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As breastmilk is produced by and stored within the female body, its meanings are often inextricably linked to the characteristics of the woman producing it and her environment (Waltz & Ross 2016). Similarly to other bodily fluids associated with life-giving essences, such as blood and semen (Cohen 2019), breastmilk is a substance believed to carry within it the essence of the person from whom it is extracted, such that its introduction into another body creates a substantive relationship, often rife with symbolic meaning. This relationship is one I refer to as ‘consubstantiation’ (Smith 1992; Parkes 2004), in which breastmilk, an essentialized substance of a woman, is fed to an infant and thus integrated into its body, such that something of the milk producer’s personhood is conferred onto the receiver. In addition to suggesting shared characteristics, the consubstantial mother-infant dyad establishes a unique interaction that involves shared resources (Miller 2018) and carries implications for the kin networks of both participants (Ginsburg & Rapp 1991).

Just as the human body can be understood both as a physical, individual self and as a “symbolic artifact” representative of larger social relationships (Scheper-Hughes & Lock 1987, p. 7), so can the maternal body and the milk it produces be read as both a simple food source and a symbol of the complex relationship between woman and infant. Each of the copious symbolic meanings of breastmilk seen across human societies and within unique circumstances has its own implications for how consubstantial mother-infant relationships are read and negotiated. As breastmilk is a substance of the woman’s body through which the infant receives both nourishment and essence of the mother’s personhood, their consubstantial relationship integrates the mother-infant dyad into a shared kinship network. I argue, however, that these ties must then be negotiated based upon whether they are considered desirable under the reign of moral motherhood (Reyes-Foster & Carter 2018), a culturally-constructed and mutable conception of what defines valued or shameful mother-infant dyads as applied to the reproductive lives of cisgender women. The symbolic meaning of breastmilk within a given dyad shapes the interpretation of the mother’s role in the relationship, the theory of what substance she is conferring to the infant, and thus the consubstantial relationship’s congruence with the strictures of moral motherhood.

Importantly, the breastmilk mother-infant dyad is not always a simple relationship between a woman and the infant whom she birthed and feeds; practices of shared milk across human history through wet-nursing, fostering, and contemporary milk donation introduce complexities to the dyad which explicate the desire of many to reinterpret consubstantial relationships and disambiguate (Thompson 2002) the infant’s mixed sources of substance. Therefore, I do not consider the symbolic meaning of the physical process of breastfeeding here so much as that of breastmilk as a substance, being that several of the consubstantial relationships relevant to this discussion are created through bottle-feeding of human breastmilk, a process socially distinct from breastfeeding. Many women in the UK, for example, view pumping and bottle-feeding their own breastmilk to the infant as preserving the same relationship created through breastfeeding (Ryan et al. 2013), suggesting that it is consubstantiation more so than “the bodily practice of nursing” (Waltz & Ross 2016, p. 52) that creates meaningful substantive relationships. Whether these relationships must be renegotiated, then, is based upon the interpretation of what symbolic substance breastmilk confers to an infant in a given circumstance through the lens of moral motherhood, especially where the dyad is between a woman and infant who are not related by both birth and nursing.

As moral motherhood is culturally constructed, its meanings — and thus the value it attributes to various relationships created through breastmilk expression and consumption — differ across contexts. Much of the concept of moral motherhood is rooted in “claims of women’s superior political morality” (Ginsburg & Rapp 1991, p. 314) — that they are removed from the influences of social whims through their ingrained role as natural nurturers. I refer to motherhood specifically rather than parenthood because the “dominant ideology… sees mothers as solely responsible for their own infants’ nutrition” (Reyes-Foster & Carter 2018, p. 26) by nature of their presumed role as milk producers. The substance shared with an infant through breastmilk is derivative of the female body, and its meanings and implications are, therefore, often deemed a mother’s duty, even and especially in circumstances of more complex mother-infant dyads, such as those created through adoptive breastfeeding and wet-nursing.

Much of the contemporary Euro-American manifestation of moral motherhood employs language of the natural and that which disrupts the natural (Bledsoe & Scherrer 2007) so as to champion breastmilk and its consubstantiation of mother and child as the pinnacle of ideal motherhood, and any break from this pattern as preternatural. The belief in breastmilk as a superior source of infant nutrition has been a cultural theme since well before the advent of germ theory and the availability of safe alternatives to breastmilk (Stevens et al. 2009), but today, due to the accessibility of choice for alternative forms of nutrition, that superiority is often framed as a moral imperative of the mother stemming from naturalism and the portrayal of nature as best. The tools involved in artificial feeding methods are intruders in the mother-infant dyad (Regan & Ball 2013) who interrupt bonding (Bledsoe & Scherrer 2007), and it is, therefore, the mother’s individual responsibility (Ginsburg & Rapp 1991) to wield sufficient control over her body — and, by extension, control over her child’s kin network — to share substance with her child. Where a mother is unable to feed her own child, chooses to feed another child, or allows her child to be fed by another, the expectations of moral motherhood intervene to direct negotiations of the relationships that emerge through consubstantiation of those outside the simplest form of the mother-infant dyad. At the core of this discomfort with disrupted natural relationships is the belief that, through breastmilk, something of the milk producer’s character, motivations, or personhood is being passed on to the infant. The first step that is necessary to understand in this process, then, is that of consubstantiation through the transfer of milk.

Consubstantiality

The consubstantial relationship between a woman and an infant arises out of the belief that her breastmilk carries with it the essence of her character (Hill et al. 1987) and implications of kinship (Parkes 2004), which then become part of the infant’s character and kin network through its consumption of the milk. These ideas are rooted in concepts of the body as an integration of both the “self and social relations” (Scheper-Hughes & Lock 1987, p. 21), such that the body’s substances become symbolic of its identity as an individual entity and a social tool. Much of the association between breastmilk and kin is related to the symbolism of milk as derivative of, or related to, blood, through the two substances’ shared characterizations as bodily fluids with heritable biological meaning. Among the Malays of Langkawi, for example, blood relatedness is understood to be the defining measure of kinship, and the breastmilk a mother feeds her infant is believed to be created out of her blood (Carsten 1995). Thus, by giving an infant their breastmilk, Malays women strengthen their blood relationship with their children. Although this may appear to be a distant concept, it has parallels within contemporary U.S. society. If an American adoptive mother goes through the arduous process of inducing lactation in order to feed her new child, she will find that the hospital may not allow her to breastfeed until the birth mother has relinquished her parental rights (Kurtzfamily 2013). In this context, breastmilk is believed to represent blood relatedness, such that only those with a legal relationship to a child are permitted to share this substance with it; as such, breastmilk is equated with blood.

This concept of relatedness through shared milk is referred to as ‘milk kinship’ in Islamic law, and carries in this context implications for incest taboos that highlight a belief in consubstantiation of milk producer and child (Parkes 2005). While the “widespread Islamic belief that a child’s character might be influenced by that of its nurse through her milk” (Parkes 2005, p. 314) demonstrates the consubstantial relationship of essence transferred through milk, milk kinship extends the belief in shared substance to posit that an infant consuming breastmilk enters into a consanguineal relationship with its nurse (Parkes 2004) and, by extension, with any other children fed by the same woman. Thus, practices such as contemporary milk banking, wherein donor milk from dozens of women are pooled and pasteurized as a conglomerate, constitute threats to the stability of an infant’s kin network — in consuming milk from myriad unknown women, an infant accumulates exponentially more unknown siblings (Cohen 2019). The relative dearth of milk banks in Muslim-majority countries (El-Khuffash & Unger 2012) therefore highlights the fear of allowing children who receive donor milk to unwittingly marry milk kin, such that those in need of donor milk often opt for an identifiable wet-nurse instead (Cohen 2019). This concept of milk kinship is thus representative of a belief in milk as a substance conferring blood relatedness.

As alluded to previously, the consubstantial relationship between mother and infant is not only understood as a form of blood relatedness, but is also rooted in a belief that a mother’s character can be transferred to, and integrated into, an infant through breastmilk. One historical context in which this form of consubstantiation arises is that of 19th-century European foundling homes for abandoned infants (Kertzer 1993). Infants born to unmarried women were often taken from their mothers — believed to be too immoral to feed their own infants — to be raised in foundling homes, while the mothers would serve as wet-nurses to other infants in the homes as a kind of indentured servitude, paying off their societal debt for having given birth while unmarried (Kertzer 1993). The irony of this set-up, of course, lies in the fact that unmarried women’s poor character, instead of “poison[ing]” their own infants (Kertzer 1993, p. 124), would simply be transferred to another infant. Even so, the belief that a mother who birthed an illegitimate child would further scathe it by contributing to its character development through her tainted milk drove authorities to prohibit such consubstantiation.

Having discussed how milk is believed to establish a consubstantial relationship between a mother-infant dyad through both kin relatedness and shared characteristics, it is then important to consider what exactly breastmilk is purported to represent. Milk is read differently across contexts, and often has multiple meanings even within the same mother-infant dyad, highlighting its dynamic nature as a symbol and the malleability of its varied meanings in negotiating the relationships it generates.

Symbolic Anthropology of Milk

The capacity of breastmilk to create and define relationships is closely linked to the symbolism it is believed to carry within it, which in turn is often related to cultural themes and assumptions pertaining to motherhood and nursing relationships. In contemporary Euro-American contexts, the predominant expectations for mothers which determine the meanings of their breastmilk are related to a moral imperative to have it all: mothers are expected to return to work quickly and “stay connected to their infant” through breastmilk (Ryan et al. 2013, p. 473), a situation which often leads women to turn to pump to balance the tension between their responsibilities. Closely related to this theme is that of natural motherhood, which expects processes of matrescence (Thorley 2015), breastfeeding included, to occur as evolutionarily intended, without the disruptions of modern technology (Bledsoe & Scherrer 2007) such as electric and even manual breast pumps (Ryan et al. 2013). Naturalism, in establishing the expectation that breastfeeding can and should occur unassisted, presents breastmilk as “a renewable resource” (Ginsburg & Rapp 1991, p. 325), such that it is read as an alternative, even a resistance (Murray de Lopez 2019), to artificial feeding methods as commodities. Taken together, a have-it-all mentality and naturalistic language create a context in which milk is at once a symbol of womanhood and a desire to bond with an infant, and a symbol of resistance to the commodification of infant nutrition. As such, it is clear that even within a single context, the meanings of breastmilk are neither static nor mutually exclusive, and they nearly ubiquitously extend beyond breastmilk as food.

With the emergence of pasteurization techniques and improved hygiene in the 19th century (Stevens et al 2009), alternative forms of infant nutrition became more feasible, but also precipitated a rather ironic shift towards a deeper understanding of the relative virtues of human milk; specifically, human milk’s role as a carrier of immunity. The symbolic value of breastmilk as immunity is rooted in its biological components, such as immunoproteins (Miller 2018), which confer aspects of the woman’s immunity onto the infant she feeds. Although movements for the resurgence of breastfeeding in recent centuries have often emphasized milk as immunity to encourage women to feel a sense of responsibility for their child’s health and safety, the simultaneous recasting of human breastmilk as a symbolic carrier of risk has complicated this approach. Since the development of safe artificial feeding options such as formula, the relative modernity (Nichter 2008) and perceived cleanliness (Stevens et al. 2009) of these options has advanced the cultural attitude towards breastmilk as a potential source of contamination, despite its concurrent contribution to immune health. This notion of risk dates back to the epidemics of diseases such as syphilis that coincided with the practice of foundling home wet-nursing in 18th and 19th century Europe (Thorley 2015; Kertzer 1993).

The tragic experience of wet-nurses of syphilitic foundling infants is exemplified by the story of a young Italian woman who unwittingly contracted syphilis from a foster infant, leading to the death of her own daughter as well as the infection of her husband (Kertzer 2008). The bidirectional fear of breastmilk as a risk, both to infants from infected wet-nurse and to wet-nurse from infected infant, rendered breastmilk a symbol of potential negative outcomes, even a harbinger of death. Similar fears of the risk of ill-health through breastmilk are found in various contexts across time: impoverished Brazilian women fear their breastmilk may sour and harm offspring (Scheper-Hughes 1985); Bangladeshi mothers may associate colostrum with pus and infection (Zeitlyn & Rowshan 1997); some critics of modern milk sharing networks fear rampant bacterial growth in stored milk (Reyes-Foster & Carter 2018).

In contrast to the copious circumstances in which the feeding of breastmilk has been associated with contamination, breastmilk has at times even been read as a potential source of risk through a woman’s withholding of her milk, as reduced Euro-American birth rates in the 19th century produced suspicion of “selfish” women shirking their maternal responsibilities and “endanger[ing]” their offspring (Ginsburg & Rapp 1991, p. 316). Clearly, there is sufficient power in breastmilk as a symbol of conferred risk to shape not only breastfeeding practices, but also external readings of those practices. Despite the intense moral implications of risk, breastmilk can simultaneously carry this symbol and others, as is evident in the chain of breastmilk donation and processing for South African newborns in intensive care.

The racialized discourses of breastmilk donation in South Africa, wherein women who are often white donate their milk to sustain predominantly Black infants being treated in intensive care, often associate the breastmilk of Black mothers with symbolic risk through potential contamination with HIV (Waltz & Ross 2016). When provided by donors, however, the intensive care context reads breastmilk as medicine. Donations of milk are endowed with a kind of healing power, a symbol of the milk itself as a substance rather than of breastfeeding as a practice; it is the relationship of shared substance with a donor that heals. Human breastmilk is further read as medicine in that banked milk, both in South Africa and in Euro-American contexts, is prescribed by some medical professionals as a treatment for insufficient weight gain, failure to thrive, and related issues in infancy (Cohen 2019; Waltz & Ross 2016). As both a cause and product of this reading of breastmilk as medicine in the context of banked milk, the life-saving nature of donation extends milk into a symbol of altruism. Donors tend to use language which suggests that their milk saves lives and establishes them as foils to “deficient” birth mothers (Waltz & Ross 2016, p. 54). Milk is thus a symbol of altruism crafted by women who believe themselves to be saving the lives of anonymous children, often of lower socioeconomic status than their own.

As is evident in these myriad ways of understanding the symbolic meanings of breastmilk, the substance is rarely thought of as mere food. Milk often carries several connotations at one time, highlighting its characterization as both mutable and containing multitudes. As is evident within the chain of South African milk banks (Waltz & Ross 2016) and other milk sharing contexts (Cohen 2019), breastmilk is at once food, medicine, altruism, bonding, immunity, risk, and bodily fluid. Its multiple roles as a shared substance of mother and child are both produced by, and read through the lens of, its social context. As such, having discussed the copious meanings of breastmilk in establishing consubstantial relationships, I now turn to the subsequent negotiations of those relationships. How do the looming expectations of moral motherhood shape infant feeding practices on the individual and societal level, and how do they guide interpretations of nursing relationships across cultures?

Negotiations of Kinship

Though the influence of the moral motherhood concept varies across contexts, it is often rooted in a belief that women both can and should exert control over their reproductive behaviors naturally (Schneider 1968), breastfeeding included. It is therefore the responsibility of a mother to establish a consubstantial relationship with her child through breastmilk (Reyes-Foster & Carter 2018); where this expected natural dyad is disrupted (Bledsoe & Scherrer 2007), the resulting relationships must then be negotiated to adjust to the confines of moral motherhood. The language of moral motherhood can be explicit, simply labeling breastmilk as ‘good’ (Hayssen 1995; Kertzer & Barbagli 2001; Smith 1992), and mothers who do not feed their own substance to their children ‘bad’ (Reyes-Foster & Carter 2018; Waltz & Ross 2016). It can also, however, be more informal and ambiguous, as in the case of induced lactation in adoptive parenting and surrogacy (Thompson 2002), where both relatedness and bonding are relevant categories for negotiation. Most negotiations of breastmilk consubstantiation, despite circumstantial differences, have in common an acknowledgment that infant feeding creates ties relevant to social relations (Carsten 1995) and a belief that motherhood is a process achieved through bonding behaviors beyond birth, most importantly nursing (Thorley 2015).

An especially illuminating context in which the negotiations of breastmilk relationships fall within the realm of moral motherhood is that of contemporary Euro-American peer-to-peer milk sharing networks. In contrast to donor milk banks, where donations are pooled and generalized (Cohen 2019), and online human milk platforms, where anonymity typically blocks parents from identifying their donor (Reyes-Foster & Carter 2018), informal peer-to-peer milk sharing, which I will refer to here simply as ‘milk sharing,’ allows parents to know and establish a relationship with their milk donor (Cohen 2019). There are several reasons why parents might prefer milk sharing over banked donor milk as a way to simplify negotiations of their infant’s consubstantial relationship to the source, or sources, of the milk. Although banked donor milk is mixed and purified by medical authorities, creating a layer of distance between donor and recipient that may bring comfort to some parents in its obscurity (Waltz & Ross 2016), many others find it challenging to disambiguate their child’s substantive tie to the milk source when that source is both anonymous and includes the substance of a high unknown number of women.

As with any case wherein the mother-infant dyad is interrupted in some way, the introduction of a milk sharing donor as substantively related to a child complicates the “two-in-oneness” (Thorley 2015, p. 311) of mother and child celebrated by moral motherhood. The relative comfort of milk sharing, however, lies in the fact that it often occurs between people with preexisting relationships and remains within higher social classes (Reyes-Foster & Carter 2018) such that there is reduced tension resulting from the integration of the donor into the mother-infant dyad and the child’s kin network. Further, milk sharing allows women to reconcile the expectation that they participate in the “ancient” practice of breastfeeding (Cassidy & Dykes 2019, p. 2) with the reality of the challenges of modern motherhood such as insufficient milk (Palmquist & Doehler 2015), while circumventing the artificial feeding alternatives that are believed to have “disembodied” motherhood (Ryan et al. 2013, p. 481). Thus, although a step removed from the consubstantiation of a child and its mother through her own breastmilk idealized by expectations of moral motherhood, milk sharing provides a way to operate with a more intimate knowledge of the donor than milk banking, while allowing society to maintain its moral imperative (Hayssen 1995) for human breastmilk over alternatives.

Although milk sharing simplifies the negotiation of an infant’s relationship to the donor, some proponents view the practice as a form of resistance to moral motherhood, acknowledging the existence of its strict expectations and attempting to push against them. These women view the role of milk sharing as redistributing the responsibility of milk production only to those who choose it, rather than to each individual woman who has a child (Cassidy & Dykes 2019) such that all children can benefit from breastmilk without all women having to give something of their own bodies to participate in motherhood (Boris 2019). The irony of milk sharing as resistance against the social regulation of women’s bodies, then, lies in the fact that its emergence as a practice is a product of the “breast is best” ideology, which in itself demands that women choose breastmilk over formula to fulfill a moral responsibility to their child (Murray de Lopez 2019, p. 813). Although operating outside of donor banks and online milk platforms, which are believed to commodify and thus taint breastmilk by establishing an extractive relationship to women’s bodies (Reyes-Foster & Carter 2018), milk sharing networks perpetuate the higher valuation of human breastmilk over alternatives, thus continuing to function within the confines of moral motherhood expectations even while aiming to resist them.

Beneficial to our conversation regarding kinship negotiations is the distinction between the state of “being a mother,” often achieved by giving birth or through genetic contribution, from the process of matrescence, or “becoming a mother,” achieved through nursing (Thorley 2015, p. 311). Here the context of European foundling home wet-nursing practices in the 18th and 19th centuries is again exemplary. An unwed woman separated from her biological child and nursing the child of another was made to experience an incomplete version of a consubstantial relationship with each of these infants. The process of matrescence was then further invalidated in foundling homes by applying layers of blame to the wet-nurses; the high infant mortality rate of the time was linked to their often involuntary contribution to the population of abandoned infants and the perceived low quality of their milk (Kertzer 1993), suggesting that even in creating a consubstantial relationship through nursing, they remained undeserving of the role of motherhood. As such, foundling homes functioned within moral motherhood expectations by severing a single woman’s relationship to her own child while discrediting her nursing relationship to the foundling infant or infants she breastfed.

Understandings of breastmilk’s role in matrescence remain relevant today in the motivations for parents by adoption and surrogacy who choose to induce lactation. Lactation induction is a labor-intensive and often expensive process that is not undertaken lightly (Brown 2014), suggesting that parents who engage in it believe that breastmilk consubstantiation carries intense and invaluable meaning to the formation of their relationship to a child carried by a third party. The motivations for induced lactation in adoption often point to a desire to negotiate relatedness, especially in the Euro-American sociocultural context that so highly values breastmilk as the moral method of infant feeding. The desire for induced lactation often stems from a notion that “nothing can really terminate or change the biological relationship” between blood relatives (Schneider 1968, p. 24), such as birth mother and infant. Adoptive parents may hope to compete with this biological relationship — and legitimize their tie to the child — by creating their own form of biological relatedness. Thus, in an attempt to align procreative intent with tangible relatedness (Thompson 2002), parents turn to consubstantiation through breastmilk. Matrescence arises here in the belief that the process of breastfeeding can transform a woman into a mother, while the absence of breastfeeding by the birth mother can render her motherhood incomplete, validating the legal adoption in a biosocial way.

Surrogacy relationships similarly expose attempts to disambiguate relatedness through breastmilk, especially as the intended parents of a child may have an established relationship with the surrogate mother that they must negotiate to legitimize their role as the parents. Some intended parents fear that allowing a surrogate mother to breastfeed will threaten their ability to bond with the child by creating an insurmountable attachment through both birth and nursing (Jefford 2021) and thus view induced lactation as the most viable pathway to providing their child with breastmilk while solidifying their role as the child’s parents.

The challenges parents face in inducing lactation and providing sufficient milk to their infant, as well as their reactions to these challenges, further illustrate the belief that consubstantiation matters to the creation of a meaningful relationship between mother and child. Brown (2014) describes feeling that she had failed her daughter — birthed by Brown’s sister but conceived from Brown and her husband’s gametes — by producing insufficient milk through induced lactation. Although she is genetically related to her daughter, Brown understood the quantity of breastmilk she produced to be symbolic of her ability to fully become a mother, rather than simply be a mother genetically. The amount of consubstantiation that Brown was able to achieve with her daughter was thus incremental, the volume of breastmilk correlated with the degree to which she perceived herself to be a worthy mother. This intense desire to produce sufficient milk ties back to the expectation of moral motherhood that a woman successfully and naturally breastfeed her children to be considered worthy of her role; without this consubstantial relationship, some feel that the foundations of their claims to parenthood, and specifically motherhood, would be incomplete.

Conclusion

The many context-specific ways in which people attempt to negotiate consubstantiation through breastmilk exhibit both the richness of human understandings of kinship and the pervasive role of moral motherhood expectations in driving infant feeding decisions and interpreting relationships of shared substance. The symbolic weight that breastmilk carries in human societies is dynamic, encompassing several conceptions of the substance as more than mere food or bodily fluid, but as essence of the woman producing it, her intentions, and her environment. While there are circumstances in which a degree of ambiguity is permitted in understandings of what consubstantiation means for the mother-infant dyad it creates or, in some cases, interrupts, many individuals attempt to demystify the meanings of breastmilk in order to stabilize or justify their position in a child’s life. At the root of these negotiations is the belief that human breastmilk carries moral value as the superior mode of infant nutrition. Those making infant feeding decisions must then access breastmilk to continue to operate within the guidelines created by moral motherhood strictures while elucidating the implications of relatedness that arise from substantive intrusions into the most simplified manifestation of the mother-infant dyad.

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