Sex Roles

, Volume 61, Issue 7, pp 476–490

Breast is Best…But Not Everywhere: Ambivalent Sexism and Attitudes Toward Private and Public Breastfeeding

Authors

Original Article

DOI: 10.1007/s11199-009-9655-z

Cite this article as:
Acker, M. Sex Roles (2009) 61: 476. doi:10.1007/s11199-009-9655-z

Abstract

Although breastfeeding is encouraged by the medical community, many women do not breastfeed because of perceived social sanctions. This experiment examines the level of positive evaluations, negative affect, and normalcy accorded a woman who is breastfeeding. 106 undergraduates and 80 older adults from the Midwestern U.S. were shown photos of a woman breastfeeding in public or private. It was hypothesized that the breastfeeding mother would be seen more positively when breastfeeding in private than in public, and that this response would be moderated by participants’ familiarity with breastfeeding, gender, and levels of benevolent and hostile sexism. Results supported these predictions. Three explanations for the negative view of public breastfeeding are discussed: familiarity, sexist attitudes, and hypersexualization of the breast.

Keywords

Breastfeeding attitudesSexismMedia

Introduction

Through recent public health efforts contemporary mothers in the United States have learned the slogan “Breast is Best.” A preponderance of medical literature finds that breastfeeding is a cost-effective way to improve the health of infants and children (Gartner et al. 2005). Breastfeeding goes beyond simply providing an advantage for the individual infant and mother in that it is an issue of public health (U.S. Department of Health and Human Services 2000b). There are numerous nutritional, immunological, developmental, psychological, environmental, social, and economic advantages (Gartner et al. 2005; World Health Organization 2003).

Even with the many organizations endorsing breastfeeding, less than 25% of mothers in the United States are following the breastfeeding recommendations set forth by medical authorities (Gartner et al. 2005). A recent representative national survey found that overall 71.4% of mothers try breastfeeding, but the number exclusively breastfeeding drops to 63% at 7 days, 42.5% at 3 months, and 13.3% at 6 months .These rates are significantly lower for non-white women (Li et al. 2005). The statistics are quite similar when looking at other industrialized, English-speaking countries including the United Kingdom, Australia, and Canada (Australian Bureau of Statistics 2001; Department of Health 2002; Haiek et al. 2007). One of the goals of Healthy People 2010, an initiative of the Department of Health and Human Services, is to increase the proportion of breastfeeding mothers to 75% at birth and 50% at 6 months of age (U.S. Department of Health and Human Services 2000a). Similarly, public policy statements by the World Health Organization, the American Academy of Pediatrics, the American Dietetic Association, the Australian National Health and Medical Research Council, and the British National Health Service endorse exclusive breastfeeding until 6 months and continued breastfeeding to at least 12 months (Department of Health 2004; Gartner et al. 2005; James et al. 2005; National Health and Medical Research Council 2003; World Health Organization 2003).

Numerous public health surveys provide evidence that most people are aware of the health benefits of breastfeeding, yet breastfeeding rates fall short of targets (Haynes 2006; Li et al. 2007; McIntyre et al. 2001b). Since it appears that campaigns to educate the public about the many benefits of breastfeeding have been successful, clearly, factors beyond simple lack of awareness inhibit breastfeeding (Guttman and Zimmerman 2000; Haynes 2006). Although many studies implicate the importance of others and the social context for breastfeeding, few studies have examined specific attitudes toward breastfeeding and breastfeeding mothers. The current study examines how college students and working adults view a breastfeeding mother in different contexts. Understanding the aspects of breastfeeding that affect observers’ evaluations provides important information about the social context of breastfeeding.

Prediction of the Choice to Breastfeed

The breastfeeding literature typically has focused on demographic and individual characteristics that increase or decrease the likelihood of breastfeeding. In short, it is generally the case that white, middle-class, well-educated, older women are more likely to breastfeed than their counterparts (Morse and Harrison 1992; Raj and Plichta 1998). Many studies also indicate that full time maternal employment is at odds with breastfeeding (e.g., Duckett 1992; Hill 2000). Other individual characteristics thought to predict breastfeeding include personality factors such as gender role identity, but examinations of these have demonstrated mixed results (Barnes et al. 1993).

Beyond looking at the woman’s attitude toward breastfeeding, research has demonstrated that the woman’s partner’s positive attitude is a strong predictor of breastfeeding (Bar-Yam and Darby 1997; Kessler et al. 1995; Okon 2004; Raj and Plichta 1998; Rempel and Rempel 2004). In their social coercion theory for weaning, Morse and Harrison (1992) argue that social context of the mother is an important determinant of breastfeeding initiation, and even more so, of breastfeeding continuation. Although context is often interpreted as immediate family environment, this may be broadened to include the greater societal context. Indeed, survey evidence indicates that social and cultural norms produce considerable geographical variation in breast feeding rates across the United States (Hannan et al. 2005). Morse and Harrison conclude by saying

Our research suggests that if a lack of breastfeeding is a “problem”, then it is a general problem of all citizens. Breastfeeding does not occur in isolation, either apart from the family context or separate from the community at large. As such, health education programs must be aimed at all sectors of the population: to grandparents and schoolchildren, to the married and the unmarried, to males as well as females (p. 372)

Public Attitudes Toward Breastfeeding

Since infants need to eat every 2–3 hours, breastfeeding mothers are likely to need to feed in public spaces unless the new mother is to become a prisoner of her home or the infant is to scream and go hungry. Nonetheless, the United States has not been particularly receptive to breastfeeding. There are few designated spaces for breastfeeding and there have been a number of highly publicized cases where a breastfeeding mother was asked to desist or to leave the premises of a public place (e.g., Feinberg 1980; Pugliese 2000). Recently, a major US airline removed a woman and her family from their aircraft, which had been sitting for 3 hours on the tarmac, because she was breastfeeding (MSNBC 2006b).

Studies of breastfeeding mothers have found that worries about breastfeeding in public are prevalent (Sheeshka et al. 2001). These worries include embarrassing themselves, embarrassing others, and fears of negative reactions. This fear of censure keeps many a mother from breastfeeding in public and in turn leads to early discontinuation of breastfeeding because of the impossibility of breastfeeding successfully without doing it in public (Marchand and Morrow 1994; Sheeshka et al. 2001). At present there are no “Breastfeeding Mothers Welcome” signs which signify public acceptance and normative status for breastfeeding in public, such as one Australian organization was planning to distribute (McIntyre et al. 2001a). Neither is breastfeeding normalized in the ubiquitous mass media. Analyses of pregnancy and infant-feeding articles in magazines in Canada, Australia and the United States find that the coverage of breastfeeding is slim, neutral at best, and often focuses on negative aspects of breastfeeding (Daniels and Parrott 1996; Mannien et al. 2002; Potter et al. 2000). The breastfeeding images that are available emphasize the private sphere of life with mothers in their nightgowns, rather than out in public (Pugliese 2000).

A few studies have examined empirically the attitudes of the general public toward breastfeeding. In one recent national survey, a large representative sample was asked about breastfeeding issues related to the workplace and public places (Li et al. 2004). Although Li et al. describe their findings as demonstrating public support for breastfeeding, this would seem an overstatement as they found only 43% of respondents thought that women had the right to feed in public places, and just 28% thought it was appropriate to show a breastfeeding mother on television. There was greater support for breastfeeding-friendly policies such as lactation rooms. These data suggest that people may believe in the importance of breastfeeding but at the same time would rather put it out of the public eye. Furthermore, acceptance is not increasing. In fact, from 1999 to 2003, people became significantly less supportive of public breastfeeding (Li et al. 2007). In a representative survey of South Australia, many respondents reported being breastfed as infants or having breastfed their own children, but they still overwhelmingly felt that bottle-feeding was more acceptable in public places (McIntyre et al. 2001b).

Some of the most positive attitudes about breastfeeding were found in a recent study of the college student population (Forbes et al. 2003). However, the researchers in this study merely asked respondents for their perceptions of a hypothetical woman who breastfeeds as compared to a hypothetical mother who bottlefeeds, rather than presenting them with a breastfeeding woman. This is problematic for two reasons. First, it is quite likely that social desirability concerns inhibited the expression of less tolerant opinions. The same public information campaigns that have raised awareness of the health benefits of breastfeeding have quite likely generated powerful social norms on behalf of breastfeeding mothers, especially among the young and relatively well-educated (e.g., Li et al. 2007). Research on attitude-behavior consistency suggests that participants may respond positively in theory, but behave quite differently when confronted with an actual situation of public breastfeeding (Kraus 1995). Furthermore, participants never rated an actual breastfeeding mother alone, but simply compared a hypothetical breastfeeding mother to a hypothetical bottlefeeding mother, making it difficult to know participants’ views of the breastfeeding mothers independently of the bottlefeeding mother.

Studies of low income women have found much less positive attitudes than the college student or general population. In one, participants reported that they felt that breastfeeding was better for the child and that society viewed the breastfeeding mother as a better mother, but paradoxically, also reported that societal views of breastfeeding were quite negative (Guttman and Zimmerman 2000). Breastfeeding is seen as immodest and disapproved of by others when in public (Guttman and Zimmerman 2000; Libbus and Kolostov 1994). A series of clever field studies in restaurants and shopping malls in Canada found that breastfeeding women got more neutral attention than bottlefeeding women (Sheeshka et al. 2001) These studies indicated that people do take notice of breastfeeding mothers, although they are unlikely to behave in an overtly hostile manner. Focus groups with the mothers in Sheeshka et al.’s study revealed that the mothers were quite uncomfortable and felt that people avoided them. They did not feel an overwhelming sense of support, nor did they get such approbation, judging from the lack of positive looks noted in this study. Other studies indicate there is a healthy dose of reality in the perception that breastfeeding in public is not widely accepted. Restaurant owners and shopping mall managers in South Australia reported they would ask mothers to move if there was a complaint about the breastfeeding, and less than 50% of managers approved of it in their establishment, even though it is protected by law in that state (McIntyre et al. 1999).

Gender and Attitudes Toward Breastfeeding

Common sense might lead us to expect that women would express more support for breastfeeding than men, as it is something uniquely female; something that provides solidarity with their gender ingroup. Breastfeeding might be closely associated with a woman’s identity as a potential mother, and thus with being female (Marshall et al. 2007). In one study, college-age women perceived mothers who breastfed as less rejecting than did college-age men, suggesting that breastfeeding is tied more closely to ideals of motherhood for women (Forbes et al. 2003). Women may also be socialized to have more knowledge than men about infant feeding through greater experience with babysitting and with friend’s babies, and this increased exposure might translate into more positive attitudes toward breastfeeding. Studies of adolescents in Northern Ireland, Korea, and Canada, do show that boys are generally less knowledgeable and positive about breastfeeding than girls (Goulet et al. 2003; Greene et al. 2003; Kang et al. 2005). Surprisingly, however, studies of adults have generally failed to find strong, consistent gender differences in breastfeeding attitudes. A recent study of U.S. college students found that women were more knowledgeable than men about breastfeeding but they did not have more favorable attitudes as compared to men (Marrone et al. 2008). One study of expectant fathers found them to be less supportive than expectant mothers of public breastfeeding (Freed et al. 1992), but several large surveys show that men are slightly more supportive of public breastfeeding than women (Haynes 2006; Li et al. 2004; McIntyre et al. 2001a). These small and inconsistent gender effects suggest that further research is needed to elucidate the role that gender plays in response to breastfeeding.

It is also possible that men’s attitudes about breastfeeding do not have the personal implications that women’s attitudes have. For women, reactions may reflect the complexity of issues tied to modern motherhood, personal choice, and non-traditional gender roles (McKinley and Hyde 2004). For instance, in a recent large study of working and non-working women, gender role attitudes had an interesting relationship with breastfeeding. The more egalitarian a woman was, the greater her intention to do any breastfeeding at all. However, for both working and non-working women, more egalitarian women planned to breastfeed and actually breastfed for fewer months than did less egalitarian women (McKinley and Hyde 2004). Thus, having nontraditional gender role attitudes predicted the choice to breastfeed, but having more traditional gender role attitudes predicted longer breastfeeding. Other research indicates that sexism is a predictor of attitudes toward breastfeeding for men, but not for women (Forbes et al. 2003). Thus it seems that gender often interacts with attitudinal variables to determine the response to breastfeeding.

Role of Sexism

Breastfeeding is something that can be done only by women and, therefore, may elicit gender related attitudes. Some theorists have suggested that women’s reproductive capabilities distinguish them as separate and lesser than men (e.g., de Beauvoir 1952/1971), resulting in a history of sex discrimination. Legal cases that uphold breastfeeding rights often do so on the grounds that breastfeeding is inherently female and thus discriminating against breastfeeders is discriminating based on sex (e.g., Williams 2007). Forbes et al. (2003) found that sexism was one predictor of male students’ attitudes toward a breastfeeding woman. It is likely that sexist attitudes would also be related to perceptions of public breastfeeding.

Glick and Fiske’s (1996, 2002) conceptualization of ambivalent sexism argues that there are two independent forms of sexism: hostile and benevolent. Hostile sexism is similar to traditional ideas of sexism, characterized by a dislike and distrust of women in general. Hostile sexists exhibit more negative affect toward essential facets of womanhood. For instance, Ward et al. (2006) found that men who were higher in masculine ideology (of which hostile sexism is a central component) viewed childbirth and breastfeeding negatively. Conversely, benevolent sexists believe in cherishing and protecting women, idealizing traditional women. Benevolent sexists like women, but benevolent sexism predicts negative responses to women who step off their pedestals (Glick et al. 1997; Viki et al. 2005). In one study examining perceptions of rape victims, men high in benevolent sexism attributed significantly more blame to a rape victim described as a married mother who was unfaithful (versus one who was not) based on her violation of the “good woman” role (Viki and Abrams 2002). This interplay between veneration and disdain for women is the essence of ambivalent sexism.

Benevolent sexists are likely to approve of behaviors that are biologically female, and one of the most quintessentially female acts is breastfeeding a child. Forbes et al. (2003) found that men who were high in benevolent sexism saw the breastfeeding mother (as compared to the bottlefeeding mother) as a better mother, as more traditionally female, and as a generally more likable person. However, in their study no other information about the woman was available. If the woman was simultaneously engaging in breastfeeding and in a non-traditional behavior (e.g., working outside the home, breastfeeding in public), the evaluations would likely look different, reflecting the more negative side of benevolent sexism. The modern breastfeeding woman often juggles multiple roles, some traditional and some not, providing an excellent case with which to examine the ambivalent responses of the benevolent sexist.

The Current Study

Anecdotal and research evidence indicates that people perceive breastfeeding as largely negative, sexual, something that animals do, and worthy of disgust (Cox et al. 2007; Van Esterik 1989); furthermore, mothers who nurse in public have been labeled “nasty”, “offensive,” “rude,” and “distasteful” (Guttman and Zimmerman 2000; Marchant 2005). Breast milk has even been identified as a bodily fluid that brings forth the emotion of disgust (Rozin and Fallon 1980). Recently in Ohio, a woman was told that to bring breast milk to her child’s daycare would cost an additional fee. The center’s explanation was that it was necessary to purchase a separate refrigerator and treat the breast milk unnecessarily as a biohazard (Heagney 2007).

It is not apparent why some people have these strong negative emotions regarding public breastfeeding. As already discussed, public breastfeeding is not seen often, perhaps rendering the unfamiliar as unfavorable (Zajonc 1980). It is also possible that people who display these negative responses may be uncomfortable with the relationship between breasts and sexuality and thus view breastfeeding as socially unacceptable (Forbes et al. 2003). The human breast has become hypersexualized in contemporary society (Ward et al. 2006). Breastfeeding, particularly in public, may bring forth images of sexuality simultaneously with motherhood, a combination likely to cause discomfort (Dettwyler 1995; Friedman et al. 1998). There may even be concerns that breastfeeding is doing something sexual (Morse 1992). Perhaps at a more elemental level, breastfeeding reminds us of our animal nature and physical body and thus makes us aware of our own mortality (Cox et al. 2007). In a recent study, Cox et al. found that people become even less accepting of breastfeeding when they are reminded of their mortality. Beyond the physical aspects of breastfeeding, another explanation for these negative reactions is that seeing women breastfeeding in public reflects a violation of gender role stereotypes of female modesty and of women staying at home with their children.

A complex picture thus emerges. While many acknowledge and endorse the benefits of breastfeeding, significant numbers feel neutral at best about breastfeeding. Discomfort with a woman’s exposure, the milk itself, and the intimacy of the act lead to conflicting and multifaceted reactions. The current study uses a controlled experiment to directly assess individuals’ reactions to images of women breastfeeding, both publicly and privately. Further, it examines the impact of self-reported sexism on these evaluations. The experiment uses actual photographs of a breastfeeding woman, and manipulates the important variable of location of breastfeeding. To minimize potential social desirability concerns, the study uses a between- subjects design while disguising the purpose of the research. Another important contribution of this paper is that it includes both college students and older working adults as participants in the experiment.

Participants in the study were asked to evaluate a number of stimuli that depicted people in various stages of undress. The target stimulus was the image of a woman breastfeeding. For participants in the private condition, the woman was depicted breastfeeding at home. For participants in the public condition the woman was depicted breastfeeding in a public setting (a coffee shop). Participants made a series of related but distinct judgments regarding positive and negative attributions about the target woman. Judgments of approval reflected the cognitive aspect of attitudes regarding the desirability of breastfeeding. Judgments of negative feelings assessed the emotional reaction of discomfort frequently noted in the literature. Judgments of normalcy measured what people think ought to be—what is expected or normal. While I expect substantial intercorrelations among these measures, they reflect unique aspects of attitudes that could reveal fine-grained patterns of response to the stimuli. One could simultaneously approve of a woman’s breastfeeding behavior, for example, but still feel discomfort in its presence and believe that it is not considered normal in society.

The study investigated the following hypotheses:
  1. 1.
    All participants will express greater approval of private breastfeeding than public breastfeeding. The woman breastfeeding in public will be seen less positively, will engender more negative feelings and will be perceived as doing something non-normative.
    1. 1a.

      Participant gender may have an impact on evaluations of the breastfeeding woman. Prior research has found small and inconsistent overall gender differences in approval of breastfeeding and public breastfeeding, so this is a more exploratory research question. I do predict that gender will interact with sexism as described in hypothesis 4.

       
     
  2. 2.

    Participants presumed to have more exposure to breastfeeding will view it more favorably than those presumed to have less exposure, and the effect of the setting will be smaller. I assume that older subjects and subjects with children will have greater exposure to breastfeeding. These participants will be more accepting of breastfeeding than childless and younger participants. The effect of the setting should be smaller for subjects with greater familiarity with breastfeeding.

     
  3. 3.

    Hostile sexism will predict disapproval of any breastfeeding. As hostile sexism predicts negative emotional reactions to women, male and female participants high in hostile sexism will respond with more negative affect and less positive evaluations to the breastfeeding woman regardless of setting.

     
  4. 4.

    The impact of setting on approval of breastfeeding will be moderated by benevolent sexism and the gender of perceiver. In particular, men who are high in benevolent sexism will express especially strong approval of private breastfeeding, but especially strong disapproval of public breastfeeding. Men low in benevolent sexism will not respond as strongly to setting. Based on previous research (e.g., Forbes et al. 2003), I expect that sexism levels will not impact female participants’ ratings.

     

Hypotheses 3 and 4 hold that precisely specifying the dimension of sexism is critical for predicting its impact on approval toward breastfeeding. Hostile sexists will disapprove of all breastfeeding, because hostile sexists typically have negative emotional reactions to functions that are uniquely female. Benevolent sexist males, because of their conditional acceptance of women depending on concordance with gender stereotypes, will instead approve of breastfeeding so long as it is done out of the public eye. Because of the prescriptive nature of the gender stereotypes held by benevolent sexists, these ambivalent reactions will likely appear on the evaluative dimension of normalcy.

Method

Participants

The participants were 106 students (33 males, 72 females) from a small, Midwestern college and an additional 80 adults (48 males, 31 females) from a large business in the area. Participants ranged in age from 18 to 72 years old with a median age of 20. Fifty-one (27.7%) were parents. The study was approved by the college’s Institutional Review Board and all participants were treated in accordance with ethical guidelines. College participants were recruited from classes, dormitories, and other campus locations. Participants enrolled in introductory psychology classes received course credit; no other participants received compensation. Volunteer participants from the local business were solicited via company email by a student experimenter who was also an employee of that company. Those who replied were sent randomly generated passwords that allowed them to access the program on the college’s server. Student participants also used randomly generated passwords to access the program. The passwords were not recorded and all participants were anonymous.

Design and Procedure

The experiment manipulated a single factor (Location) with two levels: private and public. The experiment was conducted on a computer using Microsoft Access to present the stimuli and record the responses. Participants were told that the purpose of the study was to investigate how dress and behavior influenced perceptions of people; however, the study actually explored reactions to a woman breastfeeding in either a public or private setting. Participants were told they would see photos of people dressed in various ways, and that there might be some nudity. Each participant saw a series of nine photos and subsequently answered questions about the person displayed in the photo. Each photo focused on a central person in various public or private settings. Four filler photos were of men and four were of women, with equal number of inappropriate pictures (e.g., fraternity boy mooning the camera, woman showing her breasts to receive mardi gras beads)and appropriate pictures (e.g., woman reading at desk at work, man pushing jogging stroller). The target photo contained a woman breastfeeding her child. Participants were randomly assigned to either the public or private breastfeeding condition. The private group saw a photo of the woman breastfeeding in the privacy of her own home, while the public group viewed the same woman breastfeeding her baby in a public coffee shop setting. The woman and the baby were dressed the same way and exposing the same amount of skin in both pictures. The baby was breastfeeding in exactly the same position in both photos. The target photo of the woman breastfeeding was always placed in the middle of the order. The order of the photos was counterbalanced in such a way that there were always two appropriate and two inappropriate pictures before the breastfeeding picture.

After each picture was displayed, participants answered six questions about the person in the photo and his or her behavior on a 6- point Likert scale (not at all to very much). Only the ratings of the target picture (the breastfeeding woman) were used in this study. These questions were summed into three separate scales: Positive evaluations (How much do you approve of what this person is doing?; How much do you like this person?), Negative feelings (How offensive is this person’s behavior?; How uncomfortable does this make you feel?) and Normalcy (How normal do you think this person’s behavior is?; How socially appropriate do you think this person is?). The three dependent variables are highly correlated (.80 to .85), but represent different theoretical aspects of reactions to breastfeeding. The analysis includes both multivariate and univariate treatments of these outcome measures.

Following the presentation of the photos, participants completed the Ambivalent Sexism Inventory (ASI) (Glick and Fiske 1996). The ASI is a 22-item self-report measure composed of two 11-item subscales that assess hostile sexism and benevolent sexism. The ASI instructs the subjects to indicate the extent to which they agree or disagree with the statements concerning men and women and their relationships in contemporary society. The ratings range from 0 (disagree strongly) to 6 (agree strongly); a mean item score for each subscale was calculated. In the current study, the scales of hostile sexism (alpha = .82) and benevolent sexism (alpha = .77) demonstrated comparable reliability with previous work using these scales (Glick and Fiske 1996; Greenwood and Isbell 2002). A median split was performed on participants’ scores on both the HS scales and the BS scales. Although the ASI is most often used as a continuous measure, several published papers (e.g., Ford et al. 2001; Greenwood and Isbell 2002; Hogg et al. 2006) demonstrate its acceptable use as a dichotomized measure, particularly in an experimental design. Participants were divided at the median score of 3.48 into a low Hostile Sexism (HS) group (M = 2.72) and a high HS group (M = 4.10). Subjects were likewise divided at the median score of 3.48 into a low benevolent sexism (BS) group (M = 2.90) and a high BS group (M = 4.17). Gender was independent of scores on the ambivalent sexism measure, with the same ratio of men and women in each of the low and high sexism groups. At the end of the ASI, participants provided demographic information regarding gender, age, occupation, level of education, and parental status. Age was recoded into two categories based on the average age of childbearing in the United States (Martin et al. 2006). The younger group (18–25) is below the average age for childbearing for women in the United States and the older group (26–71) is above that age.

Results

Table 1 displays average judgments of the breastfeeding mother across the three dimensions of evaluation (positive evaluations, negative feelings, and normalcy). The sample is divided by participant gender, participant age, and breastfeeding location (private vs. public—the experimental manipulation). The means suggest a powerful effect of the experimental manipulation—evaluations of the breastfeeding mother are substantially more positive (by nearly two points on a six-point scale) in the private condition than in the public; comparable differences are found for the other two evaluation dimensions (negative feelings and normalcy). By contrast, mean differences between men and women (regardless of condition) and younger and older participants are comparatively slight. Men, and older participants, expressed more support for breastfeeding than their counterparts, but the differences were small.
Table 1

Means and standard deviations for reactions to breastfeeding woman, separately by gender, experimental treatment, and age.

 

Breastfeeding location

Participant gender

Participant age

Private

Public

Male

Female

Young

Old

Positive evaluations

5.23 (.80)

3.33 (1.39)

4.43 (1.30)

4.22 (1.60)

4.28 (1.50)

4.35 (1.43)

Negative feelings

1.82 (.92)

3.63 (1.55)

2.54 (1.46)

2.82 (1.61)

2.80 (1.53)

2.55 (1.59)

Normalcy

5.26 (.94)

3.16 (1.44)

4.35 (1.45)

4.15 (1.70)

4.20 (1.62)

4.27 (1.58)

N

94

90

80

102

112

72

Reactions are on a 6-point Likert scale with higher numbers signifying higher agreement with that scale. The difference between private and public is significant for every comparison at p < .001

The data were subjected to a series of multivariate analyses of variance (MANOVA), with the three dimensions of evaluation as the dependent variables. Hypothesis 1 predicted that all participants would see a woman breastfeeding in public more negatively than one breastfeeding in private, while Research Question 1a proposes an effect for gender on these evaluations. The first MANOVA therefore included location (private vs. public) and participant gender as factors.

The main effect for location across the three dependent variables was large and significant (F (3, 178) = 51.66, p < .001), thus supporting Hypothesis 1. The slight difference between male and female participants was far from significant (F (3, 178) = .32, p = .81). The multivariate test for the gender x location interaction was also nonsignificant (F (3, 178) = 1.47, p = .23), but the univariate tests point to a trend for Positive Evaluations (F (1, 178) = 3.57, p = .06) and Normalcy (F (1, 178) = 3.13, p = .08). In examining the means for Positive Evaluations, women’s judgments were more responsive to location (Mpublic = 3.16, SD = 1.41 vs. Mprivate = 5.37, SD = .81) than men’s judgments (Mpublic = 3.58, SD = 1.33 vs. Mprivate = 5.16, SD = .68); the pattern for Normalcy was the same. Bear in mind, however, it is a small effect: a power analysis reveals that one would need an average of 188 subjects per cell for it to reach conventional levels of statistical significance. Substantively, the gender effect is dwarfed by the impact of breastfeeding location; even male subjects showed a substantial effect for location. It is also interesting to note that there is far more variance in attitudes in the public condition than the private condition. In other words, while the woman breastfeeding in private received general approval, the same woman breastfeeding in public evoked strongly diverging judgments. It is this variation which may be accounted for by experience and personal attitudes.

To examine Hypothesis 2 that increased experience with breastfeeding will moderate responses to the breastfeeding woman, age and parental status were entered into the analysis. A 2 (breastfeeding location) by 2 (parental status) by 2 (subject gender) multivariate analysis of variance (MANOVA) was conducted for the three dependent variables. There were significant main effects for location as described above, and also for parental status (F (3, 172) = 5.41, p = .001). As predicted, across the dependent variables parents regarded breastfeeding more favorably than non-parents regardless of condition. Parents evaluated the breastfeeding woman significantly more positively (M = 4.68 vs. M = 4.02 for non-parents, F (1, 174) = 4.75, p = .03), had less negative feelings (M = 2.15 vs. M = 2.97 for non-parents, F (1, 174) = 14.10, p < .001) and saw her behaviors as more normal (M = 4.69 vs. M = 4.02 for non-parents, F (1, 174) = 9.62, p = .002) than non-parents. Parental status did not interact with the location (F (3,172) = 1.10, p = .35). In other words, although parents expressed more approval of breastfeeding than non-parents, they still preferred that it be kept in the home. Gender did not interact with parental status, and the three-way interaction was nonsignificant.

Table 2 displays the means for the next analyses, which include subject age as a predictor. There was a strong main effect for breastfeeding location as previously described. While the multivariate main effect for age was not significant (F (3, 172) = 2.24, p = .09), there were significant main effects of age for positive evaluations (F (1,174) = 4.27, p = .04), negative feelings (F (1,174) = 6.44, p = .01), and normalcy ratings (F (1,174) = 4.79, p = .03). Older participants rated the breastfeeding mother more positively, felt less negatively, and saw her behavior as more normal than did younger participants. These main effects were qualified by a two-way interaction. The multivariate effect for age x condition was not significant (F (3, 172) = 1.93, p = .13), but there was a significant univariate effect for the negative feelings rating (F(1,172) = 5.57, p = .01). Post-hoc analyses indicated that there was no difference in how older and younger participants responded to the woman breastfeeding in private, but when viewing a woman breastfeeding in public, the older participants had significantly less negative feelings than younger respondents. Although not significant, the trend for the other measures was in the same direction with older respondents responding more favorably than younger respondents to public breastfeeding.
Table 2

Means and standard deviations for reactions to breastfeeding woman as a function of gender, age and location.

 

Breastfeeding location

Female participants

Private

Public

Male participants

Private

Public

Younger participants (ages 18–25)

Older participants (ages 26–71)

Younger participants (ages 18–25)

Older participants (ages 26–71)

Younger participants (ages 18–25)

Older participants (ages 26–71)

Younger participants (ages 18–25)

Older participants (ages 26–71)

Positive evaluations

5.29 (.87)

5.58 (.57)

3.10 (1.31)

3.35 (1.71)

Positive evaluations

5.19 (.63)

5.12 (76)

2.78 (1.30)

3.84 (1.26)*

Negative feelings

1.78 (.90)

1.81 (1.07)

4.00 (1.28)

3.12 (1.99)*

Negative feelings

1.85 (.77)

1.74 (1.09)

4.28 (1.30)

3.13 (1.58)*

Normalcy

5.32 (.94)

5.62 (.65)

2.90 (1.39)

3.27 (1.64)

Normalcy

5.13 (.79)

5.24 (.92)

2.67 (1.17)

3.63 (1.43)*

N

36

13

40

13

N

26

17

9

28

Reactions are on a 6-point Likert scale with higher numbers signifying higher agreement with that scale as labeled. The difference between private and public is significant for each case at p < .001. For comparisons between younger and older participants within each condition x gender group, *p < .05

A closer look at the means in Table 2 suggests that the two-way interaction between gender and condition described earlier can be largely attributed to older male participants. The difference in positive evaluations between the public and private conditions was roughly the same for older women (d = 2.29), younger women (d = 2.19), and younger men (d = 2.43); it was considerably smaller for older men (d = 1.28). The three way interaction among location, gender, and age failed to reach statistical significance, however this could reflect insufficient power due to some small cell sizes (See Table 2 for cell sizes). A power analysis was conducted using G*Power (Faul et al. 2007). Although it is difficult to be sure of the effect size in the population, Cohen (1992) suggests that an appropriate definition of a medium effect size would be 1/2 a standard deviation difference when looking at simple mean differences. Parents and non-parents differ by an average of .72 points on the three scales, older and younger participants an average of .13 across these scales. The average standard deviations for both the parent/non-parent means and the young/old means is 1.54. Thus the effect size observed is slightly lower than what Cohen would call a medium difference (.77 in this case). Using this criterion, I assumed that any interaction effects between groups would have a similar effect size (medium) and used the appropriate parameter in G*Power. Thus a post-hoc power analysis for an F-test with 8 groups, p = .05, and a medium effect size, with the total sample size of 186, results in an achieved power of .92. Since Cohen suggests that an appropriate level of power for social science is .80 (or ß = .20, or the 20% likelihood of a Type II error), this would suggest that this design has more than adequate power. However, this assumes equal cell sizes which are not present in the current study. In particular, testing for the three-way interaction between gender, age and location was hampered somewhat by an abnormally low number of subjects in one cell caused by a programming error. A highly conservative power analysis using this minimum cell size as the average number of subjects in each cell, had more modest statistical power of .55. Although I can be confident that there is sufficient power to detect main effects and interactions based on the experimental manipulation and the sexism measures (which are evident in the data), the lack of 3-way interactions between gender, location condition and parental status or age should be interpreted with caution due to the limited observed power.

The possibility that older men are especially tolerant of public breastfeeding deserves further exploration. On the other hand, we must keep this finding in perspective: this group, like the others, was far less favorable toward public breastfeeding than private. Furthermore, the pattern of means for the other two dimensions of evaluation (negative feelings and normalcy) closely parallels those of the other three groups.

The next set of analyses tested Hypothesis 3 which predicted that participants scoring high on hostile sexism would view breastfeeding more negatively. A 3- way (Hostile Sexism x Gender x Location) MANOVA was conducted. In addition to the significant main effect for location, there was a nonsignificant trend for hostile sexism (F (3, 170) = 2.19, p = .09) across the three dependent measures. The univariate analyses revealed that those high in hostile sexism viewed the breastfeeding woman less positively (M = 4.13) than those low in hostile sexism (M = 4.48; F (1, 172) = 5.30, p = .042). Ratings of normalcy demonstrated a marginally significant difference between those low in hostile sexism (M = 4.38) and high in hostile sexism (M = 4.05; F (1, 172) = 3.25, p = .07). Ratings of negative feelings as function of hostile sexism were in the predicted direction, but did not reach conventional significance levels. As predicted, hostile sexism did not interact with participant gender or location.

Hypothesis 4, which predicted an interaction between benevolent sexism, gender, and location, was tested using a 3-way (Benevolent Sexism x Gender x Location) MANOVA. There was a main effect for breastfeeding location, and no main effects for participant gender or benevolent sexism. The predicted three-way interaction of condition, gender of subject and benevolent sexism demonstrated a nonsignificant trend at the multivariate level (F (3, 172) = 2.14, p = .097). However, univariate tests returned the predicted interaction for positive evaluations (F (1, 174) = 5.57, p = .02) and normalcy (F (1, 174) = 5.42, p = .02), with a nonsignificant trend for negative feelings (F (1, 174) = 2.86, p = .09). The findings for judgments of normalcy and positive evaluation are displayed in Figs. 1 and 2 (the pattern of findings for negative feelings mirrored that for positive evaluations and thus is not plotted).
https://static-content.springer.com/image/art%3A10.1007%2Fs11199-009-9655-z/MediaObjects/11199_2009_9655_Fig1_HTML.gif
Fig. 1

Normalcy judgments of a breastfeeding woman as a function of location, gender, and benevolent sexism (F (1, 182) = 5.42, p = .02).

https://static-content.springer.com/image/art%3A10.1007%2Fs11199-009-9655-z/MediaObjects/11199_2009_9655_Fig2_HTML.gif
Fig. 2

Positive evaluations of a breastfeeding woman as a function of location, gender, and benevolent sexism. (F (1,182) = 5.57, p = .02).

The figures make plain that location makes the biggest difference in subjects’ evaluations of breastfeeding, but that the gender of the perceiver matters little unless benevolent sexism is taken into account. Benevolent sexism had little effect on the female subjects’ ratings, but was an important predictor for male subjects’ reactions, especially in the public condition. Men high in benevolent sexism actually gave private breastfeeding somewhat more favorable ratings on the positivity and normalcy dimensions than did less sexist men. Public breastfeeding was a different story: benevolent sexists expressed significantly greater negativity, and less positivity, than their nonsexist counterparts; they also saw the behavior as somewhat less normal. To put it another way, the only significant relationships between benevolent sexism and evaluation of the target occurred among men in the public condition (rsexism,positivity = −.30, p = .03; rsexism,negativity = .28, p = .05; rsexism,normalcy = −.22, p = .10).

Discussion

This study found that, in general, public breastfeeding meets with much less favor than private breastfeeding, as expected. Interactions involving gender, age, and sexism qualified this response, however. Gender had an interesting impact on evaluations. It did not directly affect evaluations, but there is a suggestion that it moderated the impact of location; specifically, women were more responsive to location than men (especially older men). The more important finding was that gender, along with location, moderated the impact of benevolent sexism. As predicted by Hypothesis 4, men high in benevolent sexism were especially sensitive to breastfeeding location, expressing strong approval when it was at home, but disapproval when it was public. Location had a comparatively smaller impact on the judgments of nonsexist men, and women.

As predicted in Hypothesis 2, greater experience (operationalized as age and parental status) resulted in more positive overall evaluations of breastfeeding. Older participants were somewhat more accepting than younger participants of public breastfeeding (although they still found it less acceptable than private breastfeeding). Hypothesis 3 was partially supported in that those high in hostile sexism disapproved of breastfeeding in general. Finally, strong support for Hypothesis 4 was found, with men high in benevolent sexism reacting strongly to breastfeeding location. Taken together, the results of this study clearly indicate that a woman breastfeeding in public engenders negative reactions, but that these reactions may be tempered by experience, gender and sexism levels. I will explore three possible explanations for the more negative reactions to public breastfeeding: 1) it is a function of familiarity; 2) it reflects sexist attitudes; and 3) it is an effect of the hypersexualization of the breast.

The most parsimonious explanation for disliking the image of the woman breastfeeding in public is that this is just an unusual behavior to see, whether in person, on television, or in photographs, as in the current study. A well-accepted tenet of social psychology is that we generally like things less if they are not seen very often and, inversely, like things more when we see them more often (Zajonc 1980). Mere exposure holds true for political candidates, commercial products, photographs of ourselves, and numerous other stimuli (Zajonc 2001). A mere exposure explanation would say that people rated the public breastfeeding mother lower than the private breastfeeding mother because it was an unfamiliar image. Although this might predict a negative attitude toward all breastfeeding, it is more likely to predict a negative attitude toward public breastfeeding. People may accept (or expect) that breastfeeding happens in the privacy of the home even if they have never seen it, but they know they have never seen it in public. Consistent with the mere exposure explanation, those who were assumed to be more familiar with breastfeeding (e.g., older respondents) were more tempered in their negative response to public breastfeeding.

There is little exposure to breastfeeding in the media; images of using formula to feed babies are increasingly far more prevalent, establishing its normalcy in public (U.S. General Accountability Office 2006). Advertisements and marketing materials for formula are able to establish bottle-feeding as more consistent with contemporary cultural and moral values than breastfeeding (Hausman 2003). Media coverage of breastfeeding emphasizes its “scandalousness” and the potentially harmful aspects of breastfeeding (e.g., undernourished babies) without communicating the point that these are rare occurrences (Bartlett 2005; MSNBC 2006a; Hausman 2003; Henderson et al. 2000). A content analysis of British television found that bottle-feeding was shown many times in programs, but breastfeeding only appeared once (Henderson et al. 2000). Even children’s books commonly depict babies as being fed with bottles (Dettwyler 1995). One study of young adolescents found that only 26% had ever observed someone breastfeeding. Notably, that 26% were more likely to intend to breastfeed when they became parents (Giles et al. 2007). Thus, it is possible that many people have never actually seen someone breastfeeding (Guttman and Zimmerman 2000; Palmer 1988). Perhaps if there were many public images of breastfeeding women in the media, seeing a woman breastfeeding at a restaurant would elicit a more positive response. A recent public health intervention with adolescent mothers in Britain has used this idea to prompt more positive feelings in the young mothers regarding breastfeeding (Baldock-Apps 2006). The young women repeatedly looked through a photo album of young mothers interacting with their babies and breastfeeding them. Increased exposure to breastfeeding through photos helped normalize breastfeeding and encouraged these girls to continue breastfeeding.

Another explanation for the dislike of women breastfeeding in public is that it represents a violation of expected gender role behavior. This hypothesis was also investigated in the present study. As predicted, men who were high on the benevolent sexism scale approved of the woman breastfeeding in private but were significantly less positive in their evaluations of the same woman in public. This dual response is a manifestation of their conditional acceptance of women (Glick et al. 1997). Women who can fulfill the ideal of the stay-at-home mother sitting in a rocking chair will be greeted with great support for the practice of breastfeeding. Women who wish to do more than stay at home and find themselves in the public eye when breastfeeding will receive the disapproval of the benevolent sexist male. Participants in the current study who were high in hostile sexism were more disapproving of all breastfeeding, regardless of location. This echoes the finding of Ward et al. (2007) who found that the men higher in masculine ideology were the most likely to view breastfeeding negatively.

One interesting finding in the current study is that the respondents who were the most accepting of breastfeeding in public were the men who were low on benevolent sexism, or to say it differently, actively non-sexist. At least for those males, the gender stereotype of the modest, mother-at-home breastfeeder did not seem to be a relevant consideration. Other studies have found that non-sexist males appear to not be as concerned with gender role violations (e.g., Abrams et al. 2003; Masser and Abrams 2004; Viki et al. 2005). Indeed, one could surmise that they are not even using the same gender roles as their more sexist counterparts and have a much more flexible conception of acceptable behavior for women. The sexism level of the female participants did not make any difference in their largely negative perception of the woman breastfeeding in public. This is consistent with Forbes et al. (2003) who also found a relationship between men’s levels of sexism and ratings of a breastfeeding woman, but no association between women’s levels of sexism and their evaluations of a breastfeeding woman. One gender difference that emerges from these results then is that for women this dislike of public breastfeeding is not about gender roles and expectations, and that some other force is operating to make breastfeeding less than acceptable.

Perhaps women are more concerned with how breastfeeding reflects on them as a woman. In one large community survey (McIntyre et al. 2001b), men and women did not differ on their actual acceptance of breastfeeding, but they did differ when asked whether men were more bothered by public breastfeeding than women, with only 36.9% of men agreeing but 60% of women agreeing. Thus, women seem more concerned about the negativity of men’s responses than men are. In a study examining expectant mothers’ perceptions of the expectant fathers’ attitudes toward breastfeeding, the mothers perceived the fathers to be more negative than they actually were (Freed et al. 1993). Another element of women’s negative attitudes toward breastfeeding could be based on their experiences and their perceptions that they could breastfeed or have breastfed more competently and modestly and therefore they denigrate the woman in the photo (who had some minimal skin and a baby showing). Future investigations should investigate what women believe others (e.g., men, employers, and the general public) think about breastfeeding to see if they do indeed perceive a general negative attitude on the part of those others. Also, research should examine more closely the type of attributions women make about a woman breastfeeding in public.

Men’s and women’s negative attitudes about breastfeeding seem to stem from different sources; consequently attempts to change these attitudes should reflect their origin. This study suggests that reduced sexist attitudes help men become more accepting of public breastfeeding. Since the influence of male partners is one of the most important predictors of individual breastfeeding behavior (Hill 2000), it would be wise to target some public health messages at males alone. Such materials targeted at males should emphasize the need for infants to feed frequently and in public and also attempt to discredit some gender stereotypes. Attending to gender roles and attitudes seems unnecessary for messages directed at women. For them, it may be more important to reduce their anxiety about the disapproval of their male partners and men in general.

The third and final potential explanation for the private–public acceptance discrepancy is that the breast has become sexualized to the exclusion of its maternal role. In Western society the primary purpose of the breast is to sexually stimulate and titillate as is evident in the breast’s prominence in pornography, mainstream sexualized advertising, and sexual situations in television, music videos, and movies (Dettwyler 1995; Ward et al. 2006). Breast augmentation, which has as its sole purpose the sexual objectification of the breast, increased more than 500% from 1992 to 2003 (Behrmann 2005). Thus, it is easy to ignore that the décolletage in the black dress could have a function other than attracting a mate. When this function becomes evident, as in public breastfeeding women, the juxtaposition of the maternal and the sexual causes discomfort to many who live in a culture where those things are kept separate (Dettwyler 1995; Friedman et al. 1998; Palmer 1988).

Forbes et al. (2003) found that more erotophobic college students rated a breastfeeding mother as a less good mother, as having less positive personality traits, and as not having traditional family values as compared to a bottle-feeding mother. Erotophobia speaks more to one’s comfort with sexuality and may not be the construct that adequately captures the essence of the issue. Acceptance of sexual and body objectification would be an interesting angle to explore as it might indicate those who see the breasts as primarily erotic. A recent study demonstrated that college women who scored higher on a message of self-objectification were more likely to endorse beliefs that public breastfeeding was indecent and embarrassing (Johnston-Robledo et al. 2007). The participants in Johnston-Robledo et al.’s study epitomize ambivalence about breastfeeding; the majority of them planned to breastfeed, but concerns about embarrassment, and the effect of breastfeeding on the shape of their bodies predicted less positive attitudes about breastfeeding. Further investigation of the interplay between sexuality, objectification, and attitudes toward breastfeeding may further illuminate the social and personal factors that limit women who intend to breastfeed from actually doing so.

Men who have internalized egalitarian attitudes toward women (the low benevolent sexists) are most accepting of public breastfeeding. Perhaps these are men who truly believe that women should have an equal place in the public sphere—whether that sphere is the world of work or providing nourishment to a child. This would suggest that changing sexist attitudes can help with breastfeeding attitudes, at least for men. Although Forbes et al. (2003) concluded that college students had rather positive feelings about women who breastfeed, the current study found those to be situationally limited. It seems clear that self-reported attitudes about breastfeeding may not correspond to reactions experienced when encountering someone who is breastfeeding. Further investigations of attitudes toward breastfeeding need to take this dichotomy into account.

Limitations and Implications

This study examined participants’ responses to a single image of a breastfeeding woman in two different locations. Future research should examine responses to a variety of breastfeeding women. Responses are likely to vary as a function of race, ethnicity, and age of the mother and the child (Morse 1992; Raj and Plichta 1998). In addition, although parental status and age were used as proxies for breastfeeding exposure in this study, actual breastfeeding experience was not directly measured. While this has not always been found to create more favorable attitudes toward breastfeeding (e.g., McIntyre et al. 2001b) it is something that should be accounted for in future studies. For instance, it would be helpful to know if these respondents were breastfed themselves or had exposure to siblings being breastfed. Nonetheless, the responses to the image of the breastfeeding woman in this study quite clearly demonstrate that public breastfeeding is not seen as acceptable by both college-age respondents and by older, working adults. It may be the case that there are differences between these groups that were not detected due to the limited statistical power that this sample size afforded. However, the main focus of this paper was to examine how the context of breastfeeding affects evaluations, and how sexism contributes to these attitudes. Clearly future research should recruit larger samples of these different populations to definitively answer the questions regarding the impact of age and parental status on attitudes toward breastfeeding. Further, it would be important to gather more data regarding participants’ actual experience with breastfeeding (e.g. having seen it, having done it, etc) as age and parental status were merely proxies for experience.

The three dimensions of evaluation—Positive Evaluations, Negative Feelings, and Normalcy—correlated so strongly that it would seem sensible to treat them as multiple indicators of a simple bipolar general evaluation. Yet, the three dimensions responded differently to the experimental factors. Multivariate tests that were nonsignificant, or only marginally significant, concealed strong and significant differences among groups for one or two of the dimensions. The most responsive evaluation dimensions varied from analysis to analysis; the effect of participant age was most apparent for the Negative Feelings dimension, while the effects of hostile and benevolent sexism were most apparent for Positive Evaluations and Normalcy judgments. The partial divergence among evaluation dimensions is widely recognized (Cacioppo and Berntson 1994). The fragmentation of sex role attitudes underlies the very conceptualization of ambivalent sexism. Positive and negative emotions predict separate—not necessarily opposite—patterns of political behavior (Marcus et al. 2000). When examining the social and political effects of breastfeeding attitudes—everything from a disapproving scowl to legislation regulating how, when, and where mothers can breastfeed—it will be important to carefully consider the individual dimensions of those attitudes.

Many millions of dollars are spent on public health campaigns to increase breastfeeding rates. Just recently, the United States Department of Health and Human Services completed a 2-year national breastfeeding awareness campaign (Haynes 2006). Its goal was to get the message out that exclusive breastfeeding until 6 months is desirable. However, these campaigns are almost always targeted toward the birth mothers. The target breastfeeding rate set by DHHS for 2010 is to have 75% of mothers breastfeeding at birth and 50% at 6 months of age. Interestingly, this same goal was targeted (and not met) for 2000 and for 1990 (Hill 2000).The evidence from the current experiment and numerous surveys (e.g., Li et al. 2004; Libbus and Kolostov 1994; McIntyre et al. 2001b) indicate that these public health efforts need to be much broader and attempt to address negative societal attitudes of the general public. Women are simultaneously encouraged and discouraged by societal expectations regarding breastfeeding. The message seems to be “The ideal mother breastfeeds, but not if we have to see it”. It sets up an impossible situation where women feel negative emotions about their feeding choice, regardless of what that choice is (Guttman and Zimmerman 2000). Normalizing the image of a woman breastfeeding a child would go a long way toward making it easier for a future mother to imagine herself breastfeeding at the airport, restaurant, or shopping mall and for the community members of that mother to encourage and support that behavior.

Acknowledgement

Thanks to Dr. Thomas Nelson and Dr. Laura Bennett-Murphy for their insightful comments on earlier versions of this paper.

Copyright information

© Springer Science+Business Media, LLC 2009