Breastfed

Breastfed in United States

United States

Exclusive breastfeeding is recommended for the first six months of a baby’s life by the American Academy of Pediatrics and the World Health Organization. Breastfeeding provides infants with nutrition and supports healthy brain and immune system development. Additional benefits to baby include:

• Decreased risk of infant mortality.
• Improved infant motor and intellectual development.
• Decreased risk of chronic disease for the infant, including childhood asthma, gastroenteritis, diabetes, sudden infant death syndrome and childhood leukemia.
• Reduced risk of obesity by up to 25%.

Breastfeeding benefits for mothers include decreased risk of breast and ovarian cancers and Type 2 diabetes.

Several social and cultural factors may lead a woman to stop breastfeeding early, or to never initiate breastfeeding. Factors associated with lower breastfeeding rates include: 

• Employers not offering paid maternity leave to mothers.
• Employers not giving sufficient breaks at work to pump breast milk or breastfeed. 
• Shaming mothers for breastfeeding in public.
• Mothers previously being unsuccessful in breastfeeding other children.
• Mothers who struggle with poor positioning and latching.
• Inadequate social support, such as a mother whose family does not approve of breastfeeding.

Black mothers breastfeed at dramatically lower rates than white mothers. Racial discrimination is a barrier that negatively impacts breastfeeding among Black mothers; they receive fewer lactation support referrals and less assistance for breastfeeding problems than other racial groups.

Interventions that support breastfeeding can increase rates of breastfeeding initiation and duration, according to the U.S. Preventive Services Task Force. In 2012, the Affordable Care Act required health insurers to cover breastfeeding equipment and support services, which led to a 10% increase in the duration of breastfeeding and a 21% increase in the duration of exclusive breastfeeding. 

Social and emotional support are proven to benefit breastfeeding mothers by creating healthy environments for stories and advice can be exchanged. Breastfeeding support groups for mothers, such as La Leche League, can provide encouragement for mothers who are breastfeeding or thinking about breastfeeding. 

Baby-Friendly Hospitals can help encourage mothers to start and continue breastfeeding; the proportion of Baby-Friendly Hospitals in a state is associated with an increase in breastfeeding rates. 

Legal policies like paid maternity leave and workplace support can also increase the proportion of women to start or continue breastfeeding.

A Healthy People 2030 objective is to increase the percent of infants breastfed exclusively for six months to 42.4%.

American Academy of Pediatrics. “Breastfeeding and the Use of Human Milk.” Pediatrics 129, no. 3 (March 1, 2012): e827–41. https://doi.org/10.1542/peds.2011-3552.

Beauregard, Jennifer L., Heather C. Hamner, Jian Chen, Wendy Avila-Rodriguez, Laurie D. Elam-Evans, and Cria G. Perrine. “Racial Disparities in Breastfeeding Initiation and Duration Among U.S. Infants Born in 2015.” MMWR. Morbidity and Mortality Weekly Report 68, no. 34 (August 30, 2019): 745–48. https://doi.org/10.15585/mmwr.mm6834a3.

Bibbins-Domingo, Kirsten, David C. Grossman, Susan J. Curry, Karina W. Davidson, John W. Jr. Epling, Francisco A. R. Garcia, Alex R. Kemper, et al. “Primary Care Interventions to Support Breastfeeding: US Preventive Services Task Force Recommendation Statement.” Journal of the American Medical Association 316, no. 16 (October 25, 2016): 1688–93. https://doi.org/10.1001/jama.2016.14697.

Chiang, Katelyn V., Ruowei Li, Erica H. Anstey, and Cria G. Perrine. “Racial and Ethnic Disparities in Breastfeeding Initiation - United States, 2019.” MMWR. Morbidity and Mortality Weekly Report 70, no. 21 (May 28, 2021): 769–74. https://doi.org/10.15585/mmwr.mm7021a1.

Gunderson, Erica P., Cora E. Lewis, Ying Lin, Mike Sorel, Myron Gross, Stephen Sidney, David R. Jacobs, James M. Shikany, and Charles P. Quesenberry. “Lactation Duration and Progression to Diabetes in Women Across the Childbearing Years: The 30-Year CARDIA Study.” JAMA Internal Medicine 178, no. 3 (March 1, 2018): 328. https://doi.org/10.1001/jamainternmed.2017.7978.

Gurley-Calvez, Tami, Lindsey Bullinger, and Kandice A. Kapinos. “Effect of the Affordable Care Act on Breastfeeding Outcomes.” American Journal of Public Health 108, no. 2 (February 2018): 277–83. https://doi.org/10.2105/AJPH.2017.304108.

Ip, Stanley, Mei Chung, Gowri Raman, Priscilla Chew, Nombulelo Magula, Deirdre DeVine, Thomas Trikalinos, and Joseph Lau. Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries. Rockville, MD: Agency for Healthcare Research and Quality (US), April 2007. https://www.ncbi.nlm.nih.gov/books/NBK38337/.

Jolles, Diana R., and Lauren Hoehn-Velasco. “Breastfeeding as a Quality Measure: Demonstrating Levers of the National Quality Strategy.” The Journal of Perinatal & Neonatal Nursing 35, no. 3 (September 2021): 221–27. https://doi.org/10.1097/JPN.0000000000000577.

León-Cava, Natalia, Chessa Lutter, Jay Ross, and Luann Martin. Quantifying the Benefits of Breastfeeding: A Summary of the Evidence. Academy for Education Development: Food and Nutrition Program, Pan American Health Organization: LINKAGES Project, 2002. https://www.paho.org/hq/dmdocuments/2011/benefitsLM.pdf.

Rito, Ana Isabel, Marta Buoncristiano, Angela Spinelli, Benoit Salanave, Marie Kunešová, Tatjana Hejgaard, Marta García Solano, et al. “Association between Characteristics at Birth, Breastfeeding and Obesity in 22 Countries: The WHO European Childhood Obesity Surveillance Initiative – COSI 2015/2017.” Obesity Facts 12, no. 2 (2019): 226–43. https://doi.org/10.1159/000500425.

Robinson, Karen, Alissa Fial, and Lisa Hanson. “Racism, Bias, and Discrimination as Modifiable Barriers to Breastfeeding for African American Women: A Scoping Review of the Literature.” Journal of Midwifery & Women’s Health 64, no. 6 (November 2019): 734–42. https://doi.org/10.1111/jmwh.13058.

Rollins, Nigel C, Nita Bhandari, Nemat Hajeebhoy, Susan Horton, Chessa K Lutter, Jose C Martines, Ellen G Piwoz, Linda M Richter, and Cesar G Victora. “Why Invest, and What It Will Take to Improve Breastfeeding Practices?” The Lancet, Breastfeeding 2, 387, no. 10017 (January 30, 2016): 491–504. https://doi.org/10.1016/S0140-6736(15)01044-2.

Victora, Cesar G, Rajiv Bahl, Aluísio J. D. Barros, Giovanny V. A. França, Susan Horton, Julia Krasevec, Simon Murch, Mari Jeeva Sankar, Neff Walker, and Nigel C. Rollins. “Breastfeeding in the 21st Century: Epidemiology, Mechanisms, and Lifelong Effect.” The Lancet, Breastfeeding 1, 387, no. 10017 (January 2016): 475–90. https://doi.org/10.1016/S0140-6736(15)01024-7.