RESEARCH

 

Ubuntu lactivism: An Afri-centric approach to breastfeeding activism

 

 

M Seabela

BSc Diet, MSc Med (Bioethics and Health Law), PhD; Department of Philosophy, Practical and Systematic Theology, The University of South Africa

Correspondence

 

 

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ABSTRACT

Breastfeeding is considered a key strategy in reducing infant mortality rates and is therefore recommended by international organisations, such as the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). In addition to effectively reducing infant mortality rates, breastfeeding offers health benefits for the mother and is considered economical and environmentally friendly, benefiting society as a whole. Despite all these benefits, there exists a perception that breastfeeding in public constitutes a lewd act and is therefore immoral. This perception has led to unfair discrimination against mothers who breastfeed in public, which we argue violates their right to autonomy and deprives their children of the right to basic nutrition.
We propose Ubuntu lactivism as a movement to protect and advocate for the rights of women who want to breastfeed to be able to do so anywhere and at any time without prejudice or obstacles. Ubuntu lactivism is an activism movement advocating for the right to breastfeed, founded on the philosophy of Ubuntu, which emphasises our interconnectedness and our interdependence as a society. Through this philosophy, we are also encouraged to unite according to the Sepedi aphorism: 'tau tsa hloka seboka di sitwa ke nare e hlotsa, meaning if we are divided in the fight against infant mortality and low exclusive breastfeeding rates, we will likely lose the battle.
The primary objective behind Ubuntu lactivism is to desexualise breastfeeding and advocate for the mother and her child's rights to breastfeed on demand, which means anywhere and anytime without prejudice or hindrance.

Keywords: Ubuntu lactivism, breastfeeding, sexualisation, commodification, infant mortality, breastfeeding rights.

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Breastfeeding in public is often a subject of moral contention, despite its health and economic benefits. The controversy stems from a liberal perception that views female breasts as organs of sexual pleasure. Consequently, breastfeeding is also misperceived as a sexual act, leading to its condemnation when performed in public. This perception is problematic, given the proven benefits of breastfeeding supported by scientific evidence, which promotes it as a key strategy for reducing infant mortality rates.

According to systematic reviews conducted by the World Health Organization (WHO), breastfeeding has short- and long-term health effects. It reduces the risk of hospitalisation owing to respiratory infections and death from complications related to diarrhoea in the first 2 years of life. Additionally, it reduces the risk of developing chronic diseases such as hypertension later in life.^[1,2] With a decrease in hospitalisations and the burden of chronic diseases on the health system, promoting breastfeeding leads to economic benefits. Given these long-lasting benefits, breastfeeding should be regarded as a moral imperative. As a life-saving strategy and a fundamental form of nutrition for infants, it should be regarded as a human rights issue. Therefore, mothers have a moral imperative to breastfeed their babies to improve their survival chances and reduce the chances of hospitalisation, while society and government have a moral imperative to protect 'the basic rights of the mother and child to breastfeed for their health and well-being, as well as those of the nations in which they reside'.^[3]

South Africa (SA) has made significant strides in supporting, protecting and promoting breastfeeding since the adoption of the Tshwane Declaration in 2011, through the implementation of regulations and policies. Traditional leaders, traditional health professionals, non-governmental organisations and civil society, as participants in the national breastfeeding consultative meeting that adopted the declaration, must play a greater role in activism for the promotion of breastfeeding as a human right. Despite efforts to increase exclusive breastfeeding, which is reported to be around 32%, and reduce infant formula use, there has been a sharp increase in the sales and use of infant formula in SA over the last few years.^[4,5] In attempts to curb the rampant marketing and increased consumption of infant formula in SA, which undermined efforts to increase the exclusive breastfeeding rate, the government restricted the marketing and promotion of infant formula by introducing regulation R991 of 2012. R991 prohibits the direct marketing of breast milk substitutes to the public and prohibits formula manufacturers from sponsoring health events. SA hospitals no longer dispense or issue infant formula for HIV-exposed infants and many of them have been accredited by the Baby-Friendly Hospital Initiative (BFHI). The BFHI is a policy by the WHO and the United Nations International Children's Emergency Fund (UNICEF) to help member states achieve Goal 3 in the Sustainable Development Goals (SDG). In addition to this, SA celebrates and commemorates Breastfeeding Week, which is the first week of August each year, where the public is taught about breastfeeding and encouraged to practice exclusive breastfeeding. Owing to maternity leaves often being only 4 months long, while exclusive breastfeeding is recommended for 6 months, the Department of Labour has introduced a policy encouraging employers to give breastfeeding employees two 30-minute breaks to breastfeed or express breast milk so they can continue with exclusive breastfeeding for 6 months.

As per the Tshwane Declaration, the government is doing its part to increase exclusive breastfeeding, now civil society needs to also fulfil its responsibility, which is advocacy and creating an enabling environment for exclusive breastfeeding. SA, being a racially and culturally diverse country, requires an activism movement that will bridge these differences and provide a unified voice, which we propose should be Ubuntu lactivism.

 

Discussion

Traditionally, in African communities, breastfeeding has been the acceptable and most preferred method of infant feeding even before it was promoted by organisations like the WHO and UNICEF.^[6] Breastfeeding was not only perceived as a superior infant feed, but African people also attributed metaphysical significance to it, considering it sacred and deserving of protection. Given the beliefs and superstitions around breastfeeding, such as the fear of breast milk being contaminated by evil spirits or cursed, certain herbs and concoctions are used to protect this practice.

Conceptualisation and proposed role of Ubuntu lactivism

Ubuntu lactivism is an Afri-centric social activism movement aimed at advancing and advocating for the right to breastfeed and to be breastfed in public, founded on the principles of the Ubuntu philosophy. The term Afri-centric is preferred in this movement over the conventional Afri-centric because the latter is associated more with African-American roots, while the former is rooted more in the African continent like the philosophy of Ubuntu.^[6]

Activism refers to 'action on behalf of a cause that goes beyond the conventional or routine'.^[2,7] This action is by individuals who represent the interest of a group in society that is often marginalised, or their rights poorly advocated for. On the other hand, the word lactivism refers to a set of 'activism' practices carried out by breastfeeding women that are portrayed through openly breastfeeding, either online or publicly.^[7] According to Stearns,^[8] lactivism should be taken to mean a set of actions or practices that epitomise breastfeeding conducted by breastfeeding mothers or women and demonstrated through breastfeeding.When expanded upon by other scholars and writers, lactivism refers to activism where mothers openly breastfeed in public spaces or online by posting breastfeeding or expressing selfies in protest of negative commentary, imagery or mistreatment of breastfeeding mothers by certain facilities.^[9] In this paper, lactivism should be taken to mean any action that promotes breastfeeding in public or protests the unfair discrimination towards breastfeeding mothers by persons or establishments, which could be done by breastfeeding mothers themselves, or any individual or organisation either online or in person. The action can include but is not limited to: mothers breastfeeding in and around establishments that seek to discriminate against breastfeeding in public; posting breastfeeding selfies with a positive hashtag promoting breastfeeding; or sharing positive images about breastfeeding to advocate for the right for mothers to breastfeed in public, which can also be done through reposting or resharing the hashtag breastfeeding selfies; boycotting public spaces that allow the harassment of mothers who breastfeed in these spaces to take place unopposed, aiming to encourage them to implement breastfeeding friendly policies.

Ubuntu lactivism should be taken to mean an Afri-centric public health activism movement for the support, promotion and protection of the right to breastfeed anywhere and anytime, which is rooted in the principles of communitarianism, humanness, reciprocity and solidarity.

Ubuntu is a Nguni word that is synonymous with many other African languages and translates to 'humanness' in English.^[10] Ubuntu is an African worldview or philosophy based on the principles of communitarianism, humanness, reciprocity and solidarity, which is a contrast to the individualistic utilitarian nature of modern Western philosophy.^[11,12]

Breastfeeding in public is generally accepted in many African communities, thus activism may not be deemed relevant. However, in a culturally diverse society like SA, where European values are also present, there is a likelihood of a cultural clash. The colonial and apartheid systems sought to displace African cultural values by replacing them with Western or European values. For instance, breastfeeding in public is often regarded as lewd and taboo by Western/European culture, which resulted in the introduction of the Immorality Act of 1957. This Act prohibited the public display of female breasts, particularly the nipples, without exempting breastfeeding. In a post-colonial/apartheid country, the cultural values of previously oppressed groups may not be fully restored, thus requiring additional support in addition to amendments to the constitution and other legislative frameworks as already implemented. Currently, the Immorality Act of 1957 was replaced by the Sexual Offences and Related Matters Act of 2007, which still prohibits the public display of female breasts and does not make an exemption for breastfeeding purposes.

The failure to amend the Sexual Offences and Related Matters Act continues to give the impression that breastfeeding in public is an offence in SA, which as per the Western cultural values, makes it seem that normative African practices like breastfeeding in public are frowned upon. It is for this reason that there is a need to introduce an African-centred approach to the activism for the right to breastfeed in public because if the discrimination against breastfeeding in public continues unchallenged, the African community will be mostly affected as the traditional African way of life promotes breastfeeding as evidenced by their traditional dress code, where toplessness is a norm in most of the cultures.

The colonial and apartheid regimes in the past, together with the recent coerced assimilation into the Western culture through the media and entertainment industry, continue to undermine the African way of life that allows and promotes breastfeeding even in public. It is therefore fitting that attempts are made to salvage and restore cultural values and practices that are crucial for the common good of society. Non-conventional methods must be employed to campaign against the coerced imposition of the Western culture, which is deeply rooted in the sexual commodification of the female body, thus creating a perception that innocent and non-sexual acts like breastfeeding are immoral or unacceptable. This paper contends that Ubuntu lactivism, rooted in the spirit of communitarianism and contrasting with the Western liberal way of life, can unite the country in respecting the rights of mothers to breastfeed in public freely and safely.

Ubuntu lactivism therefore calls for several legislative and societal changes: (1) Legislators should amend the Sexual Offences and Related Matters Act to explicitly exempt breastfeeding in public from the Act, (2) Public and privately owned spaces that accommodate mothers and their infants should have policies that protect mothers who breastfeed in these spaces while prohibiting anyone from interfering with their breastfeeding; and (3) Breastfeeding imagery should be normalised and uncensored by promoting family shows that depict acts of breastfeeding on television. Additionally, breastfeeding campaigns should include posters and billboards depicting mothers breastfeeding to normalise and destigmatise the practice.

Why public breastfeeding requires activism

We suggest that breastfeeding is a human rights issue that requires protection and advocacy for the following reasons:

1. Despite the overwhelming scientific evidence, there are still negative perceptions of breastfeeding, particularly when done openly in public spaces. It is not uncommon in contemporary Westernised society that women's breasts are perceived as mere sexual organs, a perception which sexualises an innocent and life-saving practice act such as breastfeeding. The sexual commodification of women's bodies, in this instance their breasts, may make men less comfortable with accepting their reproductive functions such as breastfeeding.^[13] Looking at women's bodies as sexual commodities is very troubling and individualistic, as it is driven by self-gratification with little to no regard for how this will impact other people, such as women and children. In mitigating the threat to breastfeeding freely in public posed by the individualistic culture of sexually commodifying women's breasts, an Ubuntu-centred approach to this problem is warranted. The primary objective of this movement is to protect the right to breastfeed and to breastfeed on behalf of the vulnerable who have been marginalised and deprived of a voice. The other objective is to desexualise breastfeeding and promote it as a natural, safe, sustainable, healthy and environmentally friendly act of nurturing a child.

2. Public health messaging on breastfeeding has proven effective in teaching the public about the benefits of breastfeeding, the duration of exclusive breastfeeding and how to maintain lactation even when the mother is separated from her infant during certain hours of the day. What is lacking from this is content aimed at desexualising and normalising breastfeeding in public, and also calling for the public to support mothers who do and have to breastfeed in public by creating a conducive space, thus bringing into the picture public involvement for the greater good of society.

Ubuntu lactivism is an activism movement that acknowledges our interconnectedness as a society and can help unify the voice of support. Ramose^[14] argues that there is a convincing sense of family atmosphere, philosophical empathy and kinship among the indigenous people of Africa. Breastfeeding impacts not only the mother, the child and the immediate family but also the community as a whole. Therefore, it is society's moral imperative to create suitable and enabling conditions for successful breastfeeding. Owing to the interconnected and interdependent nature of communitarian societies, which we argue that SA predominantly is, it is in the collective's best interest to support mothers who are willing and able to breastfeed exclusively and to eliminate all potential barriers. SA has an ailing health system and economy, where most citizens rely on public health funded by taxes contributed by less than half of the population, so any intervention that can reduce the burden on the system should be supported by all as it is to the benefit of the collective. According to recent data, only 15.8% of the population in SA has coverage for medical aid, that is, ~84.2% depend on public health services.^[15] According to the South African Revenue Service, only 41% of the population of 24 832 105 people within the employment age range of 15 - 64 years were eligible to pay tax in March 2022,^[16] meaning less than half of the population is responsible for funding health services in the country. This shows the communitarian nature of SA society, where every abled person contributes to the benefit of the collective. Therefore, it is a moral imperative for the collective to ensure that they protect their health system by promoting and supporting breastfeeding as an initiative to reduce the burden on the finances of the country.

If indeed we are people because of the existence of other people, it then follows that one cannot claim to possess humanity if they cannot co-exist with other people. In the effort to advocate for the right to breastfeed freely anywhere and anytime, restoring the dignity of mothers should be central to this agenda. Women have been reduced to sexual commodities, which in turn leads to the sexualisation of breastfeeding, undermining the mother's moral obligation to protect her child's right to basic nutrition. We cannot, as a society, claim to uphold the right to dignity as enshrined in the Bill of Rights but want to subject mothers and their children to degrading conditions like breastfeeding in public toilets or risking banishment from public spaces, as has happened in the past. A person who possesses humanity is a person of virtue, one who treats others with compassion and respects their dignity. The humiliation and injustice suffered by mothers and their children when they are treated poorly for breastfeeding in public is something that should be rebuked by all members of society, just as we would expect the public to come to our defence whenever our rights are threatened or violated. Unfair discrimination against breastfeeding mothers or treating them as sexual objects disregards and erodes their dignity, therefore a person who subjects others to such treatment is perceived as a person who lacks humanity or as in Sepedi they say 'motho wa go hloka botho'.^[11] Women should be treated just as men are, in a society that respects human rights, where every adult has a right to bodily autonomy. However, women are subjected to constant policing of their bodies as though they lack the moral capacity to know right from wrong. There should be a unified effort to ensure that women feel safe to breastfeed anywhere in the country without fear of harassment or discrimination.^[17]

Ubuntu lactivism as a proposed tool for supporting and advocating for the right to breastfeed anywhere is a commitment to show solidarity with mothers who can breastfeed and choose to do so exclusively for better health outcomes for their children. Breastfeeding is in the best interest of the community, regardless of whether one is a parent or not. In the African community, the spirit of working together is essential for the survival of the community; hence the Sepedi aphorism that states, 'tau tša hloka seboka di šitwa ke nare e hlotša', which means a divided pride of lions can easily be defeated by a wounded or limping buffalo. In this case, the common enemy for our society is the high infant mortality rate, the burden on the health care system, the sexualisation of the female breast, and the resultant negative perception of breastfeeding in public. Thus, society must speak with a unified voice that 'for the survival of the future leaders of the country, we support the right and autonomy of the mother to breastfeed anywhere and anytime without prejudice and adopt a zero-tolerance attitude against discrimination or harassment against mothers who breastfeed in public'. Failure to challenge individualistic interests such as the fixation with self-gratification as part of sexual objectification, which is at the expense of the vulnerable members of society (women and children) could undermine the efforts to increase child survival and burden on the health system through exclusive breastfeeding.

The Ubuntu philosophy is crucial for the survival of the human species, Mbigi^[11] identified survival as part of the core values of the philosophy. Breastfeeding is a matter of common good and interest owing to its effectiveness in reducing infant mortality and the burden on the health system and economy. Public goods refer to goods that serve all members of a community, not any particular group, and benefit future generations.^[11] However, it is unfortunate that the explicit marketing and promotion of infant formula continue to undermine the public good in pursuit of profit by capitalists. Despite the introduction of multinational agreements like the International Code of Breastmilk Substitutes, which restricts how infant formula is marketed to the public, these companies seem to have found loopholes in the regulation allowing them to continue marketing their products directly to the public. These products are often sold as a product of class and luxury, a life many poor people aspire to have. Now infant feeding has become a subject of political economy, where people are divided into socioeconomic groups, where breastfeeding is presented as a feeding option for the poor while formula feeding is reserved for the elite. There is a slogan in contemporary society urging media users to 'fake it until you make it', meaning that one must project oneself as the person they aspire to be even before achieving such an achievement. Therefore, mothers who aspire to a bourgeois life where the use of expensive infant formula and feeding bottles is a norm may try to adopt this lifestyle which is out of their reach. For someone who cannot afford to buy enough infant formula and has no access to safe drinking water or resources to sterilise the feeding utensils, they are exposing their children to life-threatening infections. By publicly advertising and promoting infant formula to the public, some of whom do not meet the criteria for safe and sustainable use of infant formula, the infant formula industry puts profit before the lives of poor and vulnerable children. The financial commodification of infant life by the infant formula industry is against African traditional values and therefore against the spirit of ubuntu. There is a Sepedi aphorism warning against such behaviour which says 'feta kgomo o sware 'motho', which in English means 'people's lives come before wealth or material'.^[14]

The centralisation of ubuntu in breastfeeding activism has the potential to appeal to our humanity or ubuntu and allows society to look beyond racial, cultural and socioeconomic lines. Ubuntu lactivism urges us to acknowledge our interconnectedness as a society and that if we allow the spirit of liberalism that sexualise breastfeeding thus undermining our spirit of Ubuntu, we will easily fail to bring down infant mortality rates and improve exclusive breastfeeding rates just as a divided pride of lions fails to bring down a limping buffalo. Ubuntu lactivism also calls on patriotic members of society to condemn the explicit promotion of infant formula as a means to maximise profit for capitalists at the expense of the lives of society's most vulnerable members and future leaders.

 

Counter arguments

It would be unrealistic to expect a society with heterogeneous cultures and religions to agree entirely on issues of morality and sexuality, thus several counterarguments to the right to breastfeed in public ought to be expected. One of the expected objections to a call to normalise breastfeeding would be that this practice may not be compatible or even acceptable in some cultures and religions. The intention for a call to normalise breastfeeding in public is not aimed at making it compulsory but rather at creating an enabling and protected environment for those mothers who must breastfeed in public and are comfortable and willing to do so. Considering that most democratic countries like SA are founded on principles of religious and cultural tolerance, it would be unreasonable and unjust for individuals who perceive breastfeeding in public as morally unacceptable to interfere with the autonomy of those who are in line with their cultures and religions and find it acceptable.

Another expected point of contention to the normalisation of breastfeeding in public would likely be because not all women are interested in breastfeeding publicly and there are other methods of infant feeding like feeding expressed breast milk from a cup or bottle when in public. The use of feeding bottles for breastfeeding has been linked to a 22 - 50% chance that the infant may develop nipple confusion, which is when an infant struggles to establish or develop strong suckling reflexes, proper attachment or latching vital for successful breastfeeding after being exposed to artificial teats.^[18,15] There is an argument that since children above 6 months are on complementary feeding, mothers should rather opt to feed solids when in public as an alternative. The intention of advocating for the right to breastfeed in public is primarily to increase the exclusive breastfeeding rates which are from birth to 6 months, but it does not mean that Ubuntu lactivism or breastfeeding activism discourages public breastfeeding beyond 6 months.

Another fair argument or perception raised is that not all societies struggle with breastfeeding in public. This is true; however, it is worth noting that society is made up of communities, which consist of families, and families are made up of individuals. The communities are often defined by cultural, ethnic or social class, contributing to a society that is culturally, racially and economically diverse, such as SA. One can expect to have a hierarchy of values where the values of the dominant or more influential group displace those of other groups. Therefore, even though SA comprises predominantly Black Africans who normally perceive breastfeeding in public as acceptable, due to the racial and economic inequalities in the country, Western values are still preferred or dominate indigenous or traditional African values. This means in spaces where Blacks and Whites are present, breastfeeding in public may be met with criticism thus resulting in unfair treatment to the breastfeeding mother.

One of the most popular arguments made by those opposed to breastfeeding in public is that, at restaurants in particular, mothers should excuse themselves to go breastfeed in the restrooms or cover up their babies and breasts or these facilities should have special rooms where breastfeeding is allowed like smoking rooms. Dining out as a family is an essential part of building strong bonds between family members and therefore expecting mothers to recuse themselves from their families to go breastfeed elsewhere undermines this. To also expect infants with still-developing immune systems to be fed in germ-infested public toilets intended for the excretion of waste is not only degrading but inhumane. Breastfeeding is not just for nourishment but is also important for strengthening the bond between mother and baby and soothes babies when they are restless thus expecting mothers to cover their babies' faces will likely interfere with this. Covering up also makes it look like breastfeeding is a shameful act while it is a normal thing and the same goes for having special family rooms for families with children who are breastfed. If such rooms are normalised, it might give the perception that breastfeeding is a harmful or inappropriate act which requires isolation instead of it being normalised and promoted as Ubuntu lactivism intends to do.

 

Conclusion

Given the arguments presented in the previous sections, we raise the following claims: First, breastfeeding is a central issue for feminism, as it offers health benefits to mothers. Second, breastfeeding is a human rights subject owing to it being a reproductive right and children's rights issue. Third, breastfeeding is a matter of public good owing to its benefits to the environment and general society. Thus, its protection advances the feminist agenda and also advances communal individual and communal rights. It is for this reason that we propose Ubuntu lactivism as a holistic Afri-centric approach to the advocacy and activism for the right to breastfeed anywhere and at any time for the benefit of the mother, child and society as a whole.

Declaration. None.

Acknowledgements. I owe my gratitude to God and my ancestors for helping me get this far in life despite facing multiple setbacks and I thank my parents for their support. Special thanks to Prof. M Cloete for his guidance through my PhD journey. A huge thank you to Mr M S Makwela (Senior Lecturer, University of Limpopo, in the Human Nutrition and Dietetics Department) and Mrs T T Motebejane (Assistant Director of Dietetics Services, Capricorn District, Limpopo Province) for their honest feedback on my first draft. I also want to thank my kids, Lefa and Theto for their consistent inspiration and motivation.

Author contributions. Sole author.

Funding. None.

Conflicts of interest. None.

 

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Correspondence:
M Seabela
mseabela3@gmail.com

Received 5 December 2023
Accepted 5 June 2024