Human milk is recognized as the optimal feeding for all infants because of its proven health benefits to infants and their mothers. The World Health Organization (WHO), the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), and the United States Preventive Services Task Force all recommend exclusive breastfeeding for the first six months of life [1-4]. (See "Infant benefits of breastfeeding" and "Maternal and economic benefits of breastfeeding".)
Because of ongoing educational and support efforts to promote breastfeeding in the United States, the initiation rate of breastfeeding increased to 75 percent in 2008 . The continued rates of breastfeeding also increased to 44 percent of any breastfeeding at six months of age, and 23 percent at 12 months of age. Ongoing efforts by health professionals are needed to improve breastfeeding rates in order to reach the 2020 Goals for Healthy People of 82 percent for breastfeeding initiation, and 46 and 26 percent for exclusive breastfeeding goals at three and six months of age, respectively [1,6].
The factors that influence the parental decision on whether to breastfeed and the professional support required for successful initiation and maintenance of breastfeeding will be reviewed here. The initiation of breastfeeding at birth, the composition of human milk, and complications of breastfeeding are discussed separately. (See "Initiation of breastfeeding" and "Nutritional composition of human milk for full-term infants" and "Common problems of breastfeeding and weaning".)
PARENTAL FACTORS IN FEEDING CHOICE
Understanding what factors are important in the parents' decision in choosing and maintaining breastfeeding over formula feeding enables health care professionals to provide education and support that promotes breastfeeding. In particular, identifying and addressing the factors that impede initiation of breastfeeding and the reasons for early termination will improve breastfeeding rates.
Barriers to breastfeeding — Identifying barriers to breastfeeding helps to direct efforts to address the factors that negatively impact breastfeeding and to focus programmatic resources on families that are most likely not to breastfeed.