January 3, 2024
By Sneha Hingorany, Drexel University College of Medicine

The health benefits of breastfeeding for both mother and infant have been well-touted for years. Based on these undeniable benefits, the American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of life and continuation of breastfeeding until two years of age or beyond, a recent revision from the previous recommendation of continued breastfeeding for the first year of life or longer.¹³ In fact, 83.2% of infants born in 2019 were initiated on a diet at birth with at least some component of breastmilk. However, by 6 months of age, that number dropped down to 55.8%, with only 24.9% breastfeeding exclusively.³

It is known that the key to establishment and maintenance of a sufficient milk supply in a breastfeeding mother hinges on timely and consistent milk removal. However, the reality of living in our society creates a significant hurdle for mothers who want to breastfeed. Although a significant contributor to this hurdle is insufficient paid family leave, which pushes mothers back into a workforce that oftentimes frowns upon the utilization of frequent breaks needed to pump breastmilk, another obstacle that is often overlooked and deserves mention is the taboo associated with breastfeeding in public.¹¹

In 49 states, the District of Columbia and the Virgin Islands, mothers are within their legal right to breastfeed in any public or private setting.¹⁴ However, lack of desire to breastfeed in public has frequently been cited as a reason mothers discontinue breastfeeding, oftentimes before they are able to meet their breastfeeding duration goals.^9,10 In contrast, women who indicate that they are comfortable breastfeeding in public have been shown to breastfeed longer than those who do not.¹¹

Indeed, despite laws protecting public breastfeeding, scores of women have faced scrutiny when doing so. So, where does this discomfort with public breastfeeding come from? To begin to unpack this ideology, one must turn a critical eye to the male gaze and its role in dictating societal norms. It has been demonstrated that breastfeeding in public, particularly around male strangers, puts women in the difficult position of toeing the border between her breast being seen as a source of nurturing and as a sexual entity. A woman in such a situation is often met with looks of discomfort from those around her, or a response that is outwardly critical: one that tells her to “cover up.” This forces women who do choose to breastfeed in public to behave almost as though it is illegal, despite it being the contrary, in that they feel they need to be discreet in their actions and even embarrassed by them. It’s no wonder many women choose to abstain from this method of nourishing their child; it paints her as the bad guy, the “sexual aggressor” or inviting sexual contact from men.^1,2,5

A beacon of hope: The negative perceptions about breastfeeding in public have a significant association with education and/or knowledge about breastfeeding.⁸ Many women who hesitate to breastfeed in public underestimate the health benefits of breastfeeding; those who do have that knowledge or attend more classes on the matter are more likely to breastfeed.^4,6,12 Men who are more aware of breastfeeding and its benefits are more likely to have a positive view of breastfeeding in public.⁷ This speaks to a dire need for public education regarding the benefits of breastfeeding as well as its normalization within daily life. Imagine the shift in societal ideology that could happen if the idea of breastfeeding was indoctrinated to us as children; why not bring it up in middle school health class along with the rest of the birds and the bees?

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Sources/Resources:

• Acker, M. (2009). Breast is best…but not everywhere: Ambivalent sexism and attitudes toward private and public breastfeeding. Sex Roles, 61(7-8), 476–490. https://doi.org/10.1007/s11199-009-9655-z
• Boyer, K. (2018). The emotional resonances of breastfeeding in public: The role of strangers in breastfeeding practice. Emotion, Space and Society, 26, 33–40. https://doi.org/10.1016/j.emospa.2016.09.002
• Centers for Disease Control and Prevention. (2022, August 31). Breastfeeding report card. Centers for Disease Control and Prevention. Retrieved January 19, 2023, from https://www.cdc.gov/breastfeeding/data/reportcard.htm
• Fairbrother, N., & Stanger-Ross, I. (2009). Reproductive-aged women’s knowledge and attitudes regarding infant-feeding practices: An experimental evaluation. Journal of Human Lactation, 26(2), 157–167. https://doi.org/10.1177/0890334409352853
• Grant, A. (2016). “I…don’t want to see you flashing your bits around”: Exhibitionism, othering and good motherhood in perceptions of public breastfeeding. Geoforum, 71, 52–61. https://doi.org/10.1016/j.geoforum.2016.03.004
• Hill, P. D. (1988). Maternal attitudes and infant feeding among low-income mothers. Journal of Human Lactation, 4(1), 7–11. https://doi.org/10.1177/089033448800400112
• Magnusson, B. M., Thackeray, C. R., Van Wagenen, S. A., Davis, S. F., Richards, R., & Merrill, R. M. (2017). Perceptions of public breastfeeding images and their association with breastfeeding knowledge and attitudes among an internet panel of men ages 21–44 in the United States. Journal of Human Lactation, 33(1), 157–164. https://doi.org/10.1177/0890334416682002
• Mulready-Ward, C., & Hackett, M. (2014). Perception and Attitudes: Breastfeeding in Public in New York City. Journal of Human Lactation, 30(2), 195–200. https://doi.org/10.1177/0890334414524988
• Odom, E. C., Li, R., Scanlon, K. S., Perrine, C. G., & Grummer-Strawn, L. (2013). Reasons for earlier than desired cessation of breastfeeding. Pediatrics, 131(3). https://doi.org/10.1542/peds.2012-1295
• Scott, J. A., Kwok, Y. Y., Synnott, K., Bogue, J., Amarri, S., Norin, E., Gil, A., & Edwards, C. A. (2014). A comparison of maternal attitudes to breastfeeding in public and the association with breastfeeding duration in four European countries: Results of a cohort study. Birth, 42(1), 78–85. https://doi.org/10.1111/birt.12138
• Stuebe, A. M., & Bonuck, K. (2011). What predicts intent to breastfeed exclusively? breastfeeding knowledge, attitudes, and beliefs in a diverse urban population. Breastfeeding Medicine, 6(6), 413–420. https://doi.org/10.1089/bfm.2010.0088
• Thomas, C., O’Riordan, M. A., & Furman, L. (2016). Effect of the knowledge and attitudes of a support person on maternal feeding choice. Journal of Human Lactation, 33(1), 195–204. https://doi.org/10.1177/0890334416678821
• Wyckoff, A. S. (2022, June 27). Updated AAP guidance recommends longer breastfeeding due to benefits. Publications.aap.org. Retrieved January 19, 2023, from https://publications.aap.org/aapnews/news/20528/Updated-AAP-guidance-recommends-longer
• Your breastfeeding rights. WIC Breastfeeding Support - U.S. Department of Agriculture. (n.d.). Retrieved January 19, 2023, from https://wicbreastfeeding.fns.usda.gov/your-breastfeeding-rights