Breast Flattening—Barbaric Practice or a Sign of Something Deeper?

What would you do if you were the mother of a young girl born into a social setting where her gender automatically affects her chances of independence, riches and success? Most of us live in such societies as gender imbalances are institutionalised and pervasive the world over. Take the recently exposed gender gap in US election coverage published by 4thEstate.net that showed that even on important issues specifically facing women (such as reproductive health, birth control, women’s rights), the US media consulted the voices of actual women only 12-31% of the time.

However, imagine if on top of pre-existing social and cultural barriers to a girl’s progress your culture allowed for girls to be married as child brides as soon as puberty hit and start having babies soon thereafter, thus failing to get an education; that power imbalances meant that a female child was at high risk of rape from strangers and relatives alike; that use of contraceptives was discouraged for religious reasons; that abortion of a baby conceived even as a result of forced sexual activity was illegal and severely punishable, whilst single parenthood guaranteed to alienate her even further from those around her. What would you do to protect your child whilst operating within such constraints? For some women in West Africa, the answer has come in the form of a new cultural practice of breast ‘flattening’.

Calling it ‘new’ is perhaps a little misleading. Although there is no certainty to the origin of the practice, one theory sees it as having evolved from an ancient breast ‘massage’ that was traditionally used for correcting unusual breast size, inducing milk flow for lactating women and easing discomfort during the time of weaning. How the modern practice of breast ‘flattening’ (or ‘ironing’ as it is locally known) differs is by the fact that rather than using massage to stimulate or soothe the breast of an adult woman, the modern practice has been modified and put to use in order to destroy the mammary gland and delay or prevent the growth of a teenage girl’s breasts. The other major difference from the ancestral breast massage lies in the fact that it can be excruciatingly painful and can cause irreparable damage affecting the girls’ mental, physical and sexual health.

The practice was first reported and documented in 2005 by the German international development agency (GTZ) based on their work across Africa. Recenty, Feinstein International Centre at Tuft’s University in Boston published further research in Cameroon by Rebecca Tapscott (you can download the full report here). According to her, breast ‘flattening’ tends to affect girls between the ages of eight and twelve and the way it is practiced varies widely:

“Breast flattening, a practice whereby an object is used to massage, pound, or press the breasts flat, is common in Cameroon and throughout West Africa. The prevalence rate, method, rationale, and reported outcomes vary significantly by region and individual, and have no proven correlation with socio-economic level, urban or rural living, religious affiliation, or ethnicity.

The report continues:

Tools used for breast flattening include a grinding stone, a wooden pestle, a spatula or broom, a belt to tie or bind the breasts flat, leaves thought to have special medicinal or healing qualities, napkins, plantain peels, stones, fruit pits, coconut shells, salt, ice, and others.19 Typically, the object is heated in the ashes of a wood fire in the kitchen and then applied in a pressing, pounding, or massaging motion. The heat, style of application, and duration vary by individual and by region.20 The most common description in the Northwest region requires a wooden pestle, approximately three feet long, be heated in the coals of a wooden fire. The pestle should be hot to the touch. Then, the end of the pestle is used to push and press the breasts for some minutes”

It is probable that the initial emotional reaction of anyone learning about breast flattening for the first time would be one of shock at what may well seem a barbaric practice (as it did to one blogger here); much like female genital mutilation that, according to the World Health Organisation is practiced in almost thirty different countries. In fact, many organisations are fighting to have breast flattening made illegal on the grounds of human rights abuses. This kind of action could help raise awareness of the negative effects of the practice, but is it likely to be effective in curbing it?

You see, as already mentioned, this practice appears to be a cultural response to deep-seeded cultural, social and even institutional problems. Many of the women interviewed in the research pointed to the fact that the purpose is not a repressive one towards their girls (as is female genital mutilation, for example, that aims, among other things, to repress female lebido), but it is the mothers’ attempt at shielding them from societal dysfucntion. In the mother’s eyes, if she can make her daughter appear the child that she is for longer, she reduces her chances of being raped, becoming pregnant or being married off too early. In the mother’s eyes she is helping her child stay in school and improve her chances later on in life.

In no way is this article a condonation of the practice. However, we must face facts that just focusing on banning it would not serve to correct the inherent problems that drove its usage in the first place, whilst possibly engender harmful effects by vilifying mothers. Addressing systemic problems that disadvantage young women such as: providing sexual and reproductive health education that faces the reality that teenagers will be sexually active; instituting widespread encouragement, acculturation and normalisation of the use of contraceptives by both men and women; education and employment systems that recognise the differences between the needs of men and women and strive to facilitate gender equity; non-confrontational approaches to changing gender power dynamics; and so on, would be much more effective and could probably naturally eradicate breast flattening and other cultural practices that sprout up as cultural coping mechanisms in the face of social problems.

Do you know of other examples of practices that signify a deeper social and cultural problem? Leave a reply below.

Ioulia Fenton leads the food and agriculture research stream at the Center for Economic and Environmental Modeling and Analysis (CEEMA) at INESAD. 

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