Breastfeeding Initiation in United States

United States

Breastfeeding has many benefits for mothers and infants. Initiating breastfeeding within an hour of giving birth can protect infants from infection and reduce newborn mortality. 

Breastfeeding provides infants with vital nutrients and supports healthy brain and immune system development. Additional benefits to infants include:

• Reduced risk of infant mortality.
• Reduced risk of chronic disease, including childhood asthma, gastroenteritis, diabetes, childhood leukemia and obesity.
• Reduced risk of sudden infant death syndrome (SIDS).

Breastfeeding benefits for mothers include decreased risk of breast and ovarian cancers, Type 2 diabetes and high blood pressure. Breastfeeding also facilitates bonding between mother and infant.

Both the American Academy of Pediatrics and the World Health Organization recommend exclusive breastfeeding for the first six months of a baby’s life. Despite these recommendations, roughly 15% of women never breastfeed their infants.

Racial discrimination negatively affects breastfeeding among Black women, who receive fewer lactation-support referrals and less help for breastfeeding problems than other racial groups. As a result, Black infants have lower rates of breastfeeding initiation than white infants, and the lowest rate in more than half of the United States.

Several social and cultural factors may lead women to never start breastfeeding or to stop breastfeeding early. Factors associated with lower breastfeeding rates include: 

• Not offering paid maternity leave to women with low income.
• Not giving sufficient breaks at work to pump breast milk or breastfeed. 
• Shaming women for breastfeeding in public.
• Past difficulties with breastfeeding other children.
• Struggling with poor infant positioning and latching.
• Inadequate social support, such as having a family that does not approve of breastfeeding.

Hospitals participating in the Baby-Friendly Hospital Initiative, which involves implementing the Ten Steps to Successful Breastfeeding, help encourage new mothers to start and continue breastfeeding. Higher proportions of Baby-Friendly Hospitals at the state level are associated with increased breastfeeding rates. Moreover, increased use of the Ten Steps is associated with a decrease in racial disparities in breastfeeding initiation. Improving the delivery of culturally relevant breastfeeding services tailored to the needs of communities most at risk of not breastfeeding can further narrow disparities.

Prenatal breastfeeding education interventions work to increase women’s knowledge of breastfeeding and promote positive breastfeeding practices. Research shows that new mothers who are knowledgeable about breastfeeding are more likely to initiate breastfeeding and continue for a longer duration.

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

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