Lived Experiences of breastfeeding in Jogjakarta, Indonesia

220 Pages·2017·2.17 MB·English

by  John Paul Nyonator

Lived Experiences of breastfeeding in Jogjakarta, Indonesia: Forms of authority beyond
the law

John Paul Nyonator

A Thesis Submitted in Partial Fulfillment of the Requirements for the Degree of
Ph.D. in Population Health

Interdisciplinary Degree in Population Health
University of Ottawa

©John Paul Nyonator, Ottawa, Canada, 2017.
Doctoral Committee:
Julie Laplante - Supervisor
Phyllis Rippey – Co-Supervisor
Marguerite Soulière
Ivy Lynn Bourgeault
Tanya Cassidy

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Dedication

For Klenam and Senam

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Acknowledgements
This research was financed through Social Sciences and Humanities Research Council of
Canada (SSHRC), as part of the jamu research and Faculty of Graduate and Postdoctoral Studies.
This dissertation came from months of learning from breastfeeding mothers in Jogja. I am
grateful to all my participants and their families who welcome me into their homes and shared
their experiences with me. My deepest gratitude goes to Elfrida Tuti and her family for all the
supports they gave me while I was in Jogja. I am indebted to my supervisors Julie Laplante and
Phyllis Rippey, who took me as their son. They were there for me during both bad and good
times.
I also want to thank the anthropology department, Gadjah Mada University for their
institutional supports during my stay in Jogja. I am particularly thankful to Pujo who assisted me
with all the documentations in needed for ethics and visa application. I am also grateful to
sociology and anthropology department, the University of Ottawa for facilitating the
collaboration with Gadjah Mada University.
Throughout this dissertation, I have been supported by many friends and colleagues of
whom I can name few of them. I am grateful to Angela Wegner, Selasi Gbeve, Francis Agama,
and Delali Agboada for their constructive comments and linguistic editing that help to improve
the overall quality of the thesis. I am also grateful to Costanza Torri for her thorough comments
on the part of the dissertation. I am also thankful to my colleagues in Population Health program
especially Apho, Myria, Rodrigue, Ide, Maisam, Luciane for all their encouragement.
My final thanks go to my loving wife, Klenam and my wonderful daughter Senam. I love you
two. Max Zormelo, thank you so much for all the supports. Bene and Cherita, thank you for
being great sisters and encouraging me during difficult times.
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Table of Contents
Dedication……………………………………………………………………………………...iii
Acknowledgements…………………………………………………………………………….iv
Abstract………………………………………………………………………………………....ix
Introduction……………………………………………………………………………………..1
Context…………………………………………………………………………………..7
Research in Jogjakarta…………………………………………………………………..11
Overview of thesis ………………………………………………………………………16
Chapter 1. Literature Review
The benefits and critiques of breastfeeding….…………………………………………..20
Islam and breastfeeding………………………………………………………………….30
Breastfeeding practices and Employment………………………………………………..32
Public breastfeeding……………………………………………………………………...37
Conclusion……………………………………………………………………………….39
Chapter 2. Theoretical perspective
Embodiment……………………………………………………………………………...41
Biopower………………………………………………………………………………....54
Chapter 3. Methodology
Ethnographic Fieldwork………………………………………………………………….61
Recruitment of participants………………………………………………………………64
Research Participants…………………………………………………………………….64
Description of participants……………………………………………………………….65
The choice of and training of research assistant…………………………………………72
Participant observation…………………………………………………………………...73
Interviews………………………………………………………………………………...75
Photo Novellas…………………………………………………………………………77
Data Analysis……………………………………………………………………………78
Conclusion………………………………………………………………………………81
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Chapter 4. Breastfeeding: Women’s voice on the ground
Forms of authorities evoked as part of the decision to breastfeed…………………….82
Who takes part in shaping women’s preparation towards breastfeeding.......................86
Waking up to an alarm clock to breastfeed…………………………………………….92
Mothers’ experiences after they returned from the hospital……………………………92
Navigating breastfeeding difficulties after the mothers returned home………………..96
Baby is old enough to start eating……………………………………………………..100
Infant Weaning practices………………………………………………………………105
Conclusion…………………………………………………………………………......108
Chapter 5. Family contributions to breastfeeding
Men shaping and shaped by the breastfeeding experience of their partners
serving as sources of support…………………………………………………………..110
The role of the grandmothers…………………………………………………………..117
Conclusion……………………………………………………………………………...128
Chapter 6. Working and Breastfeeding Practices
Breastfeeding shaping mothers’ work decisions………………………………………132
Work shaped by and shaping breastfeeding experiences of mothers………………….135
Conclusion……………………………………………………………………………..144
Chapter 7. Islamic faith as a form of authority influencing women’s experiences
Women’s interpretations of private and public places…………………………………148
Hiding the breast in public……………………………………………………………...150
Breastfeeding in public spaces………………………………………………………….153
Breast milk kinship in Islam……………………………………………………………161
Conclusion…………………………………………………………………………… 167
Conclusion……………………………………………………………………………………...170
Appendix………………………………………………………………………………………..177
References………………………………………………………………………………………188
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List of Illustrations
Figure 3.1. A map of different neighborhoods of the families…………………………………..65
Figure 3.2. Researcher played with a baby in the field…………………………………………..74
Figure 4.1. Infant food: Natural and healthy……………………………………………………104
Figure 6.1. Ambar expressed her milk in the washroom at work………………………………136
Figure 6.2. Juleha’s freezer was packed with expressed milk at home………………………...139
Figure 6.3. Siti’s freezer packed with expressed milk………………………………………….141
Figure 6.4. Manual pump and warmer………………………………………………………….142
Figure 7.1. A mom used a hijab to cover breasts while nursing………………………………..152
Figure 7.2. Breastfeeding dresses sold by Nadja……………………………………………….153
Figure 7.3. A mom demonstrating how she breastfed her daughter while driving motorbike…156
Figure 7.4. Lactation room at Ambarukmo Plaza………………………………………………157
Figure 7.5. Lactation room built by SGM………………………………………………………158

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List of tables
Table 1.1. Pattern of breastfeeding infants aged 0-5 months by age group…………………..177
Table 1.2. Pattern of breastfeeding in Indonesia……………………………………………...177
Table 1.3. Pattern of breastfeeding infants aged 0-5 months by characteristics………………178
Table 1.4. Places where mothers give births…………………………………………………..179
Table 3.1. Summary of the forms of authority that mothers spoke of…………………………180
Table 4.1. Duration of breastfeeding and weaning…………………………………………….185
Table 6.1. Mothers’ work status, place of work and length of maternity leave………………..186

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Abstract
In 2009, the Indonesian government passed a breastfeeding law to address the problem of
malnutrition, infant mortality and mortality of children under five years old. The law mandated
mothers to breastfeed their babies exclusively for the first six months of their lives and continue
for two years, except in cases where medical problems prevent mothers from breastfeeding. I aim
to tease out women’s experience of breastfeeding in Jogjakarta, Indonesia, five years after the
law was passed. Ultimately, I am interested in understanding how do women's breastfeeding
experiences embody different forms of authority. I drew upon data from ethnographic fieldwork
that was carried out from June 2013 until October 2014. I argue that the breastfeeding law is
remote and distant from the everyday breastfeeding practices and experiences of the women and
their families. The women who take part in the study neither draw on the law nor public health as
forms of authority to shape their breastfeeding experiences. Rather the women draw on their
Islamic faith, families, personal experiences, finance, work and media to shape their
breastfeeding experience
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Introduction
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My interest in breastfeeding first emerged while I was working on a jamu project in
Jogjakarta in 2013. During the jamu research, I observed that women often buy jamu drinks
made from papaya leafs called uyup-uyup. I became curious about it and began to ask my
Javanese friends why women would drink jamu uyup-uyup. The answer I received from my
friends was that jamu uyup-uyup enhanced the production of breast milk. This was fascinating to
me because I have always thought that as a child sucks her mother’s breast, milk is produced. I
never knew that some women experience low supply of milk and had to drink jamu to increase
milk production. Many of my friends thought I was crazy to research breastfeeding since it is
mainly in the domain of women. But I was determined to carry out this study because I was
breastfed as a child and I know that maternal and child welfare is a concern for all people.
Hopefully, this endeavor will provide original insights into women’s experiences and practices
of breastfeeding, as well as become a way of encouraging other men to offer support to women
who can or cannot breastfeed.
When I came back to Canada, I started reading more of the breastfeeding literature and
found two further reasons why studying women’s experiences of breastfeeding might be
significant. First, breastfeeding has received much more attention in the public health discourse
than in the social sciences. In the public health literature, much attention is paid to the health
risks and benefits of breastfeeding for infants and mothers (Howie, 1990; Mitchell, 1992;
Dewey, 1993; Newcomb, 1994; Lawrence, 1995; Golding et al. 1997; Scariati et al., 1997;
Labbok, 1999; WHO, 2003; American Academy of Pediatrics, 2005). However, the public health
literature has not been interested in women’s actual experiences of breastfeeding notwithstanding
aiming to apply policies and regulations that police women who breastfeed. It thus seemed to me
1