13 Bio-Intimate Economies of Breastmilk ... 321NICU, as it shifts from a bodily fluid to a food and medicinal substance.^2
In particular, we address the discursive tension between advocates who pro-
mote peer-milk sharing and breastmilk donation in the NICU as benefi-
cent, and detractors who seek to regulate these practices more stringently.
Following Charlotte Kroløkke and Michael Nebeling Petersen ( 2017 ),
we posit that the donor–recipient relation typical of peer-milk sharing
and breastmilk donation in the NICU supports a bio-intimate economy
of care, which constructs donors as particular kinds of ethical subjects. By
producing bodily resources for others to consume, breastmilk donors tell
us something about their moral character; they are altruistic, caring, and
responsible individuals who use the generative aspect of their bodies as a
means through which to enact good deeds. At the same time, donors’ dis-
plays of morality and maternal responsibility, like infant feeding decisions
generally, are linked to contemporary neoliberal discourses around risk
management and lifestyle choice (Murphy 1999 , 2000 ; Stearns 1999 ).
The Benefits of Breastmilk
In 1991, the WHO/UNICEF Baby Friendly Hospital Initiative (BFHI)
was launched to address decreasing global rates of breastfeeding. Since
that time, exclusive breastfeeding has been recommended for infants
for the first six months of life, and for two years thereafter, along with
complementary food. The New Zealand government endorsed the
BFHI initiative in 2000, and all tertiary maternity facilities and NICUs
are now BFHI accredited. Step 6 of the BFHI 10 Steps to Successful
Breastfeeding, which is relevant for this discussion, states, ‘give new-
born infants no food or drink other than breastmilk, unless medically
indicated’ (WHO/UNICEF 1989 ). Organisations such as the WHO
( 2003 ), the American Academy of Pediatrics ( 2012 ), and the New
Zealand Ministry of Health all advocate breastfeeding as the optimal
form of infant feeding. Aside from stating reservations about the ben-
efits of breastmilk substitutes and artificial baby milk, the WHO and
the American Academy of Pediatrics recommend the use of donor
breastmilk as the first alternative if a mother’s own milk is unavailable.
Additionally, Sect. 2.2. of the New Zealand Ministry of Health’s Health