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".)
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.
Initiation of breastfeeding — Data from the Centers for Disease Control (CDC) from 2005 demonstrated lower breastfeeding rates in mothers who were younger, unmarried, black, below the poverty income ratio, with the lowest educational level, and lived in rural areas .