Position of the American Dietetic Association: Breaking the barriers to breastfeeding

It is the position of the American Dietetic Association (ADA) that broad-based efforts are needed to break the barriers to breastfeeding initiation and duration. Exclusive breastfeeding for 6 months and breastfeeding with complementary foods for at least 12 months is the ideal feeding pattern for infants. Increases in initiation and duration are needed to realize the health, nutritional, immunological, psychological, economical, and environmental benefits of breastfeeding. Breastfeeding initiation rates have increased, but cultural barriers to breastfeeding, especially against breastfeeding for 6 months and longer, still exist. Gaps in rates of breastfeeding based on age, race, and socioeconomic status remain. Children benefit from the biologically unique properties of human milk including protection from illness with resulting economic benefits. Mother’s benefits include reduced rates of premenopausal breast and ovarian cancers. Appropriate lactation management is a critical component of successful breastfeeding for healthy women. Lactation support and management is even more important in women and children with special needs caused by physical or developmental disability, disease, or limited resources. Dietetics professionals have a responsibility to support breastfeeding through appropriate education and training, advocacy, and legislative action; through collaboration with other professional groups; and through research to eliminate the barriers to breastfeeding. POSITION STATEMENT It is the position of the American Dietetic Association (ADA) that broad-based efforts are needed to break the barriers to breastfeeding initiation and duration. Exclusive breastfeeding for 6 months and breastfeeding with complementary foods for at least 12 months is the ideal feeding pattern for infants. Increases in initiation and duration are needed to realize the health, nutritional, immunological, psychological, economical, and environmental benefits of breastfeeding. BREASTFEEDING TRENDS IN THE UNITED STATES National efforts to promote breastfeeding have been successful at increasing rates of breastfeeding initiation. Nonetheless, fewer than one third of infants are being breastfed beyond 6 months of age, and many potential benefits are being forfeited. The next challenge to ADA and other professional organizations is to communicate the importance of exclusive breastfeeding for 6 months and breastfeeding with complementary foods for at least 12 months. Since the first edition in 1979 of Healthy People, in which the US Surgeon General’s Report stated that breastfeeding is to be encouraged (1) and the follow-up editions in which specific goals for initiation and duration rates have been identified (2,3), the United States has seen a resurgence in breastfeeding rates. Breastfeeding initiation rates increased from a low of about 20% in the early 1970s to a high of 61.9% Position of the American Dietetic Association: Breaking the barriers to breastfeeding