Running head: TRENDS IN BREASTFEEDING

Trends in Breastfeeding
Jane Stubbert
Kapiolani Community College LPN-RN Transition Program

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If breastfeeding is so natural, why do some mothers fear it? In the 1900s, more than 95
percent of American women gave birth to their young in the comfort of their home environment.
In the 1930s, about half the women gave birth at home and the other half delivered in a hospital.
By the 1970s, only 1 percent of women delivered at home. The advantage of this trend towards
medicalization of childbirth both decrease the number of maternal and infant mortality rates.
Unfortunately, the disadvantage of this trend was the decrease in breastfeeding rates (Shannon,
ODonnell, & Skinner, 2007). Why are women so concerned about breastfeeding? First, one
must explore how hospitalization affects a womans choice whether to breastfeed or not; second,
the embarrassment associated with breastfeeding in front of the public; third, the fear that
breastfeeding will hurt; lastly, the concerns about having to commit to a breastfeeding schedule
and how that will effect their work or social lives. Breastfeeding is a natural part of life and
should be encouraged by everyone.
How does hospitalization effect a womans choice to breastfeed or not? In the hospital,
mothers and babies are initially separated. The bonding time spent with the baby in the hospital
is less than if a mother delivered at home. Along with trends in childhood practices, scientific
research discovered recipes for artificial breast milk. In the 20th century, breastfeeding rates
declined as women began to believe that the quality of the infant formula and the freedom to
bottle-feed outweighed the value of breastfeeding (Shannon et al., 2007). If the mother and
lactation consultant were unable to get the baby to latch, then formula is readily available in the
hospital. Fortunately, the advice that mothers receive from health care professionals are
beneficial to the decision of breastfeeding. According to Shannon et al. (2007), Women know

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its healthier to breastfeed. Women choose bottle-feeding over breastfeeding when they feel their
concerns about breastfeeding outweigh the benefits (p 570). It is important for lactation
consultants to stress the benefits of breast milk. Breast milk is a well-balanced nutrient that
infants need for many reasons. These nutrients promote physical and emotional development.
Breast milk stimulates the infants immune system. Breast milk also prevents infections, reduces
the risk of childhood obesity, and improves overall cardiac health. In addition, breast milk is
associated with fewer allergies and fewer cases of diabetes later in life. Not only does
breastfeeding benefit the baby, but the mother as well. Breastfeeding reduces the risk of
developing postmenopausal breast cancer, improves bone density after menopause, and promotes
contraction of the uterus after birth (Brand, Kothari, & Stark, 2011). Breastfeeding benefits
outweigh bottle-feeding physiologically. Overall, the advantage of delivering in a hospital is that
there is support from all interdisciplinary health care professionals. These professionals are
useful resources and may help answer any concerns patients may have about their medical
decisions.
Common concerns women have about breastfeeding is the embarrassment associated
with feeding in public. In the American culture, breasts are seen as sexual objects. Many
adolescents and adults are uncomfortable with seeing a baby being breastfeed (Shannon et al.,
2007). Many women have their decision of infant feeding before delivery, therefore, prenatal
education may help persuade a mothers view on breastfeeding. Discussing womans concerns
early in pregnancy, such as fear of embarrassment, may increase the possibility that she might
decide to breastfeed (2007). Moms have the right to breastfeed at anytime and anyplace.
Breastfeeding is a natural part of life and should be supported by the public.

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Ineffective latching is directly correlated with breastfeeding pain. It is normal to

experience discomfort, but it should improve within 30 seconds. If the pain is longer, the mother
should break the latch and try again. The pain can be described as a stinging or burning
sensation. It is important to understand that effective latching will save the mother from
experiencing nipple trauma. Effective latching also helps the baby get milk faster and with ease
(Shannon et al., 2007).
Breastfeeding a child can be time consuming and a big commitment, but correct nipple
attachment cuts down on time. According to Shannon et al. (2007), seventy percent of mothers
with children under the age of three work outside of the home. Many mothers have anxiety
about leaving their babies in the care of babysitters as opposed to losing momentum in their
careers. A mother may have no other choice, but to work due to the need for insurance and
financial stability. Not breastfeeding sounds more attractive and convenient for mothers.
Explaining that research has shown that woman who breastfeed their children miss less days of
work due to less sick infants may be helpful in persuading their views on choosing breastfeeding.
Women should understand that babies need to be breastfeed at least eight times in a 24-hour
period or as needed (2007). Does having to commit to a time schedule outweigh the benefits of
breastfeeding the infant? Women should do their research first.
There are many resources available for mothers, such as the World Alliance for
Breastfeeding Action (WABA), that was initiated in 1991 by UNICEF. WABA was made to
support and promote breastfeeding. Every year, on August 1st, WABA generates a brochure
during the World Breastfeeding Week. The brochure evaluates the progress towards the
protection, promotion, and support of breastfeeding. Twenty years ago, WABA stressed the
importance of activities for the Baby-Friendly Hospital Initiative. Some of the example activities

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mentioned in the brochure were to make a list of hospitals that are baby-friendly, join a mothers
support group, breastfeed where other women will see you, and give positive reinforcement to
breastfeeding mothers. Fifteen years ago, WABA talked about the positive effects of
breastfeeding, such as reducing postpartum bleeding, risk for breast and ovarian cancer, iron
deficiency anemia, and delaying ovulation. WABA 97 stated that millions of babies get sick
every year because they are not breastfeed. Breastfeeding helps boost the mother and babys
immune system. The World Health Organization (WHO) estimates that 1.5 million infant deaths
could be avoided every year if mothers choose to breastfeed. In addition to positive effects of
breastfeeding in the 97 edition of the WABA brochure, WABA further discusses the negative
effects of bottle feeding. The brochure mentioned that formula has more risk for contamination
due to how the cows milk goes through processing to get to powder form. Breast milk needs no
extra packaging or preparation. Ten years ago, WABA talked about the whole process of
pregnancy through postpartum. The goals of WABA 07 were to reinstate the importance of
breastfeeding as a part of a womans reproductive cycle and health, create awareness of a
womans right to certain birthing practices, and promote support for mothers who choose to
breastfeed. WABA 07 states that research has shown that over 1.5 million babies die every year
from diseases like diarrhoea and pneumonia (Understanding the past, 2012). This statistic can
be prevented or dramatically reduced if mothers choose to breastfeed because breast milk
supports the babys immune system. WABA continues to promote breastfeeding till today.
Nurses should provide useful resources, such as WABA, and encourage mothers to seek other
breastfeeding resources before coming to a conclusion about infant feeding.
According to Healthy People 2010, there have been evidence of trends in
breastfeeding. The goal of Healthy People 2010 was to increase the proportion of mothers

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who breastfeeding their child through the age of three to 60 percent and through the age of 6
months to 25 percent. According to the results of the National Immunization Survey, the
percentage of infants who were breastfeed from 2000-2004 has slightly increased (Breast
feeding trends, 2007). About 70 percent of women choose to breastfeed in 2000 and that
percentage raised to about 87 percent in 2004. Although the breastfeeding rates did increase, the
results did not meet the target set by Healthy People 2010. This percentage was based on
an overall state survey. So where does Hawaii stand? According to Kogan, Singh, Dee, Belanoff,
& Grummer-Strawn (2008), research shows that about 80 percent of mothers in Hawaii
breastfeed. About 53 percent of them breastfed six months or less. That means 20 percent of
mothers in Hawaii chose not to breastfeed. This is higher than the goal set by Healthy
People 2010, but 20 percent of the babies in Hawaii are not getting the best form of nutrition.
Should women fear breastfeeding or embrace it? Women have the right to choose what
method they want for their children, but should understand that breastfeeding is a natural part of
life. Breastfeeding reduces the risk for breast and ovarian cancer, infections, increases uterine
contractions postpartum and weight loss (Phillips, Brett, & Mendola, 2011). Breast milk is the
perfect form of nutrition for babies. The reasons why women choose not to breastfeed is
complex. A lack of understanding about how breastfeeding works, the fear of embarrassment
and pain, and having to commit to a time schedule all contribute to barriers women face in
breastfeeding. Many health care providers know that there are significant benefits to
breastfeeding, yet many avoid promoting these benefits due to the fear of causing women to feel
guilty about their infant feeding choices (Shannon et al., 2007). Breastfeeding has become more
popular over the years and resources, such as WABA continue to encourage breastfeeding. The

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key to breastfeeding success lies in providing support and encouragement of mothers (2007, p
574). Breastfeeding is a natural part of life and should be encouraged by everyone.

Resources
Brand, E., Kothari, C., & Stark, M. (2013). Factors related to breastfeeding discontinuation
between hospital discharge and 2 weeks postpartum. Journal of Perinatal
Education, 20(1), 36-44. doi:10.1891/1058-1243.20.1.36
Breastfeeding trends and updated national health objectives for exclusive breastfeeding-United
States, birth years 2000-2004. (2007). MMWR: Morbidity & Mortality Weekly
Report, 56(30), 760-763.
Kogan, M., Singh, G., Dee, D., Belanoff, C., & Grummer-Strawn, L. (2008). Multivariate
analysis of state variation in breastfeeding rates in the United States. American
Journal of Public Health, 98(10), 1872-1880. doi:10.2105/AJPH.2007.127118
Phillips, G., Brett, K., & Mendola, P. (2011). Previous breastfeeding practices and duration of
exclusive breastfeeding in the United States. Maternal & Child Health Journal,
15(8), 1210-1216. doi:10.1007/s10995-010-0694-4
Shannon, T., ODonnell, M., & Skinner, K. (2007). Breastfeeding in the 21st century:
Overcoming barriers to help women and infants. Nursing for Womens Health,
11(6), 568-575.
Understanding the past-planning the future: Celebrating 10 years of WHO/UNICEFs global
strategy for infant and young child feeding. (2012). 20th World Breastfeeding
Week. Retrieved from http://worldbreastfeedingweek.org/

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