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E-book Banking on Milk : An Ethnography of Donor Human Milk Relations
Donor human milk banks are expanding around the world at an exponential rate, which is directly linked to global increases in premature births. The importance of human milk for prematurely born infants has been extensively identified, even among the recent social scientific work that has questioned the efficacy of human milk and health considerations. In addition, research also shows that a significant percentage of these mothers, at least initially, experience lactation problems. Europe is taking a leadership role in the expansion of human milk banks, although issues associated with alcohol consumption and maternal donations are a concern for clinicians and healthcare staff, given the increasing problems associated with drinking among women of childbearing age. The UK with its long history and current global leadership role is an ideal place to study these considerations, which will inform these larger issues of human milk for the prematurely born infant. The country is a leader in this century-old intervention, supporting not only one of the oldest hospital-based banks in Europe but also an important cross-border collaboration on the island of Ireland, along with a research-based national bank in Scotland, each representing different cases contributing significantly to the re-birth of the medical control of human milk. The UK is poised to offer the world vital information regarding donor human milk banking, maternal bodies and “trust”. An important psycho-social theoretical concept is used to frame the triangulated data collected (including interviews, archival data and ethnographic information). In supporting an excellent experienced female researcher to return to the academy following a maternity/career break, this work directly supports women and science in society. Our EU Horizon 2020 project was called MUIMME, an old Irish word for wet nurse. Certain research topics are chosen because of an urgency of societal need; others are chosen because of their intellectual fascination. Donor human milk services involve both, insofar as they are a response to a large-scale, life-saving intervention with massive public policy implications and at the same time a theoretically complex reflection on what it means to be a woman as well as a mother, thus provoking larger social and cultural questions regarding what it means to be a social being. Milk donation provokes philosophical debates about the limits of personhood and the extent to which something one produces is something one owns. Nor do these philosophical issues function in rarefied isolation from public policy debate. Central to the recruitment of milk donors is a public awareness campaign that confronts and addresses the so-called ick factor – a gut reaction to an unfamiliar reconfiguration of maternal responsibility which activates (and re-activates) alternative economic models of reciprocity and exchange.1 The normalizing of human milk exchange practices in various parts of the world suggests that specific ideological formations are responsible for determining what is “instinctively” felt to be natural or unnatural at any given time within any given society. This book demonstrates that even so-called hard sciences, such as immunology, can profit from insights drawn from anthropology and sociology, and that the future of human milk studies needs to become genuinely transdisciplinary (Hassiotou et al. 2015). Whether milk is regarded as a biological resource, a nutritional necessity, or a symbol of relational exchange, a holistic research response is required. To understand human milk banking is to understand ties that bind, envisioning the maternal not only as a biological state but also as a strong yet flexible societal value and much of what it means to be human in a world that is ancient and modern at one and the same time. The mission of anthropology is to make the strange familiar, and the mission of sociology is to make the familiar strange.2 In either case, the constructed quality of that which is assumed to be “natural” emerges. Milk banks are fascinating from a theoretical point of view because they are at one and the same time “natural” and “scientific”. Milk banks, especially research milk banks – expand the frontiers of so-called hard science while at the same time affirming (in the words of one milk bank manager) that “it’s not rocket science”. Milk itself is at one and the same time a known and unknown substance. There is no such thing as a “milk group”, and for millennia, infants have relied on milk from someone other than their birth mothers in order to survive. Yet at the same time, the specific genetic properties of human milk, as encoded at a cellular level, are yielding ever newer discoveries. Historically, this paradox has been exploited above all by formula milk companies themselves, who have, strangely but logically enough, expanded the knowledge base of what is supposedly good, healthy and “natural” about human milk in the very effort to synthesize and supersede it.
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