?
- And why, if women participate in the modern economic structures which are claimed to be for the benefit of us all, must the breastfeeding relationship be curtailed and restricted?”
Palmer starts by building her case that breastfeeding is political. First, she points out that, first, women’s biological capacities have “been used as a pretext for excluding women from the centers of power.” (2) She continues that “even as women’s reproductive functions come to be controlled, both by themselves and others, in general there is little change in predominant male control.” (2) Men have designed and women have acquiesced to a society designed for the single male or dominant male, instead of demanding a world designed for equal partnership, centering the well-being of children. [1] Specifically, Palmer says “In the 20th century, women were presented with an illusion of liberation through the artificial feeding of babies, only to find their breasts appropriated by men and popular culture. This continues in the 21st century…both privately, when men pressure their sexual partners not to breastfeed, and publicly through pornography and the mass marketing of products and information.” (3) Second, Palmer highlights our obsession with wealth creation, which motivates the production of artificial breastmilk (which can be bought and sold and taxed) to replace the breastmilk mothers produce and give freely to their babies (and therefore cannot be taxed for it). Doctors, scientists, nutritionists, inventors, bottle makers, teat makers, bottle warmers, formula manufacturers, farmers who are subsidized to produce excess milk, all spend money, generate revenue, and are taxed. By feeding a baby artificial breastmilk, these parties and their governments increase in wealth, according to our economic accounting system. In the same system, a mother nursing her baby is virtually invisible, and therefore, there is a capitalist preference for the system that produces a measurable financial gain.
Breastfeeding is as old as being mammals. Palmer shared experiences with women of cultures who had never fed their babies with formula, and they were shocked at the idea that any woman couldn’t breastfeed. Because they had to, and knew no other way, and were frequent observers of breastfeeding their whole lives, Palmer claimed these women had no problems breastfeeding. She provides a detailed history of how the decline of breastfeeding is rooted in class divisions, industrialization, and male-female power dynamics. Palmer said that at times, wealthy women would use wet nurses, because it was common knowledge that consistent breastfeeding decreases fertility and the wealthy men wanted more children. Industrialization brought about refrigeration and surplus of goods, like milk, opening the door to infant formula.
Aggressive marketing techniques, doctors paid to recommend infant formula, and oversexualization of breasts contributed to the rapid adoption of artificial breastmilk by American and European mothers. Once the West bought into breastmilk substitutes almost completely, businesses like Nestle targeted other countries, because business’ objectives are to always increase revenue. The tragedy is that infant formula requires refrigeration and very clean water and the ability to sterilize the feeding implements. Palmer shows that businesses are reluctant to provide true directions and perils of their breastmilk substitute products, while aggressively marketing it in an area they know people cannot hygienically prepare it.
You probably have heard “breast is best” and possibly have heard the backlash of how many of my generation feel that this is shaming because some women have a harder time breastfeeding. Alternatively, “many women are suspicious of any arguments which glorify motherhood, because they have frequently been used to restrict women and exclude them from positions of power.” (11) Indeed, it’s because of this that I struggle to have this conversation with any of my friends about breastfeeding. Palmer draws the line from this shame to “a curious doublethink” caused by formula manufacturers and scientists “whose interests lie in the production of breastmilk substitutes. On the one hand there is eagerness to claim that artificially fed babies are just as healthy as breastfed ones and that the choice of feeding method is an equal one; on the other there is the claim to imitate human milk, and to use it as the gold standard to sell the commercial product.” (6) Additionally, Palmer states that while women of course should be in control of their bodies and should never be forced to breastfeed, this “does not mean that evidence about the risks of not breastfeeding should be censored.” (7) We women need to remember that not only do we have breasts, but we have spines and brains, and we’re capable of facing difficult conversations and debates and information that may require us to effect some major changes in our own behavior. We do not need facts hidden from us to protect our fragile sensibilities. Palmer puts it another way: “I know that stating these facts can be painful or even enraging to some women who have not breastfed their children, but the continued denial of the risk of not breastfeeding and the value of breastmilk, supposedly to spare women’s feelings, is a patronizing deception. The whine about ‘not making mothers feel guilty’ is such a cop out…No woman need feel guilty for ‘failing’ to breastfeed, though she has the right to feel angry or sad for being denied support and information when she needed it.” (85)
Over and over again, Palmer gives examples of how the artificial breastmilk industry has structured a system to make breastfeeding more difficult for women. She points to the aggressive advertising of artificial breastmilk world wide, but also notes some hospitals’ designs were influenced by the free planning offered by a US based formula company. “The purpose here is to impose a design that literally builds bottlefeeding into the facility by physically separating mother and infant to make bottle-feeding more convenient than breastfeeding for the hospital staff. …A single investment in such architectural services can create new sales opportunities for the entire life span of the building.” (7)
Palmer admits that “breastmilk substitutes can be useful, life-saving products, just as artificial insulin can save the lives of diabetics, but no honest doctor could advocate the use of insulin unless it were strictly necessary.” (7) However, she reminds us that in most of the world and for most women, formula “costs more than half the household income and will impoverish the rest of the family” even though breastmilk is free and better for the baby. (7)
Breastmilk, breastfeeding, is better for babies. As Palmer puts it, “In much of the world, the choice between breastfeeding and artificial milk is a choice between infant health and sickness, and too often between life and death.” (8) But even for those who live in the parts of the world where sanitized bottles, clean water, regulated formula, and literacy and the support structure and storage to prepare bottles safely, breastfeeding is better for a number of reasons. First, Palmer asserts, “the production of milk works on the supply and demand principle. The more often the baby suckles, the more milk is made.” (21) Second, the nutrients in the breastmilk is determined by the baby’s saliva and age. Colostrum “is so high in anti-infective properties that it has been called ‘the first immunization’ …[and] is the perfect consistency to help newborns learn to coordinate swallowing and breathing”, and is thick enough not to over fill a tiny infant’s stomach, which is the size of his or her fist. (29) Third, breastfeeding releases oxytocin which bonds mother and baby. Touch is essential to the wellbeing of the child. Fourth, breastfeeding can save the lives of babies. Palmer cites a study from a 2004 Pediatrics article that in the USA, about 720 babies between the age of one and 12 months die each year because they are not breastfed. “Besides the well-known likelihood of diarrhea and respiratory infections (the commonest causes of infant illness and death), not being breastfed increases the risk of meningitis, ear, urinary tract and blood infections. An artificially fed baby is more likely to suffer sudden infant death, diabetes, certain childhood cancers, overweight and obesity, high blood cholesterol, and asthma.” (48) Additionally, “breastmilk carries digestive enzymes which compensate for the fact that babies cannot produce their own enzymes in the first few weeks.” (49) Fifth, breastfeeding helps mothers’ health too. “The longer a woman breastfeeds, the lower her risk of breast and ovarian cancer, bone disease and hip fracture in later life. Not breastfeeding can increase a woman’s risk of type 2 diabetes, rheumatoid arthritis, and gall bladder disease.” [2]
Palmer dedicates the first third of the book to the benefits of breastfeeding and the perils of its substitution. The rest of the book consists of detailed, step by step historical tracking of breastfeeding trends and how we got to where we are. She outlines market trends and the growth of Nestle and other companies that profit off of artificial breastmilk. She describes how economic changes harmed opportunities for women to engage in revenue generating activities while also caring for themselves and their children. A healthy amount of the book eviscerates the flouting of international rules around advertising and distributing artificial breastmilk and the lax enforcement of them by governments, all for the sake of making money. Laws banning midwifery, combined with financial incentives for medical professionals to give formula to parents (studies have shown that parents typically use the formula they get at the hospital) harmed breastfeeding rates. It is a dense part of the book and took me longer to get through than I’d like to admit, but it’s worth the read to understand the complicated politics behind it all.
Read the book, and get ready to act. It is time to tell the truth, to re-teach women the knowledge we have lost. I applaud the Relief Society’s multi-million dollar Women and Children Health Initiative that is, in part, committing to support improved nutrition for mothers and children, including the specific support for local breastfeeding training. I urge women everywhere to be more resilient against shaming or using it as an excuse not to do what is best for children. I call on businesses and our governments to wield “flexibility, imagination, and innovation: all the qualities business gurus claim to love” to create a system that prioritizes the economic, health, social, and cultural needs of small children. (327) For example, we need to make it easier for women to bring their nursing babies to work if they want to or need to. We need to provide means for women to take at least 6 months of maternity leave to improve rates of exclusive breastfeeding during that time. We could even start with tax free maternity leave accounts for women to save to and use to live on past 6 months (1-2 years) and be able to return to their jobs. Maybe what children need more than $1000 in an account the day they are born is their mothers able to breastfeed without fear of losing their income or job. Many women in stable, equal partnerships may choose to leave work and raise their families while depending on the economic output of their husband or partner, but children of mothers who are not in such stable situations (and they are regrettably all too common) deserve to be breastfed as well, maybe even more so.
We should not force women to breastfeed, but teach and empower and make it as easy as possible for them to do so. We of course provide reasonable accommodations to people with disabilities to work—is it so great a leap to provide reasonable accommodations for mothers to bring their babies to work to breastfeed and hold and nurture? It would be an adjustment but I think such an option would once again realign our society to center the needs of the child instead of the convenience and comfort of adults. And remember, children and families will be the center of society, and “women will only have equality when large numbers of men [in chorus with women] demand a saner system so that they can be better fathers.” (339)
NOTES:
[1] Comment below if you want to help me start an organization that advocates for laws and systems that will create a child-centered, equal partnership supportive society. I’m only half joking. [Back to manuscript].
[2] P. 48. Also note that I did not include all the benefits Palmer described in the book due to space—you’ll have to read the book for that. [Back to manuscript].
Full Citation for this Article: Bell, Emilee Pugh (2026) "Review: The Politics of Breastfeeding: When Breasts Are Bad for Business, by Gabrielle Palmer," SquareTwo, Vol. 19 No. 2 (Summer 2026), http://squaretwo.org/Sq2ArticleBellReviewBreastfeedingPolitics.html, accessed <give access date>.
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