Heather Trickey reports on a cross-disciplinary research project led by Cardiff University and funded by the Wellcome Trust, which aims to use historical artefacts to stimulate discussion about infant feeding decisions. Heather is a Research Associate based in DECIPHer working towards a PhD in infant feeding policy. Heather’s PhD research is joint funded by the Medical Research Council and the National Childbirth Trust.
Achieving improved breastfeeding rates is part of the public health improvement agenda in Wales. Welsh breastfeeding rates are very low by international standards, and a majority of Welsh mothers stop breastfeeding earlier than they originally intend. As elsewhere in the UK, lower income parents are less likely to breastfeed their children. In many less well-off Welsh communities, breastfeeding beyond the early days is unusual and more than a decade of public health policy to promote breastfeeding has had little impact.
Infant feeding decisions are influenced from many directions – from what happens during and after the birth, to broader societal factors such as the influence of formula milk advertising, employment conditions and norms about feeding in public places. The beliefs, attitudes and experiences of mothers’ immediate social networks are particularly influential; where generations live in the same community, grandparents have a key role in providing practical help and support to new mothers and grandparents’ own feeding experience will affect the support and advice they feel comfortable to give their daughters. The health service cannot work in isolation from these influences. Simple public health messages about feeding and weaning may come into conflict with family social norms, and cause grandparents themselves to feel criticised for their own decisions. This may have the effect of closing down conversations within families about how norms have changed, or might be different in the future.
There is a growing interest in the use of historical artefacts as an entry into conversation about sensitive public health topics; research has shown that historical artefacts used to discuss how sexual practices and conventions have changed can prompt young people to discuss their own views, ideas and concerns. Our cross-disciplinary project uses glass feeding bottles, tins of formula milk, breast-pumps, shawls, old advertisements and advice manuals, as well as images of Welsh mothers feeding during different historical periods, to provide a non-directive opening for reflection and conversation about the ways that babies have been fed at different times.
In August 2015 we held a four-day pilot event at the Welsh National Eisteddfod. We had well over 100 visitors to the stand. Formal feedback indicates that participants responded positively to the exhibition, whether their own children has been breastfed or bottle-fed. Participants provided new information about artefacts and pointed to gaps in our collection. Some participants congratulated us on raising breastfeeding awareness; others told us it was refreshing to see all infant-feeding practices covered in the same exhibition; everyone was fascinated by the infamous ‘murder bottles’, a Victorian feeding bottle with a tube that was almost impossible to clean, making it an ideal breeding ground for bacteria.
We are in the process of analysing observational and narrative interview data and it is premature to draw conclusions. However, it seems that the stand was successful in prompting a range of thoughts and reflections about feeding that went beyond the objects and images displayed. In written feedback, visitors reflected that breastfeeding is hidden even in modern times; that breastfeeding is still not accepted as natural; that women have to cover up or use a bottle; that breastfeeding can be done ‘discretely’; that with population growth, enabling women around the world to breastfeed will be increasingly important; that whilst feeding equipment has changed over time, basic physiology has not; that modern feeding equipment is surprisingly complex when compared with traditional artefacts; and that there may be too much reliance on books to tell mothers what to do nowadays. Given the context for the event, we were struck by the words of a grandfather who compared loss of the art of breastfeeding to the near loss of the Welsh language – passed down from mother to mother, but with the potential to disappear in just one generation.
Over the next 18 months, we will be holding events in Welsh communities with low breastfeeding rates. We seek particularly to understand how grandparents reflect on, accommodate and make sense of changes in feeding behaviours up and down the generations. Findings will inform the development family and community-based public health interventions, and will enhance our understanding of the potential for historical artefacts to contribute to public health intervention.
This research stems from a Cardiff University cross-disciplinary Wellcome Trust funded project; a collaboration between Heather Trickey (DECIPHer), Social Sciences, Dr Laurence Totelin, History Archaeology and Religion http://www.cardiff.ac.uk/people/view/73040-totelin-laurence, and Dr Julia Sanders http://www.cardiff.ac.uk/people/view/39335-sanders-julia Health Care Sciences.
This article was commissioned for NCT Perspective magazine December 2015 Issue. http://www.nctshop.co.uk/Perspective-Subscription-to-NCTs-Transition-to-Parenthood-Journal/productinfo/4761/