Breastfeeding is the preferred form of nutrition for all infants. The health benefits of breastfeeding are so significant that virtually every professional organization including the American Academy of Pediatrics and World Health Organization recommend exclusive breastfeeding for the first 6 months after birth followed by supplementary foods and continued breastfeeding for 1 to 2 years or more as mutually desirable by mother and child (Figure 99-1). The Agency for Health Care Quality and Research (AHRQ) (2007) conducted an extensive metaanalysis on the benefits of breastfeeding for both mother and child. Breastfed full-term infants receive the following health benefits: reduction in the risk of acute otitis media by 27% to 50%, a 42% reduction in the risk of atopic dermatitis, and a 27% reduction in the risk of asthma (Ip et al., 2007). Even more significant are the 64% risk reduction for gastrointestinal infections and the 72% risk reduction for respiratory infections (Ip et al., 2007). Breastfeeding may also help protect the child from type I and type II diabetes (19% to 27%, and 39% risk reductions, respectively). Chen and Rogan (2004) report that infant mortality in the United States could be decreased by 21% if all infants received the recommended 6 months of human milk. The AHRQ also concluded that there is clear evidence to suggest an association between breastfeeding and a reduced maternal risk of breast cancer, ovarian cancer, and type II diabetes (Ip et al., 2007). Mothers who do not breastfeed or who have a short duration of breastfeeding are at higher risk for postpartum depression (Ip et al., 2007).

What has led to the need for lactivism in the U.S.? Until the mid-1800s, almost all infants in the U.S. were breastfed. In the 1890s and early 1900s, a shift began that essentially transformed the culture to one in which bottle feeding became the cultural norm. Increasingly in the 1900s, baby formula manufacturers advertised their products in women’s magazines and mothers had increasing doubts about being able to successfully breastfeed. As childbirth moved from the home into the hospital, medical practice began to interfere with successful establishment of lactation and breastfeeding. By 1948, only 38% of infants were receiving exclusively human milk feeds at 1 week of age, and by 1957, only 21% of infants were exclusively breastfed at the time of hospital discharge after birth (Apple, 1994).The culture of breastfeeding in the U.S. has eroded over the past 100 years, and, despite the fact that more women now “try” breastfeeding, preference for bottle feeding persists.

The federal government has tracked breastfeeding trends only since 1999. Prior to this, the earliest, and now the longest, ongoing survey of breastfeeding initiation rates in the U.S. was produced by the baby formula industry (the Ross Mothers Survey). According to the Centers for Disease Control and Prevention, breastfeeding initiation and duration rates have risen since 1999, however the increases have been modest at best. In 1999, approximately 68% of U.S. women initiated breastfeeding, and in 2006, 74% of women initiated breastfeeding—only a 6% increase. This includes mothers who may have only breastfed one time or just in the hospital before discharge. In 2006, only 13.6% of infants received human milk exclusively for 6 months, with any breastfeeding at 6 months increasing from 32.6% in 1999 to 43.4% in 2006 (Centers for Disease Control and Prevention [CDC], 2010).

A sociocultural issue that appears to underlie resistance to breastfeeding is the dual roles breasts have. Wolf (2008) wrote a commentary on why public breastfeeding remains so controversial in the U.S. Wolf asserted that American culture focuses on breasts for their sexual appeal—not for their primary function, which is to provide nourishment. The view that breastfeeding should be a private act, like sex, can make it challenging for some women to feel comfortable breastfeeding outside their homes (Wolf, 2008). Because of these conflicting views, breastfeeding mothers have been met with discrimination in public areas, stores, and restaurants. At a Toys ‘R Us at Times Square in New York, an employee asked a mother to move to a basement to breastfeed because there were children present. This resulted in a “nurse-in” at the Times Square location in 2006 (New York Civil Liberties Union, 2006). In 2004, Lori Charkoudian was asked by a Starbucks store employee in Silver Spring, Maryland, to cover up or use the women’s restroom when she attempted to breastfeed her 15-month-old daughter. This led to a “nurse-in” involving 30 mothers and their babies as well as other family members and friends (Helderman, 2004). Similarly, a mother was ticketed for breastfeeding her son in Colorado at a beach, despite the fact that Colorado passed a law protecting breastfeeding in 2004 (The Denver Channel News, 2005). Table 99-1 provides a summary of breastfeeding incidents and lactivism events.

Stay updated, free articles. Join our Telegram channel

Join