Naptime Activism: Breastfeeding Rates and How to Make a Difference

Breastfeeding is an important human rights and feminist issue. A woman’s breastfeeding success can be undermined by inadequate support from health care professionals and family members, workplace obstacles, and misinformation from the formula food industry.

It’s only because of activism – mostly volunteer – that breastfeeding initiation is where it is in the US today.

When I attended my first La Leche League meeting in 1973, I didn’t know that I would become one of only 22% of US women who were initiating breastfeeding and one of just 8% still nursing at three months. In 1970, breastfeeding rates were the lowest they had ever been.

All of this changed largely because of the activism of La Leche League International. By 1975, breastfeeding initiation had jumped to 33.4% and was at 61.9% by 1982—it had nearly doubled in just a decade. 

Surprisingly, initiation rates in the US declined for the next 15 years. The World Health Organization (WHO) attributed the general worldwide decline in breastfeeding to “sociocultural and other factors including the promotion of manufactured breast-milk substitutes” and responded in 1981 with the International Code of the Marketing of Breastmilk-Substitutes —a consensus document that recommends regulation of formula marketing. Eighty-four countries have implemented all or part of the provisions of the Code. 

The US has done nothing to implement the Code and in 2007, 72.6% of US hospitals offered free formula gift bags to all new mothers.

A CDC epidemiological review of studies on these gift bags found that 7 out of 11 who received them, showed lower exclusive breastfeeding rates. Martha Walker, nurse and lactation consultant, reversed this trend in just eight years with her Ban the Bags Campaign.

By 2015, 78.7% of US hospitals reported banning free formula samples. 

The best way a new mother can ensure that she will not be given free formula samples is to give birth at a Baby-Friendly Hospital, where these samples are not given out.

In 1991, WHO and UNICEF launched the Baby-Friendly Hospital Initiative, a global program to encourage broad-scale implementation of the Ten Steps to Successful Breastfeeding and the Code. Since then, more than 15,000 facilities in 134 countries have been awarded baby-friendly status, including 604 in the US. 

To extend the idea of baby-friendly beyond the hospital, breastfeeding women must be undeterred from breastfeeding in public and in the workplace.

Today, all 50 US states have laws that specifically allow women to breastfeed in any public or private location. However, lack of breastfeeding support in the workplace continues to be a significant obstacle to breastfeeding duration. While 83.2% of women initiate breastfeeding, only 46.9% are still exclusively breastfeeding at three months. 

Full-time employment of mothers outside the home has a negative influence on the duration of breastfeeding and research shows that supportive state laws correlate with higher breastfeeding rates.

While 39 states, DC and Puerto Rico have laws related to breastfeeding in the workplace; few of these laws have enforcement clauses, and therefore no legal recourse for violation of the law. 

On an international level, the World Alliance of Breastfeeding (WABA), a global network of individuals and organizations, works to help protect, promote and support breastfeeding worldwide. One of WABA’s signature efforts has been the launch of World Breastfeeding Week, first celebrated in 1992. World Breastfeeding Week is now observed in over 120 countries by UNICEF, WHO and their partners, including individuals, organizations and governments.

The good news is that breastfeeding initiation rates have been steadily growing since 1997 and today are at 83.2%. There are many opportunities for activism, including with the organizations and efforts listed above. Here’s how to make a difference:

• Strengthen government and citizen action that ensures adequate maternal nutrition and food security for all. 
• Encourage citizen and government action that helps to create social support systems for mothers, including maternity legislation.
• Help women to receive accurate information about infant and young child feeding.
• Work to create or improve breastfeeding in the workplace legislation in your state.
• Support media that refuse formula advertising.
• Boycott media that accept formula advertising.
• Encourage hospitals and birth centers in your area not to give out free formula samples. Use the Ban the Bags Toolkit.
• Encourage hospitals in your area to become baby-friendly.
• Expand the baby-friendly concept to antenatal clinics, primary health care services, workplaces and communities. 
• Push for legislation and regulation that protects consumers and health workers from misleading commercial promotion about breast-milk substitutes.
• Lobby national commissions on women and status of women’s groups to include breastfeeding in their action plans.
• Ask key women in public office to endorse World Breastfeeding Week (the first week of August) and to include breastfeeding messages in their speeches.
• Boycott products that use women’s breasts as promotional tools in their media advertising.
• Encourage art, media and public imagery to show the normalcy of breastfeeding
• Welcome breastfeeding mothers at coffee shops, restaurants, conferences and seminars.
• Run for office.

BREASTFEEDING RESOURCES

The Benefits of Breastfeeding for Baby
Breastfeeding Success Guide
Eco-Friendly Breastfeeding Supply Guide
10 Breastfeeding Myths
The Environmental Benefits of Breastfeeding
Helpful Herbs for Increasing Your Milk Supply
How to Overcome Low Milk Supply
How to Choose a Breast Pump
Breastfeeding Your Preemie
How to Avoid Nipple Confusion