Illustration of mother and baby bonding in NICU, Cartesian dualism fading.

Beyond the Bottle: Reimagining Breastfeeding Support in Neonatal Care

Beau Callahan in Health & Wellness June 2025 • 4 min read.

"Discover how rethinking Cartesian dualism can transform breastfeeding in the NICU, empowering mothers and improving infant outcomes."

Breastfeeding is universally recognized as the optimal form of nutrition for infants, offering a wealth of health benefits for both mother and child. Global health organizations champion exclusive breastfeeding for the first six months of life and beyond. Yet, despite these strong recommendations, breastfeeding rates, particularly for premature or critically ill infants, often fall short of targeted goals.

For infants in the Neonatal Intensive Care Unit (NICU), breastfeeding takes on a new layer of complexity. The NICU environment, with its advanced technology and medical interventions, can inadvertently shift the focus away from the holistic breastfeeding experience, emphasizing instead the immunological and nutritive benefits of breast milk as a medical necessity. This perspective, rooted in Cartesian dualism, risks overlooking the crucial relational aspects of breastfeeding.

Cartesian dualism, the philosophical concept that separates mind from body, has profoundly influenced Western medicine. In the context of breastfeeding, this dualistic view can lead to a mechanistic approach that reduces the breastfeeding mother to a lactating object, disconnecting her emotional and psychological well-being from the physical act of nourishing her child.

What's Wrong with the Mechanistic View of Breastfeeding in the NICU?

Illustration of mother and baby bonding in NICU, Cartesian dualism fading.

The Cartesian influence in healthcare fosters a reductionist perspective, fragmenting the body into isolated parts and focusing on quantifiable metrics. Breastfeeding, under this lens, becomes about the volume of milk produced, its nutritional content, and the infant's weight gain. The intimate connection between mother and child, the emotional support, and the unique dynamic of their relationship are often sidelined.

This approach can manifest in several detrimental ways:

Mothers may feel pressured to maximize milk production, leading to stress and anxiety if they perceive their supply as inadequate.
The focus on quantifiable outcomes can overshadow the mother's emotional and psychological needs, leading to feelings of isolation and disempowerment.
The separation of mother and infant, common in the NICU, disrupts the natural breastfeeding dynamic and hinders bonding.
Medical interventions, while necessary, can further distance the mother from the breastfeeding process, making her feel like a mere provider of milk rather than an active participant in her child's care.

Ultimately, the mechanistic view of breastfeeding in the NICU undermines the mother's confidence, disrupts the natural breastfeeding process, and neglects the crucial relational aspects that contribute to a positive and fulfilling experience.

A Call for Relational Breastfeeding Support

Moving beyond the limitations of Cartesian dualism requires a fundamental shift in how healthcare professionals approach breastfeeding support in the NICU. By recognizing the importance of the mother-infant relationship and prioritizing the mother's emotional well-being, we can create a more supportive and empowering environment for breastfeeding families. Future research from a more critical lens is needed to examine the complex dynamics involved when nurses and mothers are negotiating decisions and processes related to infant feeding. In focusing on the relational dimensions of the breastfeeding experience, nurses can resist the dualistic influence and dominant discourses impacting infant feeding and motherhood in the 21st century.

About this Article -

This article was crafted using a human-AI hybrid and collaborative approach. AI assisted our team with initial drafting, research insights, identifying key questions, and image generation. Our human editors guided topic selection, defined the angle, structured the content, ensured factual accuracy and relevance, refined the tone, and conducted thorough editing to deliver helpful, high-quality information.See our About page for more information.

This article is based on research published under:

DOI-LINK: 10.1111/jocn.14686, Alternate LINK

Title: Breastfeeding Woman Or Lactating Object? A Critical Philosophical Discussion On The Influence Of Cartesian Dualism On Breastfeeding In The Neonatal Intensive Care Unit

Subject: General Medicine

Journal: Journal of Clinical Nursing

Publisher: Wiley

Authors: Jacqueline Elizabeth Wijlen

Published: 2018-11-08

Everything You Need To Know

Why is breastfeeding considered so important, and what unique challenges arise when breastfeeding in the NICU?

Breastfeeding is considered optimal for infants due to its numerous health benefits for both the mother and child. Global health organizations advocate for exclusive breastfeeding for the first six months and beyond. However, in the Neonatal Intensive Care Unit (NICU), breastfeeding rates often fall short of these goals. The NICU environment, with its technology and medical interventions, can unintentionally shift focus from the holistic breastfeeding experience to the immunological and nutritive benefits of breast milk, overlooking the relational aspects.

How does Cartesian dualism, the separation of mind and body, affect the approach to breastfeeding in healthcare settings?

Cartesian dualism influences Western medicine and healthcare by separating the mind from the body. In the context of breastfeeding, this dualistic view can lead to a mechanistic approach, reducing the breastfeeding mother to a lactating object. This approach disconnects her emotional and psychological well-being from the physical act of nourishing her child, sidelining the intimate connection between mother and child.

In what specific ways can a mechanistic view of breastfeeding in the NICU be detrimental to both mother and infant?

A mechanistic view of breastfeeding in the NICU focuses on quantifiable metrics like milk volume, nutritional content, and infant weight gain, often overshadowing the mother's emotional and psychological needs. This approach can lead to mothers feeling pressured to maximize milk production, stress and anxiety if they perceive their supply as inadequate, feelings of isolation and disempowerment, disruption of natural breastfeeding dynamics due to separation of mother and infant, and intervention making the mother feel like a mere provider of milk rather than an active participant.

What is the alternative to Cartesian dualism, and how can healthcare professionals implement a more relational approach to breastfeeding support?

Moving beyond Cartesian dualism requires healthcare professionals to shift their approach to breastfeeding support in the NICU. By recognizing the importance of the mother-infant relationship and prioritizing the mother's emotional well-being, we can create a more supportive and empowering environment for breastfeeding families. Future research should focus on the relational dimensions of the breastfeeding experience, enabling nurses to resist dualistic influences and dominant discourses impacting infant feeding and motherhood.

What does 'relational support' mean in the context of breastfeeding support in the NICU, and how does it differ from the traditional mechanistic approach?

Focusing on relational support means recognizing the importance of the mother-infant relationship and prioritizing the mother's emotional well-being. This involves providing emotional support, encouraging bonding between mother and child, and ensuring the mother feels like an active participant in her child's care. By focusing on the relational dimensions of the breastfeeding experience, nurses can resist the dualistic influence of Cartesian dualism and dominant discourses impacting infant feeding and motherhood in the 21st century.