From a population perspective, the achievement of the goals of exclusive breastfeeding throughout the first 6 months of life and continued breastfeeding with the introduction of age-appropriate complementary feeding for infant feeding, women and families must be inspired and empowered to overcome health system, sociocultural, and economic/political barriers. This article discusses trends in breastfeeding, influences on the reacceptance of a breastfeeding norm, and breastfeeding as a social and public health issue. The goal is to create an enabling environment for optimal breastfeeding in health care and social norms, and to adjust the social and political realities to support an economic milieu that favors breastfeeding.
Key points
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Breastfeeding initiation has increased over the last 2 decades in the United States; increases in optimal breastfeeding lag.
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The number of published research studies has increased significantly, despite little dedicated federal funding for breastfeeding translational and programmatic research.
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Sociocultural factors, such as migration, ethnic belief systems, subtle discrimination, and social and other media, as well as political factors, such as laws and regulations, also create barriers to breastfeeding decisions and practices.
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The lack of guaranteed paid maternity leave and governmental provision of free formula immediately after birth in the United States, in contrast to the rest of North America and most countries in the world, creates an artificial short-term economic benefit for the use of human milk substitutes.
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The US Affordable Care Act offers new support for preventive health, including support for breastfeeding and for maintaining lactation after return to work.
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Health care practices and systems must change to cease creating barriers to breastfeeding.
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Clinicians have an essential role to play today in supporting needed changes in medical education and practice modifications based on the new and increasing research on how best to support optimal infant feeding.
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