Sociology, Anthropology and Education: Culture, Systems and Teaching
Culture, systems and teaching
The WHO International Code of Marketing of Breast-milk Substitutes (1981) and later resolutions restrict promotion of breast-milk substitutes, bottles and teats: no advertising, no free samples, no gifts to health workers. The Ten Steps to Successful Breastfeeding (revised 2018) describe facility practice, from antenatal counselling to coordinated discharge. Know these as frameworks, not slogans.
Sociology and anthropology: feeding happens inside families and cultures. Colostrum may be discarded, prelacteal feeds given, or breastfeeding considered taboo in public; the practitioner's job is cultural humility, curiosity about the family's beliefs, and negotiation rather than correction. Structural determinants - parental leave, workplace lactation space, shift work, housing, racism and implicit bias in care - shape outcomes more than any single teaching session. Disparities in lactation support are well documented.
Education: adults learn when content is relevant, problem-centred and practised. Health literacy varies; use plain language, limit to 2–3 messages per visit, and confirm with teach-back ("Tell me in your own words what you'll do at the next feed"). Skills need demonstration and return demonstration; knowledge alone rarely changes behaviour. Peer and community support improve duration and are worth referring to.
Trap: the question that offers "give the mother an information leaflet" as the best answer when a skill, a follow-up visit, or a supportive policy is available.
Rule of thumb: information changes knowing; demonstration plus follow-up changes feeding.