In a fascinating paper in the Journal of Medical Ethics, philosophers Fiona Woollard and Lindsey Porter conclude that mothers do not have a moral duty to breastfeed.

The paper is Breastfeeding and defeasible duties to benefit. The authors begin by quoting colleagues Lee and Furedi who deftly summarize the current moral milieu.

A process of cultural transmission seems to have turned provision of health information about the benefits of breastfeeding into hostility about formula use. This has a detrimental effect on relationships that are very important for new mothers, namely with health professionals and with other mothers.

[pullquote align=”right” cite=”” link=”” color=”” class=”” size=””]The moral duty to feed a baby does NOT imply a moral obligation to breastfeed just as the moral duty to educate a child does not imply a moral obligation to pay for private school.[/pullquote]

Or, as Woollard and Lindsey explain:

For many women experiencing motherhood for the first time, the message they receive is clear: mothers who do not breastfeed ought to have a darned good reason not to; bottle feeding by choice is a failure of maternal duty.

That’s certainly what professional lactivists believe, but they’re wrong.

We argue that this pressure arises in part from two misconceptions about maternal duty. First, confusion about the scope of the maternal duty to benefit and second, conflation between moral reasons and duties.

Indeed:

While mothers clearly have a general duty to benefit their offspring, we argue that this does not imply a duty … to carry out each particular beneficent act. Mothers do not have a moral duty to carry out each and every act that would benefit their baby. Mothers do have moral reason to perform each beneficial action. However, not complying with a moral reason, unlike failure to comply with a duty, is not an accountable matter. Therefore, the act of holding mothers to account for individual beneficent act omissions, and the demand that individual omissions be justified, is unwarranted. The expectation that mothers who bottle feed should have a ‘darned good reason’ is morally unwarranted, in addition to being demonstrably harmful.

We generally take this for granted in the day to day business of parenting. Mothers (and fathers) have a duty to protect children. Skiing is a potentially dangerous leisure activity. If mothers had a moral duty to carry out each and every act that might possibly protect their children, they would be morally required to forbid their children from skiing. But though everyone recognizes a mother’s duty to protect her child, very few people think that duty encompasses forbidding any activity that raises the possibility of injury.

Similarly, in many areas of the country private schools offer better education than public schools. If we believed that mothers have a moral duty to provide what is “best” for children, we would be forced to conclude that those mothers have a moral duty to provide the private school education regardless of the cost, but we don’t.

Though mothers have a general moral duty to provide “the best” for their children, they does not imply specific moral duties to provide every possible advantage in education or any other sphere. No one expects mothers to provide a ‘darn good reason’ for sending their children to free public schools.

Many lactivists are also natural childbirth advocates. Curiously they have no difficulty recognizing that the general moral imperative for mothers to protect babies does not imply a specific moral duty to give birth in exactly the way that doctors recommend. They argue — correctly in my view — that mothers have a right to autonomy over their own bodies and that, therefore, the moral duty to protect babies must be balanced against the moral right of women to give birth in the way that they choose.

For example, homebirth in Oregon has a perinatal mortality rate 9X higher than comparable risk hospital birth, yet very few believe that any Oregon mother who chooses homebirth must justify her desire to have a homebirth to other healthcare providers, other mothers or society at large.

The benefits of breastfeeding are far smaller than the benefits of hospital birth, yet lactivists routinely invoke a maternal moral duty to breastfeed. Diane Weissinger, in her seminal paper on the language that should be used to counsel new mothers, recognized this problem:

When we … say that breastfeeding is the best possible way to feed babies because it provides their ideal food, perfectly balanced for optimal infant nutrition, the logical response is, “So what?” Our own experience tells us that optimal is not necessary. Normal is fine, and implied in this language is the absolute normalcy and thus safety and adequacy-of artificial feeding …

In other words, Weissinger acknowledges that there is no moral duty to breastfeed … but then goes on to ponder how women can be browbeaten into believing that such a duty exists regardless.

The mother having difficulty with breastfeeding may not seek help just to achieve a “special bonus”; but she may clamor for help if she knows how much she and her baby stand to lose. She is less likely to use artificial baby milk just “to get him used to a bottle” if she knows that the contents of that bottle cause harm.

The mantra of the lactivist movement, “Breast Is Best,” is understood as invoking a moral duty to breastfeed. That’s why lactivists generally feel superior to mothers who formula feed, and feel justified in shaming those other mothers.

And that’s why they vehemently hate the phrase “Fed Is Best.” “Fed Is Best” embodies the very real maternal moral duty of making sure that babies are adequately fed while implying correctly that there is no moral duty to breastfeed.