Societal Barriers to Breastfeeding

    Posted September 10th, 2009 by

    When people think of breastfeeding difficulties, the things that probably come to mind are supply issues, bad latch, cracked nipples, constant feedings, and the like. Certainly, there are women who are afflicted by those difficulties and who cannot overcome them. But I believe the societal barriers to breastfeeding (propagated by the kyriarchy)  have a much more significant impact on breastfeeding rates than the medical or technical issues.

    What are the societal barriers to breastfeeding?

    Formula advertising: Everywhere you look, formula is being pushed on new moms. Buying maternity clothes? You can enter a draw to win a year’s worth of formula. Buying a parenting magazine? Expect a few two-page spreads telling you about the latest hype on formula being closer than ever to breast milk. Giving birth at a hospital? Expect to go home with a sponsored bag full of formula samples and coupons unless you are lucky enough to give birth in a baby friendly hospital. Surfing the web looking for breastfeeding advice? The formula companies will try to deceive you into clicking on their ads by pretending they are about breastfeeding. We need to push to make compliance with the WHO International Code of Marketing Breast-Milk Substitutes into a standard or a law or find some other way to ensure that formula and bottle companies are not acting unethically and unnecessarily sabotaging breastfeeding in pursuit of corporate profits.

    Insufficient education of medical professionals: Women having trouble with breastfeeding often turn to their pediatrician or to a general practitioner. Unfortunately, the amount of education that these doctors have in breastfeeding is insufficient. It will obviously range from school to school and jurisdiction to jurisdiction, but I have heard of some doctors having merely a few hours of training on breastfeeding. In addition, pediatricians attitudes about breastfeeding are declining, doctors whose skills are most lacking are least likely to seek training to upgrade their knowledge and skills, and there are plenty of medical professionals who are just downright not supportive of breastfeeding, either on purpose or out of ignorance. So when I hear people say, the pediatrician said “X” and I trust him, so we followed his advice, forgive me for being a bit skeptical. If you are having breastfeeding difficulties and your doctor does not refer you to a lactation consultant, you should be concerned. Be proactive and build your A-Team before your baby arrives.

    Lacking access to lactation consultants and breast pumps: People who are struggling with breastfeeding need access to qualified lactation professionals, i.e. International Board Certified Lactation Consultants, and may often need access to a quality double electric breast pump to help maintain or increase supply while working on breastfeeding issues. However, a lot of people who do have access to health care still do not have access to these essential breastfeeding supports.

    Lack of maternity leave: In the United States, women do not have access to decent maternity leave. Some have no access to maternity leave at all. In Canada, most women have access to maternity leave, but there are things that prevent many women from being able to take leave or that force them to go back early. It can take months to get breastfeeding well established and many women are back at work before that has happened.  The lacking maternity leave provisions in many countries pose a significant barrier to breastfeeding.

    No workplace support for breastfeeding: Whether they are forced back to work due to lacking maternity leave provisions or choose to go back to work, women do not have sufficient support for breastfeeding in the workplace. Some states have laws that protect women’s rights in this regard, but many do not. Even among those that do have laws, employers are known to put pressure on breastfeeding women or make them feel bad for needing facilities or time to pump. There is also not enough support for babies at work programs, which allow women to bring small babies to work with them if they choose. Without the right support, women often find themselves trying to pump enough milk sitting on a toilet without frequent enough breaks to maintain milk supply.

    Milk banks not a priority: As I explained in my post on blood, milk and profits, there is an entire industry and infrastructure set up to collect, screen, and distribute blood to those that need it. But milk banks are not a priority. There are too few of them and the ones that exist appear to be in it more for the profits than for ensuring every baby has access to breast milk. Making milk banks a bigger priority would allow women with excess milk to provide it to those that need it, thereby reducing the dependency on formula.

    Attitudes and imagery: People will breastfeed if they see others breastfeeding. Peer pressure, feeling normal, having role models. Call it what you like, it is what it is. If the predominant image in public, in magazines, in movies, on television, is bottle feeding, then people will see that as normal. If it is not, then fewer people will breastfeed and those that do will be ostracized and discriminated against by the anti-nursing-in-public brigade. This is one of the reasons I think it is so important to breastfeed in public. This is why I think we need at least as many breastfeeding dolls as bottle feeding dolls.

      We need to keep providing medical, technical and moral support to women who are struggling with breastfeeding. That will always be a requirement. But to truly facilitate breastfeeding, we need to break down these barriers so that all families and all babies can benefit from the health benefits of breastfeeding and the economic benefits of breastfeeding.

      Which of these barriers have you faced? Did it prevent you from breastfeeding for as long as you wanted to? Are there other societal barriers that I missed?

      Annie is a breastfeeding advocate and blogs about the art and science of parenting at the PhD in Parenting blog.

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      September 11, 2009 at 11:29 am by Bettina

      BRAVO! Thank you for raising awareness of “The Booby Traps” and all you are doing to help Best for Babes put pressure on the barriers, not moms! The more everyone realizes that trying to breastfeed in this country is like trying to run a marathon in flip-flops while people are throwing tomatoes at you, the more we will drive people to action.


      September 11, 2009 at 11:19 am by Hechicera

      I did face barriers having to return to work early, and had to be creative to ensure I did not lose my milk supply. Other than that I didn’t feel like I had too many problems.

      One thing that helped was that my OBs would refer people to the local La Leche League classes. So, education was there, both from the OBs, their nurses and direct referral to an experienced group.

      The other thing was that when I nursed “in public” I would always use a nursing shawl I carried in the baby bag. It was a lovely crocheted one from my great-aunt. That generation, born prior to 1900 (granted all were late 90′s and almost gone), didn’t bat an eye when I told them I intended to breastfeed. The shawl helped avoid any confrontation in public. While it was obvious what was “going on under there” I had taken a step to mark the activity as my private activity. So people that complained where usually accosted by others about “why were they looking?”. I think the shawl’s ability to turn the tables was quite helpful. Though the modern ones not as nice as the old crochet ones.

      Does anyone else wonder if the loss of the agrarian roots to society isn’t a factor as well? Since I saw baby animals nursing it never crossed my mind that breastfeeding was “unnatural”. Lambs are really cute when they nurse too. But, now days no one sees that. Even zoos show babies being bottle fed. It’s not just that you don’t see people nursing, you don’t see anything nurse anymore. Are nursing baby animals in any children’s books anymore even?


      PhDinParenting Reply:

      @Hechicera, I remember visiting a farm where they raised sheep to make cheese. I was horrified (but shouldn’t have been surprised) at how they let the babies nurse for a certain number of days (about 2 weeks I think) and they then get taken from the mother and put on the bottle so that they can use the mother’s milk to make cheese. Even in the agrarian world, things are not ideal!


      Hechicera Reply:

      @PhDinParenting, Oh, that must have been startling. I think most small goat/sheep operations don’t remove the kids/lambs. Of course, the reason they do that in the more commercial ones, after the animals have the colostrum, is to steal all the milk for people! So, I still think it makes you think, real milk is good. Otherwise, why would we be putting baby sheep or goats on formula to be able to steal (all!) their real milk?


      September 11, 2009 at 10:57 am by Clarissa Jarem

      I definitely agree here. Social stigmas towards breastfeeding are so prevalent in society. I have never once been told by a stranger, “hey good to see a breastfeeding mom.” But I have many times been reprimanded for exposing innocent children and often innocent husbands to my breast while nursing my child in a public place. It makes me rather taken aback and I have contemplated not nursing at times due to whoever is around. Then I make myself nurse in public if my daughter wants to. How dare my fear of someone else’s opinion change what I do for my baby! Obviously these people have no concern for my opinion or legally protect rights so I nurse on.


      September 11, 2009 at 8:57 am by BFproblems

      Could not agree more. Especially the part about doctors not having enough knowledge about breastfeeding. You know I believe not even the nurses that help with the birthing or c-sections know much about breastfeeding either. They are too quick to offer formula and don’t have a clue about proper latching on either.


      PhDinParenting Reply:

      @BFproblems, True – and it wouldn’t be the end of the world if they were quick to refer people to a specialist, i.e. a lactation consultant. I don’t expect my general practitioner to know everything about cancer, allergies, etc., but I do expect to be referred to an appropriate specialist if I am having problems. Same goes for breastfeeding.


      September 11, 2009 at 5:01 am by Tina

      In the past week, I’ve done a round of daycare trial days, where I’ve gone in with my children (20 months and 3 years) for half a day, to experience each daycare so that I can determine which one is best for my children. I am still nursing my 20 month old, and happened to nurse her while in the daycares with her. In 2 out of the 3 daycares, I was reprimanded after the fact for nursing outside of their designated nursing areas. I have used 2 other daycare facilities prior to this and neither had issues with me nursing anywhere in their facility. I am also aware that state law prohibits any restrictions on where I nurse. Hence I was appalled, offended, and outraged that, in a facility whose priority and business it is to nurture babies and young children, something as wholesome and natural as breastfeeding is treated as something wrong at best, shameful and lewd at worst. One facility cited difficulties they might experience in explaining to other parents why their child might be asking about exposed breasts. What’s so difficult or embarrassing about explaining breastfeeding?? The second facility claimed that breastfeeding was a disruption to the class. (I was in my son’s 3 year old classroom at the time, but I was in a far corner of the room while the children were engaged in a group activity on the other side of the large room.) I’m not one who normally rocks the boat, but now I wish I knew what I could do to start putting a dent in this mountain of ignorance.


      PhDinParenting Reply:

      @Tina, That is horrible and happens much too often. One of the posts I linked to above describes my reaction to people saying that they didn’t want their children to see my breastfeeding my children:


      liz Reply:



      September 11, 2009 at 1:36 am by carla

      As a mother who nursed, long term, this was a moving piece keep up the excellent work and I hope woman get the message.



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