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Reluctant To Breastfeed?

Written by: Sharon Ransom, MD

Dear Dr. Ransom,

Why are some women reluctant to breastfeed?

Women in their childbearing years may have heard about the present initiative to promote breastfeeding. Although the concept of breastfeeding sounds both "old school' and somewhat 'radical' there is an historical basis to this trend. Back in 1984 the

Surgeon General's Workshop on Breastfeeding and Human Lactation was the first national meeting to focus exclusively on breastfeeding. The World Health Organization goals first published in 1978 and restated in 1989 and again in 1999 are that nation will increase the proportion of mothers who exclusively or partially breastfeed their babies in the early postpartum period to at least 75% and the proportion who continue breastfeeding until their babies are 5 to 6 months old to at least 50%. Furthermore, at least 25% will be breastfed at a year post partum.

Why this push for breastfeeding? Some of the world's finest scientists have turned their attention to human lactation and have determined that the nutrients in human milk are precisely 'engineered' for the human infant. Unfortunately, despite both the national and international efforts to increase the numbers of breastfed babies, there are several common beliefs and attitudes towards breastfeeding prevent some women from successfully breastfeeding.


The most common of these are:

  • Failure to breastfeed due to tobacco use
  • Embarrassment over breastfeeding in public
  • Lack of social support
  • Time and social constraints

Some women fear that because they are smokers they should not breastfeed. However, the data are clear that children of smoking mothers do better if breastfed in regard to general health, respiratory illness, and risk of sudden infant death syndrome (SIDS). Unfortunately, the duration of breastfeeding in smokers is inversely related to the number of cigarettes smoked per day. If you are a smoker, avoid smoking for 2 hours before a feeding to improve the "let-down" reflex and minimize the amount of nicotine in the milk.


The discomfort of breastfeeding in public is a common reason for choosing not to breastfeed. Clearly mothers have a right to breastfeed where they go with their babies, even if that is out in public. Legislation has been enacted in nearly one-half of the states in the U.S. to help change society's attitudes that breastfeeding is something indecent and should not be done in public.


In order to increase the discretion of public breastfeeding many styles of dresses and shirts are now marketed with hidden panels and clever folds to make feeding baby easier than ever. Your mother, who may recall the use of the baby blanket artfully slung across her shoulder to breastfeed the baby while in church or at the park, would be thrilled by the stylish choices of clothing available now for the nursing mom.


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