We use cookies to ensure that we give you the best experience on our website. You can change your cookie settings at any time. Otherwise, we'll assume you're OK to continue.


View Profile

Publication details for Prof Helen L. Ball

Klingaman, K. & Ball, H. (2007). Anthropology of caesarean section birth and breastfeeding: Rationale for evolutionary medicine on the postnatal ward. Durham Anthropology Journal 14(1).

Author(s) from Durham


Investigating biology and behaviour in the context of evolution enables the public, scientists and medical professionals to better understand the impact of particular medical care on human physiology and emotions. Evolutionary medicine is a useful starting point because recognition of the possible mismatches between an individual’s predisposition to interact a certain way and the environment in which he or she is found can lead to practical improvements. Human parturition and postnatal care are salient examples of how culturally constructed beliefs can inhibit appropriate somatic and psychological support. Our research examines birth events, feeding strategies and the attitudes underlying them in order to better understand how modes of delivery and postnatal arrangements affect breastfeeding outcomes, maternal satisfaction and safety.


Aniansson, G et al. 1994. A prospective cohort study on breast-feeding and otitis media in Swedish infants. Pediatr Infect Dis J.13(3): 183-188.
Ball, HL 2006. Bed-sharing on the post-natal ward: breastfeeding and infant sleep safety. Paediatrics and Child Health 11: in press.
Ball, HL and KP Klingaman (in press) Breastfeeding and mother-infant sleep proximity: implications for infant care. in Trevathan, WR, Smith, EO and JJ McKenna (Eds). Evolutionary medicine. 2nd Edition. Oxford University Press: Oxford.
Ball, HL et al. (submitted) Randomised trial of mother-infant sleep proximity on the post-natal ward: implications for breastfeeding initiation and infant safety. Archives of Disease in Childhood.
Beaudry, M et al. 1995. Relation between infant feeding and infections during the first six months of life. J Pediatr. 126: 191-197.
Belizan, JM et al. 1999. Rates and implications of caesarean sections in Latin America: Ecological study. British Medical Journal. 319: 1397-1400.
Bowlby, J. 1969. Attachment and loss v. 1. Hogarth Press: London.
Brinton, LA et al. 1995. Breastfeeding and breast cancer risk. Cancer Causes and Control. 6: 199-208.
Chapman, DJ and R Perez-Escamilla 1999. Identification of risk factors for delayed onset of lactation. Journal of the American Diabetic Association. 99(4): 450-454.
Davis, MK 1998. Infant feeding and childhood cancer. Lancet. 2(8607): 365-368.
Davis-Floyd, RE and CF Sargent (Eds). 1997. Childbirth and authoritative knowledge: Cross-cultural perspectives. University of California Press: Berkeley.
Dettwyler, KA. 1995. A time to wean: The hominid blueprint for the natural age of weaning in modern human populations. In Stuart-Macadam, P and KA Dettwyler (Eds) Breastfeeding: Biocultural perspectives. Aldine de Gruyter. 39-74.
Dewey, KG. 2004. Impact of breastfeeding on maternal nutritional status. Adv Exp Med. Biol .554: 91-100.
Dewey, KG et al. 1995. Differences in morbidity between breast-fed and formula-fed infants. J Pediatr. 126(5): 696-702.
Donati, S et al. 2003. Do Italian mothers prefer cesarean delivery? Birth 30(2): 89-93.
Duncan, B et al. 1999. Exclusive breast-feeding for at least 4 months protects against otitis media. Pediatrics. 91(5):867-872.
Enger, SM et al. 1998. Breastfeeding experience and breast cancer risk among postmenopausal women. Cancer Epidemiol Biomarkers Prev. 7(5): 365-369.
Garofalo, RP and AS Goldman. 1999. Expression of functional immunomodulatory and anti-inflammatory factors in human milk. Clin Perinatol. 26(2):361-377.
Gerstein, HC. 1994 Cow’s milk exposure and type 1 diabestes mellitus. Diabetes Care. 17(1): 13-19.
Gessner, BD et al. 1995. Risk factors for invasive disease caused by Streptococcus pneumoniae among Alaska native children younger than two years of age. Pediatr Infect Dis. 14(2): 123-128.
Goldman, AS.1993. The immunse system of human milk: antimicrobial, anti-inflammatory and immunodulating properties. Pediatr Infect Dis J. 12(8): 664-672.
Gwinn, ML et al. 1990. Pregnancy, breast feeding and oral contraceptives and the risk of epithelial ovarian cancer. J Clin Epidemiol. 43(6): 559-568.
Hausman, BL. 2003. Mother’s milk: Breastfeeding controversies in American culture. Routledge: New York.
Heinig, MJ and KG Dewey. 1997. Health effects of breast feeding for mothers: a critical review. Nutrition Research Reviews. 10: 35-56.
Howie et al. 1990. Protective effect of breast feeding against infection. BMJ. 300:11-16.
Hrdy, SB. 1999. Mother nature: Maternal instincts and how they shape the human species. Ballatine Books: New York.
Institute of Medicine. 1991. Nutrition during lactation. Washington, DC: National Academy Press.
Kac, G et al. 2004. Breastfeedig and postpartum weight retention in a cohort of Brazilian women. Am J Clin Nutr. 79(3): 487-493.
Konner, M. 1981. Evolution of human behavior development. In Monroe, RH, Monroe, RL and JM Whiting (Eds) Handbook of cross-cultural human development. New York: Garland STPM Press. 3-52.
Lee, S-I et al. 2004. Women’s attitudes toward mode of delivery in South Korea – A Society with high cesarean section rates. Birth 31(2): 108-116.
Leidloff, J. 1997. The continuum concept: In search of happiness lost. Addison-Wesley Publishing: New York.
Levine, OS et al. 1999. Risk factors for invasive pneumococcal disease in children: a population-based case-control study in North America. Pediatrics. 103(3): 28.
Marcus, PM et al. 1999. Adolescent reproductive events and subsequent breast cancer risk. Am J Public Health. 89(8): 1244-1247.
Marild, S et al. 1990. Breastfeeding and urinary tract infection (letter). Lancet. 336: 942.
Mayor, S. 2005. 23% of babies in England are delivered by caesarean section. British Medical Journal. April 9; 330(7495): 806.
Menacker, F. 2005. Trends in cesarean rates for first births and repeat cesarean rates for low risk women: United States, 1990–2000. United States Department of Health and Human Services, Centers for Disease Control and Prevention, National Vital Statistics Reports 22 September 2005. 54(4): 1-12.
McKenna, JJ and T McDade. 2005. Why babies should never sleep alone. Pediatric Respiratory Reviews. 6: 134-152.
Miovech, S et al. 1994. Major concerns of women after cesarean delivery. JOGN Nursing 23(1): 53-59.
Montagu, A. 1961. Neonatal and infant maturity in man. Journal of the American Medical Association. 178: 56-57.
Montagu, A 1986. Touching: the human significance of the skin. 3rd Edition. Harper and Row: New York.
Nesse, RM and GC Williams. 1995. Why we get sick: The new science of Darwinian medicine. Vintage Books: New York.
Newcomb, PA et al. 1994. Lactation and a reduced risk of premenopausal breast cancer. N Engl J Med. 330(2): 81-87.
Newcomb, PA et al. 1999. Lactation in relation to postmenopausal breast cancer. Am J Epidemiol. 150(2): 174-182.
Odent, M. 2002. The farmer and the obstetrician. Free Association Books: London.
Patel, RR et al. 2003. Effect of operative delivery in the second stage of labor on breastfeeding success. Birth 30(4): 255-260.
Perez-Escamilla, R et al. 1996. The association between cesarean delivery and breast-feeding outcomes among Mexican women. American Journal of Public Health 86(6): 832-836
Perez-Bravo et al. 1996. Genetic predisposition and environmental factors leading to the development of insulin-dependent diabetes mellitus in Chilean children. J Mol Med. 74: 105-109.
Pettitt, DJ et al. 1997. Breastfeeding and incidence of mon-insulin-dependent diabetes mellitus in Pima Indians. Lancet. 350: 166-168.
Pisacane, A et al. 1992. Breast-feeding and urinary tract infection. J Pediatr. 120(1): 87-89.
Pomkin et al. 1990. Breast-feeding and diarrheal morbidity. Pediatrics. 86(6):874-882.
Ransjo-Arvidson, AB et al. 2001. Maternal analgesia during labor disturbs newborn behaviour: effects on breastfeeding, temperature and crying. Birth 28(1): 5-12.
Ravelli, AC et al. 2000. Infant feeding and adult glucose tolerance, lipid profile, blood pressure and obestity. Arch Dis Child 82(3): 248-252.
Riordan, J et al. 2000. The effect of labor pain relief medication on neonatal suckling and breastfeeding duration. J Hum Lact. 16(1): 7-12.
Rosenblatt, KA et al. 1993. Lactation and the risk of epithelial ovarian cancer. Int J Epidemiol. 22(2): 192-197.
Rowe-Murray, HJ and JRW Fisher 2002. Baby friendly hospital practices: Cesarean section is a persistent barrier to early initiation of breastfeeding. Birth 29(2): 124-131.
Scheper-Hughes. N 1992. Death without weeping: The violence of everyday life in Brazil. University of California Press: Berkely.
Shu, XO et al. 1999. Breastfeeding and risk of childhood acute leukemia. J Natl Cancer Inst. 91(20): 1765-1772.
Simkin, P and Ancheta, R 2005. The labor progress handbook: Early interventions to prevent and treat dystocia. Blackwell Publishing: Oxford.
Small, MF 1999. Our babies, ourselves: How biology and culture shape the way we parent. Anchor Books: New York.
Smulevich, VB et al. 1999. Parental occupation and other factors and cancer risk in children: I. study methodology and non-occupational factors. Int J Cancer. 83: 712-717.
Trevathan, WR. 1987. Human birth: An evolutionary perspective. Aldine de Gruter: New York.
United States Department of Health and Human Services 2000. HHS blueprint for action on breastfeeding. Washington, DC.
Vestermark, V et al. 1991. Influence of mode of delivery on initiation of breastfeeding. European Journal of Obstetrics, Gynecology and Reproductive Biology 38(1): 33-38.
Von Kries, R et al. 1993. Breast feeding and obesity: cross sectional study. BMJ. 319: 147-150.
Walker, R et al. 2004. Increasing cesarean section rates: Exploring the role of culture in an Australian community. Birth 31(2): 117-124.
Washburn, SL 1960. Tools and human evolution. Sci Am. 203: 63-75.
Weiss, HA et al. 1997. Prenatal and perinatal risk factors for breast cancer in young women. Epidemiology. 8(2): 181-187.
World Health Organization 2003. Global strategy for infant and young child feeding. World Health Organization: Geneva.
Wright, AL et al. 1995. Relationship of infant feeding to recurrent wheezing at age 6 years. Arch Pediatr Adolesc Med. 149: 758-763.