This image from the Holy Family Support Group captures the peer-to-peer organization of mother-to mother support groups like La Leche League.
A survey of literature over mother-to-mother and maternal support groups reveals that there is currently scholarship dedicated to examining maternal support networks, but much of the effort in this area is done in the health care related fields rather than in English Studies. Much of that work focuses on what makes such support networks successful and how and why mothers benefit from such networks. Karen Youens, Debbie Chisnell, and Di Marks-Maran explore a case study of a mother-to-mother breastfeeding group in the UK in order to examine the effectiveness of such a support organization. While they found the group to be effective, one of their most interesting findings is that the institution of the program, while it provided effective peer support, resulted in the establishment of a broader network of other support organizations. It seems that an unexpected result of the network is that exigencies for new and related organizations were revealed. Ellen L. Lipman et al. discuss a mixed-methods study that they conducted in order to examine the outcomes for single mothers utilizing support organizations. Before utilizing these support groups, many single mothers’ felts isolated and had poor coping skills, while membership in support groups gave many women self-esteem, support, confidence. They found that these outcomes mirrored outcomes from group psychotherapy sessions. María José Rodrigo and Sonia Byrne explored two types of support networks for mothers: informal and formal. They examine the mothers’ satisfaction with the support and the relationship of that satisfaction to their personal agency. They found that non at-risk mothers tended to have more informal support, while at-risk mothers relied more on formal support. Informal support includes private exchanges, are part of the natural framework surrounding mothers, and often includes mutual assistance in which individuals who respect each other may give and get help, community. Formal support usually comes in the form of unidirectional meetings and involves strict protocols. Formal support agencies include social services, volunteer associations, neighbors, child protection agencies, and law enforcement. Mothers who seek formal support are more likely to help form formal support agencies. Rodrigo and Byrne sought to explore how the agency of mothers was impacted by these types of support, and they found that women who utilized informal support had more self-efficacy defined as “individual judgment about how well a person can carry out the necessary steps to deal with a specific task or challenge” (14). Mothers who had informal support networks had more self-efficacy in the form of self-confidence. Mothers who had formal support networks had less self-efficacy because the support offered by the organizations was unidirectional and resulted in vulnerability, intimidation, and humiliation. Such support was also stigmatizing. Mothers utilizing formal support networks feel that they have less agency and often give up sooner than mothers who use informal support. Nancy Mohrbacher and Sharon Knorr also explore with the self-efficacy of mothers. Lack of experience with breastfeeding, whether firsthand or via observing other mothers breastfeeding, negatively impacts a mother’s agency and success in breastfeeding. Mohrbacher and Knorr claim that that mother-to-mother breastfeeding support groups offer “vicarious experience” which positively impacts their self-efficacy, making them feel that they can be successful at breastfeeding.
Carnation baby formula advertisement.
Some articles frame LLLI as a node within a network. This network includes those with an interest in infant feeding, including medicine, science, and manufacturing industries. Jennifer M.C. Torres, does not specifically examine LLLI, but her scholarship does shed some light on work that LLLI does. Torres explains in the article that lactation consultants “provide a unique lens for the complexity of medicalization because they are positioned at the crossroads of medicalization and demedicalization. The IBCLC certification originated from a combination of breastfeeding advocacy groups that resisted medicalization of breastfeeding and the contemporary medicalization of breastfeeding that emphasizes the nutritional properties and health benefits of breast milk” (165). Some lactation consultants create or lead breastfeeding peer-to-peer support groups (such as LLLI groups) in which medical control is challenged “by providing a setting that values breastfeeding women’s experiential knowledge” (163). Lactation consultants, in order to demedicalize breastfeeding, must also medicalize it since they operate within the realm of medicine, often working at hospitals. Much of LLLI’s work seems to be focused on developing mothers’ autonomy and challenging the medicalization of breastfeeding, which has resulted in views of breast milk as a product (163), the technological management of breastfeeding (164), and frequent dissemination of misinformation of breastfeeding by medical professionals (164). The concept of breast milk as a product is so pervasive in medicine and science that Kate Boyer was able to use it to “propose a new framework for how geographers might conceptualize mobile biosubstances” (np.). Unlike lactation consultants, LLLI does not have to walk a fine line between demedicalizing and medicalizing breastfeeding. Amy Koerber explains that, “In the words of one La Leche League leader, to breastfeed a baby in U.S. society a woman has to ‘buck the system’” (93). According to Koerber, “By consulting La Leche League, which resists mainstream medical discourse as well as broadly accepted social and cultural norms, a woman is empowered to resist the cultural norm that forbids public breastfeeding” (97). So, it is clear that what LLLI offers to breastfeeding mothers is the ability to resist the way in which medical discourse and the focus on breast milk as product has framed the nursing mother and the breastfeeding relationship.
Lactogen. Like mother’s breast milk, but better…
The success of mother-to-mother support groups, the outcomes for the mothers, and maternal agency are the primary foci of the studies that were conducted in these articles. Examining LLLI’s organization, it’s foundations, it’s operation as a network, and the rhetoric that it produces through the lenses of Bitzer and Vatz’s theories of rhetorical situation, Bisecker’s response to the Bitzer and Vatz debate, and Thomas Rickert’s theory of ambient rhetoric, can provide a more complex understanding of the way in which mother-to-mother support groups form, grow, and change as the result of the use of rhetorical strategies and the agency that rhetorical strategies allow to various network nodes.
In order to begin understanding how LLLI is an important object of study in rhetorical studies, it is useful to examine the way in which the formation of the organization can be viewed as a rhetorical action. In rhetorical theory, there is often an exigence that is viewed as a starting point of a rhetorical situation. For Bitzer, the exigence is the cause of the rhetorical action. The founders of LLLI claim that they formed the organization in order to provide support and guidance to mothers at a time when the rate of breastfeeding was low and the medical establishment had a preference for formula. According to Amy Koerber, the field of medicine at the time viewed breast milk as a foundation upon which formula could improve. The role of the rhetor is to simply report the exigency to the audience. The rhetor has no agency. This doesn’t seem to be likely in the case of LLLI, however, since the founding members were stakeholders in the formation of the organization. While rhetorical action is the goal of rhetoric, and only those who are capable of taking such action are the audience of rhetoric, other parties do play a role in the network. People, events, objects, and relations all constrain the decision-making process and the ability to act. The women who founded LLLI were nursing mothers at a time when breastfeeding was not the preferred method of infant feeding. To take rhetorical action, the women who wanted to nurse had to navigate a society that looked down upon breastfeeding. Their families, their doctors, their friends, and the expectations of society more broadly, all constrained their ability to act. LLLI helped women take rhetorical action by supporting them in their decision to breastfeed and by giving them information. If we were to map the network according to Bitzer’s approach, the central node in the network would be the rhetorical situation. Most movement from this mode is outward, except for the possible alteration of the situation by the audience. The situation is not changed by the rhetor, as the rhetor as a node simply reports on or spreads information about the situation to the audience, who receives the information and does not transform the information, but simply acts to change the situation via a rhetorical act. What moves in the network is primarily information. This, in turn, may bring about a change in the rhetorical situation by sparking rhetorical action It seems that the network dies here, and may begin all over again with the altered rhetorical situation. One primary problem with Bitzer’s approach is that it seems to rule out the idea that the organization could be taking rhetorical action rather than simply passing on information to women who will then take rhetorical action. LLLI aimed to help these women by taking action on the exigence of the lack of support for breastfeeding mothers. LLLI is both the rhetor and an actor in this rhetorical situation, but there is more to the network than this. There is a type of support network that resembles Bitzer’s organization more closely: the formal support network that Rodrigo and Byrne discuss. These organizations seem to offer only a top down flow of information, and often the organizational rhetoric is presented as the one truth rather than an interpretation. These approaches give the audience little agency except to act or not act on the situation with the action that the rhetor prescribes.
Vatz’s theory of the rhetorical situation seems a bit more promising that Bitzer’s when used to analyze the rhetorical situation of the mother-to-mother support network. According to Vatz, the rhetor decides what is a rhetorical situation by deciding that there is an exigence that needs to be addressed; therefore, the rhetor is not neutral. LLLI decided that the low rate of breastfeeding and lack of support for mothers is an exigence. While formula was broadly preferred, these women felt breastfeeding was optimal. The medical discourse of the time suggested that need for breastfeeding support was not a clear exigence, since it was believed formula could improve upon breast milk (Koerber). Vatz says that rhetors cause a situation to be salient and translate it into meaning. The LLLI founders made the situation salient, and they did not operate as neutral rhetors. They were all stay at home mothers, so the arrangement of the organization and the advice that that the organization provided was tailored for stay at home mothers. According to Vatz, it was the action of these women in creating the organization that created a rhetorical situation. LLLI began producing materials about breastfeeding, the choice of language that was used in publications like The Womanly Art of Breastfeeding was in no way neutral. Even the choice of the phrase “womanly art” was not neutral. At a time when formula was viewed as preferential by the medical establishment, mothers chose formula in order to give their children the best infant-feeding option, and breast milk was studied as a disembodied fluid, the choice of the phrase “the womanly art” crafts a statement about breastfeeding. The audience, who does not necessarily have to be only those who are capable of action, receives the situation via the meaning that was crafted by the rhetor. The audience of LLLI was primarily mothers, but others could also learn from the rhetoric of LLLI. A map of the LLLI network based on Vatz’s approach differs from Bitzer’s approach primarily because of the idea that those involved in the network are not neutral. According to Vatz’s approach, the central node in the network would not be the rhetorical situation, but the rhetor’s perception of the rhetorical situation. Like Bitzer’s approach, most movement from this central node is outward. What is conveyed by the rhetor to further nodes in the network is the rhetor’s perception of the event or situation. The rhetor’s choice of words or language is an interpretation of the situation and is therefore not neutral. This perception is received by the audience, who then may or may not act on it. Like Vatz’s approach, the network may start all over again once the audience receives the information and acts on it. Though there are some changes in the central node, the organization is still primarily hierarchical from the top down.
While Bitzer and Vatz discuss various nodes in the network of LLLI, both of their approaches to rhetorical situation seem to leave something out of the discussion of the links or relationships between various nodes in the rhetorical network, such as that of the mother-to-mother breastfeeding support group LLLI. Biesecker pushes back against the notion that either an “objectively identifiable and discrete situation or an interpreting and intending subject” provide the foundation for rhetorical discourses. She says that differánce is a catalyst for the rhetorical discourse. Biesecker says that every element in a system, such as the symbolic act, “is a function of its place in an economy of differánce” (118). Biesecker’s approach makes the network much more complex, since difference is everywhere in the network. Biesecker’s theory of the rhetorical situation is different because there are many more opportunities in the network for perception of various nodes to affect the network. Biesecker says that “neither the texts’ immediate rhetorical situation nor its author can be taken as simple origin or generative agent since both are underwritten by a series of historically produced displacement” (121). The network is not so simple to map here. If difference is the origin of the rhetorical situation, then the central node in this network may perhaps be the conflict caused by the competing agendas of the medical establishment that was in favor of formula and the mothers who founded LLLI, who found value in breastfeeding their children. The relationships between the nodes are much more complex, like the interweaving of texts that Biesecker mentions. Another thing that Biesecker brings to the conversation is the idea that the audience plays a much more complex role in the network than Bitzer and Vatz recognize. Biesecker says that the individuals in a network, who all have complex backgrounds and cannot be viewed as having fixed identifies, are influenced by and influence the network. There is no central, fixed subject. In fact, “Like any other object, the subject is a historical construct precisely because its ‘unique’ and always provisional identity depends upon its operations within a system of différences and the larger movement of différance: the subject is neither present nor “above all present to itself before différance’” (125). So the subject is not fixed, but provisional, meaning that the subject is a product of identification in the moment and space; it is fluid and changing. This means that we should “see the rhetorical situation as an event that makes possible the production of identities and social relations” (126). The concept of différance “obliges us to read rhetorical discourses as processes entailing the discursive production of audiences, and enables us to decipher rhetorical events as sites that make visible the historically art” (126). We could build on a map of Vatz’s rhetorical network by starting out with a central conflict or difference, that is interpreted by the rhetor, who has a complex background and reports the situation through an interpretation. According to Vatz, that rhetor, in this case the organization itself, is the only one who is identified as having agency in the network of LLLI. The complexity of Biesecker’s rhetorical organization allows for more agency by various nodes in the network. Support networks organized in this way show more potential for peer-to-peer support, as found in informal support networks that seem to give more agency to individual mothers than in formal top-down organizations.
By introducing Biesecker’s concept of différance into the discussion of LLLI, we can see that it is likely that it was not a single event but a series of events or displacements that prompted the original founders to form LLLI. Breast milk was displaced as the ideal infant food, embodied feeding at the breast was displaced in favor of feeding with a bottle, and maternal knowledge resulting from “vicarious experience” was displaced in favor of the detached clinical knowledge of the medical establishment. These elements act as historically produced displacements that contribute to the origin of LLLI’s rhetoric. The audience of LLLI’s rhetoric was constructed of that particular moment in time. LLLI perceived the audience of that to be stay-at-home mothers who were married to a male breadwinner. The identity of the audience relied on the dominant system. The ideal family structure was a married heterosexual couple. Because formula feeding had become so popular, and was preferred by the medical establishment, it was likely that the audience, the subject, may have had no direct experience with breastfeeding. LLLI tailored the rhetoric, and in fact constructed a view of the situation, in response to the historical displacements listed above and to elements of the dominant cultural system. The Womanly Art of Breastfeeding, LLLI’s breastfeeding manual, was constructed to reach this audience, as it has been constructed by the audience. This enduring construction of the audience of LLLI’s rhetoric continued in subsequent editions of the manual despite changes to the social fabric of American society. Despite the 1990s publication of a series of feminist critiques of the anti-feminist nature of LLLI’s rhetoric, even the 5th (1991), 6th (1997), and 7th (2004) editions contained an introduction that continued to state that the ideal audience of the manual consisted of women married to a breadwinner and the manual included a chapter on fatherhood. The manual had, thus far failed to adapt fully to the new displacements caused by societal changes, and the organization had failed to see the way in which it had contributed to or been implicated in the displacement of women who did not met the characteristics of the ideal LLLI mother. Women who did not fit this mold and who depended on advice from LLLI as a knowledgeable organization operated by mothers potentially felt that they had less autonomy and agency than those mothers that LLLI addressed themselves to, in part because LLLI did not give advice to help them with their situations. It wasn’t until the 8th edition was published in 2010 that LLLI began to re-envision its audience and address itself to all women, regardless of sexuality, marital status, economic status, and employment status. (Elements of the original preference for these characteristics of the intended audience were still evident, however.) If it had failed to begin adapting, then the changes in society may have contributed to the organization’s decline.
Bitzer, Vatz, and Biesecker have differing theories about the origin of the rhetorical situation.
While Biesecker allows us to understand the rhetorical situation as being based on differences caused by displacement, Thomas Rickert’s notion if ambient rhetoric allows us to build on what we gain from Biesecker because it looks beyond the notions of difference and displacement to understand the way in which all elements of the ambient environment contribute to the development of rhetoric. By attuning to the ambient environment, we begin to understand that agency does not belong only to humans. Indeed, objects also have agency. Rickert asserts that the world is not simply a world of involvements, but that the world is itself involved in involvements (162). He proposes a new definition of rhetoric: “rhetoric is a responsive way of revealing the world for others, responding to and put forth through affective, symbolic, and material means, so as to (at least potentially) reattune or otherwise transform how others inhabit the world to an extent that calls for some action (which can include, of course, steadfastness, refusal, or even apathy)” (162). So rather than simply persuading others, Rickert suggests that the use of rhetoric reveals our being in the world and asks us to do something in response to our being in the world. Ambient rhetoric harkens back to Mohrbacher and Knorr’s claim that mother-to-mother breastfeeding support groups offer “vicarious experience” which positively impacts their self-efficacy, making them feel that they can be successful at breastfeeding. By creating an ambient environment in an informal support network meant to welcome breastfeeding mothers and offer them “vicarious experience” with breastfeeding, LLLI is practicing a rhetoric of ambience.
Detail from The Three Ages of Women c. 1905
Concepts that have been ignored, such as the chora, which shows “how ideas and world come together a grace us with a powerfully destabilizing concept that unseats the dichotomy between nature and artifice,” (56), and the role of place in kairos, are vital to an understanding of rhetoric as ambient. Rickert’s discussion of kairos and the problem posed by the traditional rhetorical understanding of kairos, that it is concerned with time and decorum, rather than place, allows us to examine the role of space in the rhetoric of LLLI and breastfeeding in general. Rickert says, “I am trying to embed kairos more concretely in place, to see what happens when we attend to kairos’s material emplacement and unfolding and not just timeliness or decorum. I argue that without a more materialist understanding of emplacement, kairos is an empty concept” (76). To understand the way on which place plays an important role in LLLI’s rhetoric, it’s helpful to turn to an example of the way in which the concept of space contributes to developing a rhetorical construction of breastfeeding. In “Legally Public but Privately Practiced: Segregating the Lactating Body,” by LM Rose, explores the way in which the location of the lactation room on the campus of Ohio University frames the lactating body as other. I would argue that the action of the university of establishing a lactation room was as rhetorical as it was practical (if not more so). Rose’ article explores the othering that results from placing the only single occupant lactation room on the university campus in a remote area far away from faculty offices. Of course, one could argue that the establishment of a lactation room at all is a positive sign of the normalization of breastfeeding, but is it enough that it exists? What about where it exists within the context? Who has access to it? Certainly the decision to establish a lactation room was timely and considered to be appropriate, but it seems likely that those involved in the establishment of the room did not consider the implications of the location of the room. The establishment of the room itself seem progressive and a woman and mother-centered act, but when we examine the place of the room, we see that it plays a large role in the queering of the breastfeeding body. So what does this example of the kairos of place reveal about the rhetoric of LLLI? Depending on the place of the act of breastfeeding, it may be considered a purely nurturing act, or it may be considered an act of defiance (such as at a nurse-in). When LLLI meetings are held in a home, which is most often the case, the suggestion is that breastfeeding belongs in the realm of domesticity. When LLLI meetings are held outside in parks, as has sometimes been the case, the suggestion is that breastfeeding belongs in the public realm. The space of the organization is a critical node in the network.
LLL of Greenwich Stamford holds a meeting in a park.
Rickert’s theory and the discussion of materiality provides an excellent way to explore the way in which things (the bottle and the breast pump) have had an absolutely vital role in the rhetoric of breastfeeding. Bitzer, Vatz, and Biesecker didn’t really address the agency that belongs to non-living things. The quote above makes it clear that things play a significant role in making rhetoric possible, and this is certainly the case for LLLI’s rhetoric surrounding breastfeeding and attachment parenting. In fact, we could argue that technological innovations (formula, the bottle, the pump), necessitated LLLI’s argument, since these innovations made it possible for non-mothers to feed an infant. (Certainly manual expression and wet nurses also made this possible, but it became incredibly easy with these innovations.) LLLI was formed at a time (1956) when formula was preferable to breast milk because it was believed that formula could improve upon breast milk, and the scientist studying breast milk were often applying what they learned about breast milk to the improvement of formula. The properties and value of breast milk was being examined in a disembodied way. They were effectively divorcing the ambient environment of infant feeding from the act of feeding, and it was in part this loss of the non-food properties of the breastfeeding relationship (one of the displacements that caused the seven founders of LLLI to come together to share their experiences and understandings of breastfeeding).
The core philosophy LLLI is contained within ten statements that emphasize the benefits of breastfeeding:
- Mothering through breastfeeding is the most natural and effective way of understanding and satisfying the needs of the baby.
- Mother and baby need to be together early and often to establish a satisfying relationship and an adequate milk supply.
- In the early years the baby has an intense need to be with his mother which is as basic as his need for food.
- Breast milk is the superior infant food.
- For the healthy, full-term baby, breast milk is the only food necessary until the baby shows signs of needing solids, about the middle of the first year after birth.
- Ideally the breastfeeding relationship will continue until the baby outgrows the need.
- Alert and active participation by the mother in childbirth is a help in getting breastfeeding off to a good start.
- Breastfeeding is enhanced and the nursing couple sustained by the loving support, help, and companionship of the baby’s father. A father’s unique relationship with his baby is an important element in the child’s development from early infancy.
- Good nutrition means eating a well-balanced and varied diet of foods in as close to their natural state as possible.
- From infancy on, children need loving guidance which reflects acceptance of their capabilities and sensitivity to their feelings.
Several of these statements reflect the idea that breastfeeding is relational, that it is an ambient environment in which the mother nurtures the child.
Innovations in objects related to infant feeding (bottles, breast pumps, and formula) as well as innovations in food storage made it possible to view infant feeding as purely nutritive rather than also nurturing. Much of LLLI’s rhetoric centers around countering the affordances that infant-feeding related objects provide. LLLI’s rhetoric is not solely crafted to convince mother’s that breast milk is superior to formula, but also that the mother-child relationship created through the bond of breastfeeding is as important as the nutritive value of breast milk. Formula necessitated attention to the components of breast milk and the nutritive value; breast pumps, which allow women to work outside the home and leave their babies, underscore the idea that breast milk is disembodied. This necessitated LLLI’s argument for attachment parenting and the need of the child for the mother. The bottle necessitated the “back to the breast” rhetoric that explains that bottles result in nipple confusion.
Avent Isis breast pump and bottles kit. Objects necessitating (or making possible) LLLI’s attachment parenting rhetoric.
A rhetorical analysis of changes between the 5th, 6th, 7th, and 8th editions of The Womanly Art of Breastfeeding, reveals that in earlier editions, LLLI seemed reluctant to address the use of those objects (bottles, pumps, formula supplements) that make it’s rhetoric necessary. In fact, the 5th edition encouraged mothers to have babysitters give a few bottles as possible so that the baby would want to nurse from the mother’s breast when she returned home from work. Later editions dropped this advice. Some later editions, particularly the 8th, gave advice for using a bottle and pumping milk. This was important for LLLI because by ignoring the objects that necessitated their rhetoric in the first place, the rhetoric of LLLI created an either/or dichotomy: either you feed your child our way, or you don’t. By discussing how to use the objects in support of a mother-child relationship that, as closely is possible for the particular mother and child, resembles the one espoused by LLLI, the organization provides a middle way for mothers who must work.
Packaged donated breast milk. According to Boyer, donated breast milk is sold to hospitals for $35 an ounce by Prolacta.
Through this rhetorical exploration of the network of La Leche League International, we can see the way in which the organization was formed when the founders recognized displacements causing différances between what the dominant discourse regarding infant feeding, which valued disembodied infant feeding with formula, and the lived experiences and values of mothers who believed that in addition to providing optimum nutrition, breastfeeding is a relationship between the mother and child. These différances deterred some women from breastfeeding, while others sought support through vicarious experience, so the rhetor’s responded by taking rhetorical action in forming the LLLI network and by employing rhetoric to convince mothers that breast feeding is the better choice. In addition to différances, many other elements of the ambient environment contribute to the need for rhetoric and rhetorical action regarding breastfeeding support. While other theories of networks, such as Manuel Castell’s social network theory and Deleuze and Guattari, can help us understand how such support groups operate, rhetorical situation theories and ambient rhetoric help us understand who has agency in the LLLI network, how the network forms, and how it may eventually dissipate.
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