In Memoriam

Dana Raphael, Proponent of Breast-Feeding and Use of Doulas, Dies at 90

By Sam Roberts

Feb. 19, 2016

Dana Raphael, an apostle of breast-feeding and a catalyst for the movement to recruit nonmedical caregivers to assist mothers during and after childbirth — attendants she called doulas — died on Feb. 2 at her home in Fairfield, Conn. She was 90.

The cause was complications of congestive heart failure, her son Seth Jacobson said.

Dr. Raphael, a medical anthropologist and a protégée of the cultural anthropologist Margaret Mead, was among the first scientists to challenge milk formula manufacturers, linking a proliferating dependence on formula to high infant mortality rates in impoverished developing nations.

Proponents of breast-feeding expressed concern that women in poor countries diluted formula too much, undernourishing their babies in the process, or mixed it with impure water.

In the early 1980s, Dr. Raphael and a team she fielded also found that many poor and malnourished women in third world nations were physically unable to breast-feed or were too preoccupied with the basics of survival to do so.

At the time, she headed the Human Lactation Center in Westport, Conn., which she and Dr. Mead founded in the 1970s. Armed with her team’s findings, she proceeded to work with manufacturers to educate impoverished mothers about using formula only as a supplement to breast-feeding.

She also campaigned to encourage breast-feeding in developed countries and to better prepare new mothers for childbirth through educational and emotional support.

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Her book, “The Tender Gift: Breastfeeding,” published in 1973, was a product of her own devastation at not being able to breast-feed, she wrote.

“I lacked the knowledge and the assistance needed to let down my milk,” she recalled. “The more my hungry son screamed, the guiltier I felt.”

Other mothers, she found, were going through the same thing. Many lacked the family support systems that previous generations had — the grandmothers and aunts who could advise and assist — largely owing to changing social patterns.

“When grandmother walked out of the nursery and took up painting and golf, out with her went the whole cultural tradition of pampering mother along with baby,” Dr. Raphael wrote in 1970 in an article in The New York Times Magazine. “No one is there to tell her how to hold the nursing infant, how long to keep him suckling or how to care for uncomfortably full breasts or irritated nipples.”

In America, she wrote, “we prefer to leave the responsibility to medical authorities — usually males who are uninformed about the nonmedical aspects of breast-feeding.”

To fill that need, Dr. Raphael advocated the use of female attendants, or doulas, to guide mothers during and after childbirth. She was credited with coining the term — from the Greek word for a female servant — in an article she wrote in 1969.

Her stated goal was to make the mother happy regardless of how she chose to feed her baby, and to help those who wanted to breast-feed do so successfully.

“Good mothering is defending the new mother against the subtle pressure of a bottle-dominated culture,” Dr. Raphael wrote. “Good mothering is putting a buffer between the mother and a world where the breast is first a sexual object and incidentally a feeding organ.”

She was later executive director of the Eleventh Commandment Foundation, which studied the effects of childhood sexual abuse on women’s experiences of pregnancy, labor, childbirth and lactation.

She also wrote several other books in the 1970s and 1980s.

Dana Louise Raphael was born in New Britain, Conn., on Jan. 5, 1926. Her father, Louis, owned a department store chain. Her mother was the former Naomi Kaplan.

She received her bachelor’s degree and doctorate in anthropology from Columbia. She was married to Howard Boone Jacobson, who died in 2013.

In addition to her son Seth, she is survived by a daughter, Jessa Murnin; another son, Brett Raphael; and six grandchildren.A version of this article appears in print on Feb. 21, 2016, Section A, Page 23 of the New York edition with the headline: Dana Raphael, 90, Advocate for Breast-Feeding