Breast Ironing

Breast ironing is a form of abuse and should be treated as other forms of physical abuse.

Introduction

Breast Ironing also known as “Breast Flattening” is the process whereby young pubescent girls breasts are ironed, massaged and/or pounded down through the use of hard or heated objects in order for the breasts to disappear or delay the development of the breasts entirely. It is a cultural belief by those carrying it out that young girls will be protected from harassment, rape, abduction and early forced marriage and therefore be kept in education.

Much like Female Genital Mutilation (FGM), Breast Ironing is a harmful cultural practice and is child abuse. Professionals working with children and young people need to be aware that this practice may be occurring. Similarly to Female Genital Mutilation (FGM), breast ironing is classified as physical abuse therefore professionals must follow their Local Safeguarding Children’s Board Procedures.

The United Nations (UN) states that Breast Ironing affects 3.8 million women around the world and has been identified as one of the five under-reported crimes relating to gender-based violence (http://www.unwomenuk.org/breast-ironing-must-be-stopped/ ). 

The custom uses large stones, a hammer or spatulas that have been heated over scorching coals to compress the breast tissue of girls as young as 9 years old. Those who derive from richer families may opt to use an elastic belt to press the breasts so as to prevent them from growing. 

The mutilation is a traditional practice from Cameroon designed to make teenage girls look less "womanly” and to deter unwanted male attention, pregnancy and rape. The practice is commonly performed by family members, 58% of the time by the mother. (Source document ohchr – Harmful Practices / Gender Empowerment and Development).

In many cases the abuser thinks they are doing something good for their daughter, by delaying the effects of puberty so that she can continue her education, rather than getting married.

Legal Position

Breast Ironing, is a form of physical abuse and if professionals are concerned a child may be at risk of or suffering significant harm they must follow the Tees LSCBs Procedures, involving the Police as appropriate. 

There have been no prosecutions for physical assault related to breast ironing and there are no figures available for the number of teenage girls who might be affected within the UK. CAME Women’s and Girl’s Development Organisation (Cawogido) is working in Cameroon and the UK to tackle the issue of breast ironing and believe that similarly to FGM the practice is happening but due to the hidden nature of the act it is difficult to detect.

Conservative MP, Jake Berry has called for "breast-ironing" to be made a criminal offence, however unlike FGM it is not currently a specific offence.  

Identification and Assessment

If any agency / or anyone working with children becomes aware of a child who may have been subjected to or is at risk of Breast ironing they must make a referral to Children’s Social Care Services or where the risk is imminent call the police on 999. 

Risks

Breast ironing is one of five UN defined ‘forgotten crimes against women’. It is a practise whereby the breasts of girls typically aged 8-16 are pounded using tools such as spatulas, grinding stones, hot stones, and hammers to delay the appearance of puberty. 

Breast ironing is often carried out by the girl’s mother with the belief that she is:

  • Protecting her daughter from sexual harassment and / or rape
  • Preventing the risk of early pregnancy by “removing” signs of puberty
  • Preventing her daughter from being forced into marriage, so she will have the opportunity to continue with her education 

The girl may believe that the practice is being carried out for her own good and she will often remain silent. Young pubescent girls usually aged between 9 – 15 years old and from practising communities are most at risk of breast ironing. 

Breast ironing is a cultural custom originating in Cameroon, where up to 24% of girls are believed to have experienced it. It is also practiced in other nations such as: Ginea-Bissau, Chad, Togo, Benin, Guinea. However, there are indications that the tradition has now spread to Central and West African Diaspora living within the UK.

Staff should bear this in mind when working with families from these countries but at the same time not assume that this has taken place. 

Indicators

Breast ironing can often be a well-kept secret between the young girl and her mother. Often the father remains completely unaware. Some indicators that a girl has undergone breast ironing are as follows:

  • Unusual behaviour after an absence from school or college including depression, anxiety, aggression, withdrawn etc.;
  • Reluctance in undergoing normal medical examinations;
  • Some girls may ask for help, but may not be explicit about the problem due to embarrassment or fear;
  • Fear of changing for physical activities due to scars showing or bandages being visible. 

There may be older women in the family who have already had the procedure and this may prompt concern as to the potential risk of harm to other female children in the same family. 

Health consequences

Due to the instruments which are used during the process of breast ironing, for example, spoon/broom, stones, pestle, breast band, leaves etc. combined with insufficient aftercare, young girls are exposed to significant health risks. Breast ironing is painful and violates a young girl’s physical integrity. It exposes girls to numerous health problems such as cancer, abscesses, itching, and discharge of milk, infection, dissymmetry of the breasts, cysts, breast infections, severe fever, tissue damage and even the complete disappearance of one or both breasts.

This form of mutilation not only has negative health consequences for the girls, but often proves futile when it comes to deterring teenage sexual activity. The practice not only seriously damages a child’s physical integrity, but also their social and psychological well-being.

Justifications

The practice is carried out under the misguided intention to “protect” women and girls from men’s sexual harassment. These violent acts are not only perpetrated by men on women, but by older generations of women on young girls. In practicing communities, it is believed many boys and men believe girls whose breasts have grown are ready to have sex, therefore elders (mothers, grandmothers, aunties etc.) believe that by suppressing a girl’s development of her breast she will be protected from rape, kidnapping, sexual harassment and early forced marriage.

Children’s Social Care will liaise with the Paediatric services where it is believed that Breast Ironing has already taken place to ensure that a Medical Assessment takes place.

It should be remembered that this is an act of abuse to a child, although it will have lifelong consequences, and can be highly dangerous at the time of the procedure and directly afterwards.

Assessment

Children’s Social Care Services in consultation with the Police will hold a Strategy meeting and undertake a Section 47 Enquiry if it has reason to believe that a child is likely to suffer or has suffered Breast Ironing.

Where a child has been identified as at risk of significant harm, it may not always be appropriate to remove the child from an otherwise loving family environment. Parents and carers may genuinely believe that it is in the girl’s best interest to conform to their prevailing custom.

Where a child appears to be in immediate danger of Breast Ironing, legal advice should be sought and consideration should be given, for example, to seeking an Emergency Protection Order or a Prohibited Steps Order. Make it clear to the family that it is highly likely to mean they will be breaking the law if they arrange for the child to have the procedure as it is an act of physical abuse / assault.

Useful Guidance Pathway Tools, Contacts and Websites:

House of Commons Hansard – Breast Ironing

CAME W G Impact of Breast Ironing

HALO Project

NB Tees LSCBs Procedures: Female Genital Mutilation; Forced Marriage