Breastfeeding Medicine

Physicians blogging about breastfeeding

Sustaining breastfeeding in the US: a control issue?

with 3 comments

The New York Times today drew notice to a recent CDC report on the rates of breastfeeding in the US from 2004-2008.

We still aren’t making the mark.

The overall percentage of moms initiating breastfeeding continues to increase, and in fact appears very close to reaching the Healthy People 2010 target of 75%.  However,  the rates of “any” sustained breastfeeding at 6 and 12 months  (41.7% and 21% respectively) are disappointing, as are persistent racial and geographic disparities.
What will it take to allow breastfeeding to become normative in our society?

Many things, including

  • educating future parents – for example, the state of New York has a K-12 breastfeeding curriculum.  And parents can educate kids  about advertising tactics in general (e.g., the new chocolate formula marketed for toddlers.  My own kids refer to formula as “yucky milk” , but this is a whole new ball game.)
  • empowering women who do choose to breastfeed – help them succeed, and they will help others, a la
  • workplace supports – the elusive paid family leave.  And equal pay for moms’ equal work (April 20 is Equal Pay Day – see And short of that, onsite childcare.  And short of that, provisions for workplace pumping.


This piece in today’s Huffington Post came up as I was writing this draft between clinical obligations.  Just read it! –  especially the interview with Dr. Paige Hall Smith, Director of the University of North Carolina Greensboro’s Center for Women’s Health and Wellness and Founder/Co-Director of the annual Breastfeeding & Feminism Symposia (a partnership between UNC Greensboro and UNC Chapel Hill [home of ABM’s own Drs. Miriam Labbok and Alison Stuebe].)

As Dr Smith says,

The problem isn’t breastfeeding. This has to do with increasing the status of women. If we do that, we will increase the rates of breastfeeding.”


“We need to give women control…That’s the bottom line. We must create structures in society that give women more control over their bodies. Women who have control over their lives, body, time and space [and I’m talking about private, public and work space] are more likely to breastfeed than those who don’t have that same kind of control.”

That’s a tall order.

Kimberly Lee, MD, MS, IBCLC, is an Associate Professor of Pediatrics (Neonatology) at the Medical University of South Carolina.

Written by neobfmd

April 21, 2010 at 9:32 am

3 Responses

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  1. I’m so happy to see the public discourse on how to help mothers succeed in breastfeeding.

    As I work with mothers who are breastfeeding in the early weeks, I’ve noticed some things. One is that even when all is well–easy birth, no breastfeeding problems, lots of support, a strong desire to succeed–too many mothers still struggle. I think another area we need to be looking at is the underlying cultural assumptions we as American women bring into motherhood–assumptions that contradict the biological realities of breastfeeding. We often have a hard time with the amount of touch a baby needs. Or with viewing our personal worth by what measurable, short term results we can see–whether a paycheck or a clean house. Or a belief that motherhood is a job, and like any job the worker must have significant time off. These and other intangible, often subconcious beliefs do so much to shipwreck our desire to breastfeed, even before we face problems of unsupportive doctors, short maternity leave, etc. I’d love to see more discussions that also address these very vital issues.


    April 21, 2010 at 12:29 pm

    • Well said, Michelle! Expectations and assumptions are so tough for everyone to confront.

      I think discussions like this (and in the “real world”) are the only way our culture is really going to change.


      April 22, 2010 at 10:37 am

  2. Great article. It is really discouraging as a new BF mother to see all the other mothers around me quit BF. They simply do not have the education or support they need. They don’t know how to access support and the people they do see just don’t have enough BF education. Also there just are not enough moms around them who are BF. NIP is such a big debate but the more we see moms nursing the more normal it becomes. I really didn’t know a thing about BF besides it is supposed to be “natural and easy (ha)” before I had my LO. So many of the women who quit use common BF myths as their reason. If they only knew…

    Another issue that needs addressed is paid maternity leave. We can simply force the workplace to allow mothers to pump but really we are so far behind other countries in our support of maternity leave. If mothers did not have to stress about going back to work so soon to make money then I believe we would see higher BF rates. Or another alternative is encouraging infant-in-the-workplace policies that allow moms to bring their new babies to work. New research is saying that this is an effective employee retention method.


    April 21, 2010 at 2:44 pm

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