Inadequate Support, Marketing and Stigma are Killing Breastfeeding in the USA

By Claire Davaine

International Women's Initiative Staff Writer

(Photo Source)

“Breastfeeding is an unequalled way of providing ideal food for the healthy growth and development of infants; it is also an integral part of the reproductive process with important implications for the health of mothers”, states the World Health Organisation (WHO).

Review of evidence has shown exclusive breastfeeding for 6 months is the optimal way of feeding infants and has long-term benefits for both the baby and the mother. Benefits are particularly noticeable when mothers exclusively breastfeed for the baby’s first 6 months and continue breastfeeding up to 2 years of age with appropriate, complementary foods.

For the baby, it reduces the risk of infections, diarrhoea and vomiting, as well as sudden infant death syndrome (SIDS), childhood leukaemia, type-2 diabetes, obesity and cardiovascular disease in adulthood. For the mom, breastfeeding and making breast milk lowers risk of breast and ovarian cancer, as well as osteoporosis, cardiovascular disease and obesity.

But breastfeeding in America hit its lowest rates ever in the 1970s. The Centers for Disease Control and Prevention (CDC), World Health Organization and American Academy of Pediatrics among others implore new mothers to exclusively breastfeed their babies for at least six months.

However, according to the Centers for Disease Control and Prevention (CDC), approximately 77 percent of American mothers start breastfeeding immediately after birth, but only about 16 percent of those moms are breastfeeding exclusively six months later.

“Certainly it’s just not the norm in the U.S. yet to have long-term exclusive breastfeeding,” said Laurence Grummer-Strawn, chief of the Nutrition Branch at the CDC. “We have a number of barriers in American society that make it difficult for women to continue breastfeeding.”

A lack of knowledge

Most women in the United States are aware that breastfeeding is the best source of nutrition for infants, but they seem to lack knowledge about benefits and risks associated with breastfeeding.

In addition, the Office of the Surgeon General, the CDC and the Office on Women's Health, revealed in their surgeon General's Call to Action to Support Breastfeeding that women’s obstetricians rarely provide information about breastfeeding and infant formula during their prenatal visits.

Moreover, many people believe infant formula is equivalent to breast milk in terms of its health benefits because of prepared formula commercials. In fact, prepared formula has been enhanced in recent years and advertising of formula is widespread an increasing. To such an extent point that the bottle feeding is now viewed by many as the “normal” way to feed infants. More, only few women can rely on friends who have breastfed successfully, and therefore are likely to choose to breastfeed.

Beyond ‘bad or no education’, we should also underline the paradox of breast which is used as a sexual object for marketing purpose more than the healthiest way to nursing. It could explain the discomfort of many people of seeing a woman nursing her baby.

Social Norms & Embarrassment

Today, nursing in public has become a hot-button issue. Women are told to cover up, feed in a bathroom, feed somewhere else, or are subjected to the stares of an uninformed public.

Restaurant and shopping center managers have reported that they would either discourage breastfeeding anywhere in their facilities or would suggest that breastfeeding mothers move to an area that was more secluded. 

In some cases, these women are asked to stop breastfeeding or to leave restaurants, stores, even churches because they’re nursing.

Even though the practice may be legal or partially socially accepted, a national public opinion survey conducted in 2001 found that only 43 percent of U.S. adults believed that women should have the right to breastfeed in public places, some mothers may nevertheless be reluctant to breastfeed in public due to other people's objections, negative comments, or harassment.

Federal law

For many years, breastfeeding laws in the US mostly just exempted breastfeeding from indecency laws, which didn't mean that women had a legally protected right to do it in public. Today, the law explicitly protects moms who breastfeed in public in almost all 50 states, DC, and the Virgin Islands.

At the federal government level, Public Law 106-58, Section 647 states: “Notwithstanding any other provision of law, a woman may breastfeed her child at any location in a Federal building or on Federal property, if the woman and her child are otherwise authorized to be present at the location.”

Federal law - In the Workplace

In the US, mothers can legally breastfeed in public in every state, and federal law permits working mothers a reasonable time to express breast milk in a private setting at the workplace. According to the PPACA, Section 4207, enacted in March 2010, employers are required to provide reasonable break time for nursing mothers.

However, in practice, employed mothers typically find that returning to work is a significant barrier to breastfeeding. Women often face inflexibility in their work hours and locations and a lack of privacy for breastfeeding or expressing milk, have no place to store expressed breast milk, are unable to find child care facilities at or near the workplace, face fears over job insecurity, and have limited maternity leave benefits.

Although, in many aspects, the law is on the side of a breastfeeding mother when nursing in the Workplace, courts have typically concluded that breastfeeding is a choice made by the mother and not protected under Title VII of the Civil Rights Act of 1964 and the Pregnancy Discrimination Act (PDA).

State Laws

Laws vary by state and most states have laws that specifically allow women to breastfeed in any public or private location. 49 states have laws that specifically allow women to breastfeed in any public or private location. 29 states exempt breastfeeding from public indecency laws and 27 have laws related to breastfeeding in the workplace. Several states have unique laws related to breastfeeding.  But only 5 states have implemented or encouraged the development of a breastfeeding awareness education campaign.

All up-to-date information about the breastfeeding laws are registered in the National Conference of State Legislatures: Breastfeeding Laws. The La Leche League also provides a series of written articles related to the law and breastfeeding.

Importance of an enforcement provision

Although laws have been established to protect women’s right to breastfeed, harassment remains. Hence the importance of enforcement provision.

Indeed, if there is no enforcement provision with the law, the law tends to be useless as there is almost nothing you can do if the law is broken – no penalty for violating the law – and the vast majority of public breastfeeding laws in the US have no enforcement provision. That means that while a state may have a law that says a mother has a right to breastfeed in public, if someone harasses her while she does it, there is probably no legal action she can take against the harasser.

As a law without enforcement protects no one, some states have comprehensive breastfeeding legislation which provide more protection against anyone subjecting a nursing mother to harassment or discrimination in violation of the current state breastfeeding law, as well as protection from all indecent exposure laws.