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Article

Abstract

This paper explores the commodification of women and biological processes, the confusion of scientific evidence with social agendas, and the conflict between marketing and public health. I assert that key actors in the healthcare marketplace - government, businesses, and doctors – have acted to enable weak medical and scientific evidence to be manipulated by ideological and profit-making partisans in a poorly regulated market. I focus on the unique role of the medical profession, which has acted with government and the private sector to shape the markets in human milk and infant formula. In a striking parallel to the pharmaceutical industry, where physicians’ prescribing practices are essential to raising demand for drugs, doctors also play a key role in the markets for mothers’ milk. First, physicians increase demand for this commodity - human milk - by identifying it as valuable, and then prescribe it to their patients as a cure for a medical problem. My claim is that this unacknowledged commodification of mothers’ milk perpetuates a traditional view of women and their role in the labor force, reinforces racial and class stereotypes about who is a good mother, strengthens the authority of the medical profession, and garners enormous profits for entrepreneurs in the human milk and infant formula markets. This commodification also distorts the decisions that new mothers and their partners make about breast feeding, formula feeding, or donating milk to a third party, and raises public health concerns about infants who may be at risk of harm from contaminated or adulterated human milk. The paper has four parts. The first part examines the history of breastfeeding and the deeply conflicted role of physicians in simultaneously promoting and discouraging breastfeeding. Both professional pediatrics and the federal government have been actively involved in the marketing breastfeeding as normative behavior. The second part of my paper addresses the markets in human milk and infant formula. The markets in human milk include both a not-for-profit market encompassing milk banks and informal milk-sharing agreements arranged online and a for-profit market that includes wet nurses and a corporation that takes donated milk and manufactures it for sale to hospitals for $184 an ounce. Women who donate milk to this for-profit corporation are apparently unaware of the profits made by the corporation when their milk is sold. The market for infant formula – the “next best thing” to mother’s milk – is supported by the medical profession and the government through the Women’s Infant and Children’s Nutrition (WIC) Program. The monopsony power of the WIC program has led to increased formula prices for all consumers. The third part of my paper connects the commodification of breastfeeding and the markets in human milk and infant formula. Here I draw on the work of pro-commodification scholars who suggest that incorporating market-based analysis can actually protect vulnerable populations, including women. My paper proposes a limited market solution in which women will be able to sell or donate their milk, under regulations which protect both women and their children. I conclude with recommendations for changes in the law, the marketplace, and the health care system to promote the autonomy of American women and protect their own and their children’s health.

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