Applying Feminist Poststructuralism as a Framework for Exploring Infant Feeding Interactions in the Neonatal Intensive Care Unit

Keywords: Feminist poststurcturalism, Nursing practice, Infant feeding, breastfeeding, chest feeding, neonatal intensive care unit


Childbearing/rearing families in Canada face a variety of conflicting discourses related to infant feeding, entrenched in a complex web of gendered, social, institutional and political discourses. For parents of preterm and/or critically ill infants, this area remains largely under-explored through a feminist lens. We offer a critical examination of the applicability of feminist poststructuralism (FPS) as a theory to explore infant feeding interactions in the neonatal intensive care unit (NICU). Scholarly literature from diverse perspectives, including nursing, healthcare, gender studies, and social sciences is critiqued and the use of FPS as a guiding framework for nursing research and praxis is discussed. We discuss FPS and the relevance of various discourses to explore the phenomenon of infant feeding interactions in the NICU. Ultimately, we propose that FPS does offer a relevant lens through which to critically examine infant feeding interactions and bring voice to the complex processes embedded in the NICU.

Author Biographies

Jacqueline Elizabeth van Wijlen, McGill University & St. Francis Xavier University

Jacqueline is a graduate of St. Francis Xavier University (Bachelor of Science in Nursing with Advanced Major), Dalhousie University (Master of Nursing-Nurse Practitioner Stream: Family/All-Ages) and a current PhD student at McGill University in the Ingram School of Nursing. The focus of her PhD research is a qualitative exploration of infant feeding in the Neonatal Intensive Care Unit (NICU) using a feminist poststructural lens. In conjunction with her PhD studies, Jacqueline currently holds a tenure-track position as an Assistant Professor in the Rankin School of Nursing at St. Francis Xavier University, teaching courses in research methods, maternal-child and family health & wellness.

Megan Aston, School of Nursing, Dalhousie University

Dr. Megan Aston is a Professor and Associate Director of Research and International Affairs at the School of Nursing Dalhousie University and has a scientific affiliate position at the IWK Health Centre and Nova Scotia Health Authority. Her program of research focuses on maternal, child and newborn health in the community and hospital both locally and globally. She also conducts research with children with intellectual disabilities, their families and health care professionals who care for them. She uses feminist poststructuralism informed by discourse analysis to examine how nurses and clients negotiate beliefs, values and practices that have been socially and institutionally constructed through relations of power.


Alianmoghaddam, N., Phibbs, S. & Benn, C. (2017). Resistance to breastfeeding: A Foulcauldian analysis of breastfeeding support form health professionals. Women and Birth, 30, e281-e291 DOI:

Aranda, K. (2006). Postmodern feminist perspectives and nursing research: A passionately interested form of inquiry. Nursing Inquiry, 13(2), 135-143. DOI:

Aranda, K. (2018). Feminist theories & concepts in healthcare: An introduction for qualitative research. London, UK: Macmillan Publishers Ltd. DOI:

Aston, M. (1990). Bonding sounds too much like glue: Pedagogical implications of the experiences of breastfeeding. Masters Thesis, Kingston, ON: Queen’s University.

Aston, M. (2002). Learning to be a normal mother: Empowerment and pedagogy in postpartum classes. Public Health Nursing, 19(4), 284-293. DOI:

Aston, M., Meagher-Stewart, D., Sheppard-LeMoine, D., Vukic, A. & Chircop, A. (2006). Family health nursing and empowering relations. Pediatric Nursing, 32(1), 61-67.

Aston, M. (2008). Public health nurses as social mediators: Using feminist poststructuralism to guide practice with new mothers. Nursing Inquiry, 15(4) 280-288. DOI:

Aston, M. (2016). Teaching feminist poststructuralism: Founding scholars still relevant today. Creative Education, 7(15), 2251-2267. DOI:

Aston, M., Price, S., Etowa, J., Vukic, A., Young, L., Hart, C., MacLeod, E. & Randel, P. (2015). The power of relationships: Exploring how public health nurses support mothers and families during postpartum home visits. Journal of Family Nursing, 21(1), 11-34. DOI:

Aston, M., Price, S., Kirk, S.F.L. & Penney, T. (2012). More than meets the eye. Feminist poststructuralism as a lens towards understanding obesity. Journal of Advanced Nursing, 68(5), 1187-1194.

Benoit, B., Goldberg, L. & Campbell-Yeo, M. (2016). Infant feeding and maternal guilt: The application of a feminist phenomenological framework to guide clinician practices in breastfeeding promotion. Midwifery, 34, 58-65. DOI:

Bicking, C. & Moore, G.A. (2012). Maternal perinatal depression in the neonatal intensive care unit: The role of the neonatal nurse. Neonatal Network, 31(5), 295-304. DOI:

Boykova, M. (2016). Transition from hospital to home for parents of preterm infants: A literature review. Journal of Perinatal and Neonatal Nursing, 30(4), 327-348. DOI:

Blackburn, A.C. (2009). Stories, ethics and the interpretations of meaning: Bearing witness to mothers’ stories of their neonatal intensive care experience. Doctoral Thesis, Retrieved from:

Boucher, C.A., Brazal, P. M., Graham-Certosini, C., Carnaghan-Sherrard, K. & Feeley, N. (2011). Mother’s breastfeeding experiences in the NICU. Neonatal Network, 30(1), 21-28. DOI:

Brown, A. (2017). Breastfeeding as a public health responsibility: A review of the evidence. Journal of Human Nutrition & Dietetics, 30(6), 759-770. DOI:

Canadian Paediatric Society. (2013). Nutrition for healthy term infants, birth to six months: An overview. Retrieved from:

Canadian Paediatric Society. (2014). Nutrition for healthy term infants, six to 24 months: An overview. Pediatric Child Health, 19(10), 547-549.

Carroll, K. (2014). Body dirt or liquid gold? How the ‘safety’ of donated breastmilk is constructed for use in the neonatal intensive care unit. Social Studies of Science, 44(3), 466-485. DOI:

Carter, P. (1995). Feminism, breasts and breast-feeding. New York, NY: Palgrave Macmillan. DOI:

Cassidy, C. Goldberg, L. & Aston, M. (2016). The application of a feminist poststructural framework in nursing practice for addressing young women’s sexual health. Journal of Clinical Nursing, 25, 2378-2386. DOI:

Cody, W.K. (2003). Paternalism in nursing and healthcare: Central issues and their relation to theory. Nursing Science Quarterly, 16(4), 288-296. DOI:

Cricco-Lizza, R. (2016). Infant feeding beliefs and day-to-day feeding practices of NICU nurses. Journal of Pediatric Nursing, 31(2), e91-e98. DOI:

Dalzell, J., Rogerson, E. & Martindale, L. (2010). Breastfeeding: Contemporary issues in practice and policy. Oxon, UK: Radcliffe Publishing Ltd.

Davies, B. & Gannon, S. (2010). Feminism/post-structuralism (Ch. 36). In B. Somekh & C. Lewin’s (eds.) Research Methods in the Social Sciences (2nd ed.). Thousand Oaks, CA: SAGE Publications. pp. 312-319.

Deeney, K., Lohan, M., Spence, D., Parkes, J. (2012). Experiences of fathering a baby admitted to neonatal intensive care: A critical gender analysis. Social Science & Medicine, 75(6), 1106-1113. DOI:

Dieterich, C.M., Felice, J.P., O’Sullivan, E. & Rasmussen, K.M. (2013). Breastfeeding and health outcomes for mother-infant dyad. Pediatric Clinics of North America, 60(1), 31-48. DOI:

DiQuinzio, P. (1993). Exclusion and essentialism in feminist theory: The problem of mothering. Hypatia, 8(3), 1-20. DOI:

Dykes, F. (2005). ‘Supply’ and ‘demand’: Breastfeeding as labour. Social Science & Medicine, 60(10), 2283-2293. DOI:

Dykes, F. & Flacking, R. (2010). Encouraging breastfeeding: A relational perspective. Early Human Development, 86(11), 733-736. DOI:

Edwards, N.P. (2005). Birthing autonomy: Women’s experiences of planning home births. New York, NY: Routledge.

Feldman-Winter, L. (2013). Evidence-based interventions to support breastfeeding. Pediatric Clinics of North America, 60(1), 169-187. DOI:

Foucault, M. (1975/1979). Discipline and punish: The birth of the prison. New York, NY: Vintage Books.

Foucault, M. (1982). The subject and power. Critical Inquiry, 8(4), 777-795. DOI:

Gionet, L. (2013). Breastfeeding trends in Canada (Statistics Canada Catalogue No. 82-624-X). Retrieved from:

Greaves, L. (2018). Personal and political: Stories form the women’s health movement 1960 2010. Toronto, ON: Second Story Press.

Haug, F. (1987). Female sexualization: A collective work of memory. Norfolk, UK: Thetford Press. hooks, b. (2000). Feminist theory: From margin to center (2nd ed). Brooklyn, NY: South End Press.

hooks, b. (2015). Feminism is for everybody: Passionate politics. New York, NY: Routledge.

Hurst, N., Engebreston, J. & Mahoney, J.S. (2013). Providing mothers’ own milk in the context of the NICU: A paradoxical experience. Journal of Human Lactation, 29(3), 366-373. DOI:

Infant Feeding Working Group. (2015). Nutrition for healthy term infants:Recommendations from birth to six months. Retrieved from:

Inglis, D. (2010). A feminist phenomenological study of skin-to-skin contact with mothers and nurses in NICU. Masters’ Thesis, Retrieved from ProQuest Dissertations & Theses Global (UMI No. MR63637).

Jefferies, A.L. (2014). Going home: Facilitating discharge of the preterm infant (Canadian Pediatric Society position statement). Paediatrics & Child’s Health, 19(1), 31-36. DOI:

Johnson, S., Williamson, I., Lyttle, S. & Leeming, D. (2009). Expressing yourself: A feminist analysis of talk around expressing breast milk. Social Science & Medicine, 69(6), 900-907. DOI:

Layne, L. (1996). "How's the baby doing?" Struggling with narratives of progress in a neonatal intensive care unit. Medical Anthropology Quarterly, 10(4), 624-656. DOI:

Lupton, D. (1992). Discourse analysis: A new methodology for understanding the ideologies of Health and illness. Australian Journal of Public Health, 16(2), 145-150. DOI:

MacConnell, G., Aston, M., Randel, P. & Zwaagstra, N. (2012). Nurses’ experiences providing bereavement follow-up: An exploratory study using feminist poststructuralism. Journal of Clinical Nursing, 22(7-8), 1094-1102.

Marcotte, M. (2017). Examining the climate for aboriginal mothers in neonatal intensive care units (NICUs): An exploratory qualitative study about views of health care professionals. Doctoral Thesis, Retrieved from:

Murphy, E. (1999). ‘Breast is best’: Infant feeding decisions and maternal deviance. Sociology of Health & Illness, 21(2), 187-208. DOI:

Murphy, E. (2000). Risk, responsibility, and rhetoric in infant feeding. Journal of Contemporary Ethnography, 29(3), 291-325. DOI:

Lee, R. (2018). The ethics and politics of breastfeeding: Power, pleasure, poetics. Toronto, ON: University of Toronto Press. DOI:

McCarter-Spaulding, D. (2008). Is breastfeeding fair? Tensions in feminist perspectives on breastfeeding and the family. Journal of Human Lactation, 24(2), 206-212. DOI:

Nathoo, T. & Ostry, A. (2009). The one best way? Breastfeeding history, politics, and policy in Canada. Waterloo, ON: Wilfrid Laurier University Press.

Neyer, G. & Bernardi, L. (2011). Feminist perspectives on motherhood and reproduction. Historical Social Research, 36(2), 162-176.

Oakley, A. (1986). Telling the truth about Jerusalem. New York, NY: Basil Blackwell.

Obeidat, H.M., Bond, E.A. & Callister, L.C. (2009). The parental experience of having an infant in the newborn intensive care unit. The Journal of Perinatal Education, 18(3), 23-29. DOI:

Palmer, G. (1988). The politics of breastfeeding. London, UK: Pandora Press.

Palmer, G. (2009). The politics of breastfeeding: When breasts are bad for business. (3rd ed.). London, U.K.: Pinter & Martin Ltd.

Patel, S. & Patel, S. (2016). The effectiveness of lactation consultants and lactation counselors on breastfeeding outcomes. Journal of Human Lactation, 32(3), 530-541. DOI:

Paynter, M. & Goldberg, L. (2018). A critical review of human milk sharing using an intersectional feminist framework: Implications for practice. Midwifery, 66, 141-147. DOI:

Perrella, S.L., Williams, J., Nathan, E.A., Fenwick, J., Hartmann, P.E., & Geddes, D.T. (2012). Influences on breastfeeding outcomes for healthy term and preterm/sick infants. Breastfeeding Medicine, 7(4), 255–261. DOI:

Rich, A. (1986). Of woman born: Motherhood as experience and institution. New York, NY: W.W. Norton and Company.

Richardson, B., Goldberg, L., Aston, M. & Campbell-Yeo, M. (2018). eHealth versus Equity: Using a feminist poststructural framework to explore the influence of perinatal eHealth resources on health equity. Journal of Clinical Nursing, 27, 4224-4233. DOI:

Schanler, R.J. (2011). Outcomes of human milk-fed premature infants. Seminars in Perinatology, 35(1), 29-33. DOI:

Shattnawi, K.K. (2015). Suspended liminality: Breastfeeding and becoming a mother in two NICUs. International Journal of Advanced Nursing Studies, 4(2), 75-84. DOI:

Smith, P.H., Hausman, B.L. & Labbok, M. (2012). Beyond health, beyond choice: Breastfeeding constraints and realities. New Brunswick, NJ: Rutgers University Press.

Smith, P.H. (2018). Social justice at the core of breastfeeding protection, promotion and support: A conceptualization. Journal of Human Lactation, 34(2), 220-225. DOI:

Snitow, A. (1992). Feminism and motherhood: An American reading. Feminist Review, 40, 32-51. DOI:

Statistics Canada. (2019). Exclusive breastfeeding, at least 6 months, by age group [Table 13-10-0096-22]. Retrieved from:

Stevens, E.E., Patrick, T.E. & Pickler, R. (2009). A history of infant feeding. The Journal of Perinatal Education, 18(2), 32-39. DOI:

Taylor, E.N. & Wallace, L.E. (2012). For shame: Feminism, breastfeeding advocacy, and maternal guilt. Hypatia, 27(1), 76-98. DOI:

Thomson, G., Ebisch-Burton, K. & Flacking, R. (2015). Shame if you do – shame if you don’t: Women’s experiences of infant feeding. Maternal & Child Nutrition, 11(1), 33-46. DOI:

UNICEF. (2015). Breastfeeding. Retrieved from:

van Esterik, P. & O’Connor, R.A. (2017). The dance of nurture: Negotiating infant feeding. New York, NY: Berghahn Books. DOI:

van Wijlen, J.E. (2019). Breastfeeding woman or lactating object? A critical philosophical discussion on the influence of Cartesian dualism on breastfeeding in the neonatal intensive care unit. Journal of Clinical Nursing, 28(5-6), 1022-1031. DOI:

Victora, C. G., Bahl, R., Barros, A.J.D., França, G.V.A., Horton, S., Krasevec, J., . . . Rollins, N. C. (2016). Breastfeeding in the 21st century: Epidemiology, mechanisms, and lifelong effect. The Lancet, 387(10017), 475-490. DOI:

Weedon, C. (1997). Feminist practice & poststructuralist theory (2nd ed.). Oxford, UK: Blackwell Publishing.

World Health Organization. (2001). The optimal duration of exclusive breastfeeding: Report of an expert consultation (WHO/NHD/01.09). Geneva, CH: Author. Retrieved from:

World Health Organization. (2014). Global nutrition targets 2025: Breastfeeding policy brief (WHO/NMH/NHD/14.7). Geneva, CH: Author. Retrieved from:

World Health Organization and United Nations Children’s Fund. (2018). Implementation guidance: Protecting, promoting, and supporting breastfeeding in facilities providing maternity and newborn services – the revised Baby-Friendly Hospital Initiative. Geneva, CH: Author. Retrieved from:

How to Cite
van Wijlen, J. E., & Aston, M. (2019). Applying Feminist Poststructuralism as a Framework for Exploring Infant Feeding Interactions in the Neonatal Intensive Care Unit. Witness: The Canadian Journal of Critical Nursing Discourse, 1(1), 59-72.