Breastfeeding and misogyny

A couple of years ago, I wrote a blog https://www.cordeliauys.co.uk/why-does-the-uk-have-such-low-breastfeeding-rates about why I thought the UK has such low breastfeeding rates. In fact, the whole of the so-called developed world has low breastfeeding rates, but the UK has pretty much the lowest: https://kellymom.com/fun/trivia/bf-rates-2004/

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One reason I didn’t mention in my blog was misogyny, not the vehement kind one usually thinks of, but the more pervasive kind that means anything pertaining solely to women is neglected or ignored. If you read 𝘐𝘯𝘷𝘪𝘴𝘪𝘣𝘭𝘦 𝘞𝘰𝘮𝘦𝘯 by Caroline Criado Perez, you will start to grasp the extent to which our world is designed by, and for, men. Anything to do with the female body, such as menopause or endometriosis, receives much less attention than conditions that solely affect men. There is currently a campaign by @jessica_ann_pin for detailed clitoral anatomy in medical literature and curricula, as up until now this has been almost totally absent.⁣

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It is of course possible for people who don’t identify as women to breastfeed/chestfeed, but on the whole, and for most of human history, it has been women who have breastfed. I am convinced that this is the main reason so little attention has been paid to the lactating breast by doctors and scientists. It beggars belief that between 1840, when the Victorian anatomist Sir Astley Cooper published 𝘈𝘯𝘢𝘵𝘰𝘮𝘺 𝘰𝘧 𝘵𝘩𝘦 𝘉𝘳𝘦𝘢𝘴𝘵, and the early 2000s, when the Australian Professors Peter Hartmann and Donna Geddes had the brainwave to use ultrasound imaging to investigate the lactating breast, there was no new research into what happens inside the breast of a lactating woman.⁣

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Sir Astley Cooper carried out detailed dissections of lactating breasts using the cadavers of women who had been breastfeeding. His work informed all textbooks on breast anatomy for the next 160 plus years. Although Sir Astley was clearly a gifted anatomist, and many of his findings were accurate, Peter Hartmann’s research shows that Sir Astley got several things wrong. ⁣

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For example, there are fewer main ducts in the breast than he thought, and his method of injecting hot wax into the nipples of cadavers caused a major misapprehension: because the wax pooled near the nipple, it artificially stretched the ducts near the nipple, creating what were believed to be milk reservoirs, which were named lactiferous sinuses. These can be seen in any diagram of the lactating breast drawn before the year 2000. We now know lactiferous sinuses do not exist, but even today, on the website for the US National Cancer Institute, it says: ‘𝘑𝘶𝘴𝘵 𝘣𝘦𝘧𝘰𝘳𝘦 𝘵𝘩𝘦 𝘯𝘪𝘱𝘱𝘭𝘦, 𝘵𝘩𝘦 𝘭𝘢𝘤𝘵𝘪𝘧𝘦𝘳𝘰𝘶𝘴 𝘥𝘶𝘤𝘵 𝘦𝘯𝘭𝘢𝘳𝘨𝘦𝘴 𝘵𝘰 𝘧𝘰𝘳𝘮 𝘢 𝘭𝘢𝘤𝘵𝘪𝘧𝘦𝘳𝘰𝘶𝘴 𝘴𝘪𝘯𝘶𝘴 𝘸𝘩𝘪𝘤𝘩 𝘴𝘦𝘳𝘷𝘦𝘴 𝘢𝘴 𝘢 𝘳𝘦𝘴𝘦𝘳𝘷𝘰𝘪𝘳 𝘧𝘰𝘳 𝘮𝘪𝘭𝘬.’ ⁣

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Until very recently, there have been very few doctors who specialise in the lactating breast and how it functions. Thankfully things are changing: the breast surgeon Katrina B. Mitchell is also an IBCLC lactation consultant. Her ideas on how to treat blocked ducts and mastitis, and nipple blebs, have transformed current guidance. Hopefully more will follow in her footsteps and give this important subject the attention it deserves.⁣

Links

https://www.rnceus.com/Breast_in_situ/Revised.html

https://www.researchgate.net/publication/7782076_Anatomy_of_the_lactating_human_breast_redefined_with_ultrasound_imaging

https://www.researchgate.net/publication/6176773_The_Lactating_Breast_An_Overview_from_Down_Under ⁣