Breastfed

Breastfed in United States

United States

Both the American Academy of Pediatrics and the World Health Organization recommend exclusive breastfeeding for the first six months of a baby’s life. Breastfeeding provides infants with vital nutrients and supports healthy brain and immune system development. Additional benefits to infants include:

• Lower risk of infant mortality compared with infants who were never breastfed and lower risk of sudden infant death syndrome (SIDS).
• Lower risk of certain diseases, including childhood asthma, gastroenteritis, diabetes and childhood leukemia.
• Lower risk of obesity.

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

Several social, cultural and individual 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.
• 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 struggling with poor positioning and latching.
• Inadequate social support, such as having a family that does not approve of breastfeeding.

Black mothers breastfeed at dramatically lower rates than white mothers. Racial discrimination negatively impacts breastfeeding among Black mothers; they receive fewer lactation support referrals and less assistance for breastfeeding problems than other racial groups. Low-income women are more likely to return to work earlier and to have jobs that make it more difficult to continue breastfeeding, compared with women with higher incomes.

Interventions that support breastfeeding can increase rates of breastfeeding initiation and duration, according to the United States Preventive Services Task Force. In 2012, the Affordable Care Act began requiring 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 benefit breastfeeding mothers by creating environments for encouragement and advice to be exchanged. Breastfeeding support groups for mothers, such as La Leche League, can provide encouragement for mothers who are breastfeeding or thinking about breastfeeding. 

Hospitals participating in the Baby-Friendly Hospital Initiative encourage breastfeeding through policies and clinical practices; higher proportions of Baby-Friendly Hospitals at the state level are associated with increases in breastfeeding rates. 

Policies like paid maternity leave and workplace support can also increase the proportion of women who start or continue breastfeeding.

Healthy People 2030 has an objective to increase the percentage of infants breastfed exclusively for their first six months.

Barraza, Leila, Cheryl Lebedevitch, and Alison Stuebe. “The Role of Law and Policy in Assisting Families to Reach Healthy People’s Maternal, Infant, and Child Health Breastfeeding Goals in the United States.” Law and Health Policy. Department of Health and Human Services, Office of Disease Prevention and Health Promotion, May 4, 2020. https://www.healthypeople.gov/sites/default/files/MICH_report_2020.05.04_508_0.pdf.

Centers for Disease Control and Prevention. “Strategies to Prevent Obesity and Other Chronic Diseases: The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies.” Atlanta, GA: U.S. Department of Health and Human Services, 2013. https://www.cdc.gov/breastfeeding/pdf/bf-guide-508.pdf.

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.

Dewey, Kathryn G., Darcy Güngör, Sharon M. Donovan, Emily M. Madan, Sudha Venkatramanan, Teresa A. Davis, Ronald E. Kleinman, et al. “Breastfeeding and Risk of Overweight in Childhood and beyond: A Systematic Review with Emphasis on Sibling-Pair and Intervention Studies.” The American Journal of Clinical Nutrition 114, no. 5 (November 8, 2021): 1774–90. https://doi.org/10.1093/ajcn/nqab206.

Dietrich Leurer, Marie, and Eunice Misskey. “The Psychosocial and Emotional Experience of Breastfeeding: Reflections of Mothers.” Global Qualitative Nursing Research 2 (November 5, 2015): 233339361561165. https://doi.org/10.1177/2333393615611654.

Eidelman, Arthur I., Richard J. Schanler, Margreete Johnston, Susan Landers, Larry Noble, Kinga Szucs, and Laura Viehmann. “Breastfeeding and the Use of Human Milk.” Pediatrics 129, no. 3 (March 1, 2012): e827–41. https://doi.org/10.1542/peds.2011-3552.

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.” AHRQ Evidence Reports/Technology Assessments, No. 153. Rockville, MD: Agency for Healthcare Research and Quality, 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.

Li, Ruowei, Julie Ware, Aimin Chen, Jennifer M. Nelson, Jennifer M. Kmet, Sharyn E. Parks, Ardythe L. Morrow, Jian Chen, and Cria G. Perrine. “Breastfeeding and Post-Perinatal Infant Deaths in the United States, A National Prospective Cohort Analysis.” The Lancet Regional Health - Americas 5 (January 2022): 100094. https://doi.org/10.1016/j.lana.2021.100094.

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.