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Statement on Breastfeeding

    Overview

    Breastfeeding USA strives to present evidence-based information to families so that they can make truly informed decisions related to birth, babyhood, and beyond. We believe that the foundation of these decisions can be rationally based on the biological norm for parents and babies. We are here to support all families in their lactation journey, which could include breastfeeding, chestfeeding, and expressing milk, and these terms are used interchangeably in this document.

    • We believe that the decision to breastfeed, chestfeed, or express milk is not about lifestyle, but about the total physical and emotional health of the mother or birthing parent and baby, both in the short and the long term.
    • We strive to provide the information and support which families and mothers may need as they make decisions about nurturing their infants and children.
    • We believe that it is beneficial for parents to interact with, support, and encourage each other as they follow the path of parenthood.
    • We understand that individual circumstances may sometimes make it necessary for families to make decisions which may be different than those they would have made in ideal circumstances.
    • We believe that informed decision making helps families to be comfortable and confident in their choices.
    • We believe in the importance of preserving breastfeeding to whatever degree possible.
    • We believe that human milk is the biologically normal food for babies.
    • We believe that breastfeeding matters.
    • We recognize that as we prioritize evidence-based research on lactation and related subjects, relevant research has not included all groups of people, and we advocate for greater inclusion within research.
    • We strive to provide inclusive support and recognize that language evolves. We seek to be adaptive as we gain feedback or new information relevant to the support we offer. For more information, see our statement on diversity, equity, and inclusion.

    Biological Norms

    1. Each mammal species makes milk unique for its offspring; the milk has properties which are most likely to ensure the survival of its species. Human milk is the biologically normal food for human babies. Research has shown that there are positive health outcomes for mothers and babies as a result of breastfeeding.

    2. People who give birth are biologically prepared to lactate and then nurse their young. Good health, and affordable health, really can begin with breastfeeding. Breastfeeding is normal and healthy. Breastfeeding matters.

    3. Primates, especially humans, give birth to babies that are extremely vulnerable for a long period of time. Frequent feedings and interaction with parents is paramount.

    • Frequent feeding in the early months is necessary because the macronutrient makeup of human milk includes lower fat content and supports rapid digestion.
    • The normal neurobiological development of human babies requires prolonged and frequent access to the birthing parent.
    • Frequent feeding is required to establish and maintain robust milk production.
    • Human milk was designed for human babies and provides all the baby needs in the amounts necessary for proper growth and development.
    • Human babies do not have the capability of being independent for many years, and it is common for them to be dependent on a caregiver for comfort and meeting their needs.
    • Breastfeeding provides the ideal combination of nutritional building blocks and emotional/physical contact that supports the optimal development of the brain and neurological system that makes humans so special.

    4. The circumstances of birth can have a powerful effect on the course that breastfeeding takes.

    • We believe that keeping birthing parents and their babies together after birth whenever possible promotes early breastfeeding. However, we understand that there are many circumstances that require the separation of mother or birthing parent and baby. In the event of separation, breastfeeding can still be supported.
    • Minimal use of medications and frequent skin-to-skin contact postpartum have been shown to promote the establishment of breastfeeding.
    • Health care providers should be aware of the impacts of birth interventions on lactation, have a plan for those impacts, and educate patients so they have fully informed consent.
    • Access to timely lactation support from an IBCLC or similarly trained health care professional can address some of the challenges brought about by the circumstances of birth and should be available to all parents.
    • We understand that supplementation (with one’s own milk, donor milk, or formula) may have a role in infant feeding. It’s important for parents and medical providers to understand the consequences and risks related to different kinds of supplementation for informed decision making.

    5. Most babies are born with the innate ability to find the breast, latch and suckle. This ability should be supported, and intervention is warranted only when there are indications that the baby is not breastfeeding well.

    6a. Human babies nurse frequently after birth and need to be fed on cue. Each baby is an individual, but they usually require at least 8-12 feeds/24 hours.

    • Some babies nurse without any discernible pattern.
    • Some babies nurse with a pattern, for instance, every 2-4 hours, based on the beginning of one feeding to the beginning of the next feeding.
    • Some babies cluster feed during some parts of the day, often in the evening, while nursing less frequently during other parts of the day.

    6b. Milk production, for the most part, is based on supply and demand – the more milk that is removed from the breast, the more is produced. Frequent feeding is one of the best ways to ensure milk production and not generally a sign of low supply.

    7. It is biologically normal for mothers and babies to sleep in very close proximity. Some babies consume significant amounts of milk during the nighttime sleep period.

    8. Weaning is a gradual process during which foods other than human milk are slowly introduced to the baby’s diet. Most healthy, full-term babies begin to show a readiness to eat other foods sometime during the middle of the first year of life.

    • Based on many factors, the biologically normal age for weaning in human children seems to range from 2.5 to seven years of age.
    • The actual age of weaning is strongly influenced by cultural factors.
    • There is no specific age by which a child should fully wean. The decision to wean is personal and up to the individuals in the nursing dyad.
    • There is value to human milk and breastfeeding for as long as it continues.

    9. In most societies, women support other women and families/communities support each other during pregnancy, childbirth, breastfeeding and beyond. Knowledge about these activities is passed on as a part of everyday life. The need for mother-to-mother and peer-to-peer interaction remains strong today and its value to society should not be underestimated.

    10. It is important to acknowledge that throughout history and through the present day in the United States, there have been disparities in access to support for and prioritization of breastfeeding as the biological norm across groups based upon factors such as race/ethnicity, socioeconomic status, gender identity, and physical disabilities. This has created barriers to breastfeeding/chestfeeding which continue to impact rates of breastfeeding initiation and duration. Furthermore, widespread misinformation, lack of adequate training for healthcare professionals, aggressive marketing and promotion of formula-feeding in the U.S, lack of health care coverage, and lack of family leave policies have posed significant barriers to lactating families. It is necessary to continue to address these barriers in order to provide culturally competent lactation support for all families.

    11. Breastfeeding is an acknowledged national public health issue, and as such we have a right to expect governmental policies that are supportive of pregnancy and lactation, and legislation that enables exclusive breastfeeding and breastfeeding through, at a minimum, the second year of life. Learn more about all of the ways to structurally support lactation from the US Breastfeeding Committee.