I for one am quite surprised by the data showing that Asian and Hispanic women are more likely to breastfeed than white women. As a (white, educated) woman who had numerous problems breastfeeding, I could have continued seeing one of the half dozen lactation consultants I talked with to help me continue nursing without supplementing, but exclusive breastfeeding became financially and emotionally draining for me. I imagine that a woman in a worse financial situation would give up breastfeeding easily. (Especially since LCs aren't often covered by insurance, but formula is covered by WIC.)

I'm glad to see that the initial rates of breastfeeding are so high but would like to see data from 1, 2, 3, 4, and 5 months postpartum. That is, are the breastfeeding mothers doing it until 6 months and then immediately weaning? Are they choosing to stop earlier to go back to work or for baby-led weaning?

As a Latina woman, I have noticed that motherhood is very important in my culture. Many of the women I know, who are from working class backgrounds, seem (perhaps they are not actually!) to be fulfilled by their primary job raising children. Families, especially immigrant families, often try to adhere to traditional family models, probably to maintain some sort of stability in their new foreign environment. The man (probably largely due to machismo!) will focus on making money and the woman stays at home, feeds their baby, cleans the house, and makes food for them. (Of course, I don't mean to imply this is the ideal family structure at all, and many women, including my own mom, are dissatisfied with this lifestyle and would feel a lot more accomplished if they were given opportunity to pursue work and interests outside of the home!) Anyway, breastfeeding is definitely an important part of Latina motherhood. When my cousins and I played house, we would have pretend talks about how long we were going to breastfeed our dolls....That might sound creepy, but it just goes to show how we were surrounded by those kinds of images and messages.

RE: < High School: Mother might be less likely to have a job, making it both easier to find the time to breast feed, and more important financially.

I wouldn't trust the consensus that breastfeeding is necessarily better for children. There seems to be a strong counter-argument that breastfeeding itself is a kind of fad among the educated classes, in the same way that other "natural" lifesyles have gained favor among the elite. The supposed benefits of breastfeeding may just be the result of generally more attentive parenting by people who have more time for it. Also, other classes of people might simply not feel the need to breastfeed since they are not subjected to the same social pressures.

I thought this was a good article questioning the conventional view:
http://www.theatlantic.com/magazine/archive/2009/04/the-case-against-breast-feeding/7311/

Yeah, it seems like there are at least two major issues playing into this, first a cultural expectation and acceptance of breast feeding (and though North American society seems to claim that "breast is best" it certainly doesn't pull through on the acceptance part with women being forced off buses, into bathroom stalls at the mall and just generally out of sight.)

But there is also a financial component. A mother might not be able to breastfeed or pump at her place of work due to inconsiderate bosses (or unable to bring herself to do it in the way they want her to, (for example: in a bathroom stall taking up all of her limited lunch break giving her no time to eat.) I'm not sure how expensive breast pumps are but if I had a baby right now I wouldn't be able to afford one)

Or a woman might not be able to afford the cost of baby formula and would view breast feeding as a way to cut down on that expense.

Ideally we should live in a world where anyone who wants to breast feed can do so, and anyone who doesn't should be enabled to do so as well. But we don't, and so studies like this are going to be flawed.

I'm just wondering if the graph designer really meant to imply that a Bachelor of Science outranks a Bachelor of Arts.

This class component is the reason why I wish lactivists would focus on things like legislation to guarantee a woman's right to pump in the workplace and decent paid maternity leaves, rather than on throwing nurse-ins every time someone gives a nursing mother the stinkeye in public. How much more likely would women be to nurse if they could actually take time off after having a baby, and were able to have time and space to pump if they wanted to?

I also hate the way breastfeeding is so much put on the shoulders of mothers, as though it were a simple choice for women. I see so much advertisement with the "Breast is Best" message- a message that women have received, given the initiation rates in the graph above. But it's one thing for a woman to choose to breastfeed and another for her to actually have the time, support and correct information to do so. Biologically, the vast majority of women could still be nursing at six months- if we really mean it that we as a society want women to do this, we need to stop trying to guilt women about it and actually put legislation (mat leaves, more access to LC's, guaranteed pumping breaks) in place to make it possible for them to do it.

For women with less than a high school education, they might be more likely to be unemployed and therefore at home with the baby because of that. Or, they might be high school students, or at least of the age to be high school students, and therefore not have finished high school yet.

Latina and Asian women -- cultural differences? Higher unemployment compared to white women? (Which doesn't account for the lower rate of breastfeeding in black women, so maybe a combination of the two?) I'd want to see the groups of women of color plotted against unemployment rates and rates of female-headed households for those groups.

It would be interesting to see the numbers based on the age of the mother and whether they had chosen to work after their babies were born. As noted in prior comments, it was not uncommon for our parents generation to be formula-fed. This could result in limited free support and advice from family if breastfeeding doesn't work for you which in turn would lower the numbers that breastfeed longer than "initiation".

Could families/communities that traditionally have stronger family bonds produce mothers that breastfeed longer? Breastfeeding is definitely cheaper than formula in these families/communities as they can provide support and advice for breastfeeding. I agree that nursing bras are mostly necessary but the rest (nursing pads, lactation consultants, supplements, surgery, etc) are not necessary or required to breastfeed. (Lucky for us Canadians, lactation consultants at the hospitals are generally free). That being said it should also be stated that some babies just do not "get it" regardless of how much time, effort, money a Mom spends on trying to breastfeed. It always upsets me when Moms get blamed for not successfully breastfeeding - babies do what they are going to do.

This is not an answer to the questions in the post, but I have to say I'm disappointed to see the direction most readers seem to be taking this: breastfeeding is a fad, a luxury, it's terrible how women are "bullied" into it, yadda yadda yadda.

What about using this study as a reason to call for better, fairer treatment of nursing mothers in the workplace? What about some concern for the position of a mother with a less accommodating job who doesn't want to risk her child's health? Why, finally, does this seem to be turning into a discussion targeted more at easing the guilt of well-to-do nice white ladies than at opposing the real barriers society places before less privileged mothers?

"Mothers who have the privilege to stay home with their babies — for three, six, or even twelve months — then, are going to find it much easier to follow the AAP guidelines."

Of course, obviously no respectable woman would stay out of the workforce for more than a year; she'd be an embarrassment to feminism. Especially if she has an education.

Breastfeeding is a big job? Being a parent is a big job. They require more than just feeding. Two hourly feeds generally don't last past the first couple of months.

Breastfeeding can be achieved by most with the right attitudes and support.I'm no talking expensive 'lactation consultants'!Other mothers who get together to support each other can work wonders for confidence and success.The cost can be negligible, if you're not prepared for having some cost involved in having kids why go there?While you may need nursing bras, nothing else is strictly necessary.Purpose bought large white handkerchiefs washed soft make great bra inserts.I got along for 13 months with nothing more and found it the most rewarding experience of my life.It can all get too complicated!!

I'd like to see a study comparing rates of breastfeeding between Canada and the US. The reason? Canadian parents are given the opportunity to take a year away from work on maternity/parental leave while receiving up to 60% of their wages. Many do. Breastfeeding takes time and if Canadian women have more time to do so, are more women tending to breastfeed and are they breastfeeding for longer? Are women from all backgrounds and classes more likely to breastfeed?

No podcast love? We did a contexts podcast interviewing Julie Artis on this exact subject a few months back:

http://thesocietypages.org/podcast/2009/12/13/the-sociology-of-breastfeeding/

Many of the points raised in this podcast have been raised in these comments, but if you're interested in the subject and want an expert take on it, I'd recommend giving it a quick listen (and then subscribing to the podcast...)

Latina women also have, on average, better birth outcomes despite the fact that they have (again, average) lower SES and other predictors of poor outcomes. It's a big question in birth outcome research (or at least it was in the last decade) - what is different about latina women that protects them/their babies from these risk factors?

I haven't actually looked at the most recent data, but it's something that comes up a lot in the literature about religion and health because one potential protective factor is high religiosity in traditional hispanic cultures. I'm sure there are plenty of other protectors too, this is just where I have encountered the data.

I got pregnant young and didn't have a degree at the time. I chose to breastfeed because it was the best thing for my baby, not because I couldn't afford formula.

It doesn't surprise me that Hispanic women and teenagers would be more likely to breastfeed. It is a widely-accepted part of most Hispanic cultures. Whereas well-educated white Americans tend to overcomplicate it and worry about whether they "could" successfully breastfeed, Hispanic women just naturally assume they will. It is just a natural part of life for these women. As for teens, many make the decision to leave school and stay home with their baby, which they have the luxury to do if they are still living at home with their own parents.

I think that it's strange that the author seems to assume that APIAs are -- as a whole -- more wealthy and more educated.

Nursing bras? Shirts? Pads? Pumps? Creams? Are ya kidding me? Put the kid on your boob and voila! Even the calories required can cheaply be found...eat a slice or two of bread with peanut butter on it and some carrots.

Maybe white women don't nurse their children because they don't see it. And besides, isn't the powdered, dead, color-less stuff called formula "just as good?":

I guess if we all ate powdered, dead stuff out of a can, we'd be the epitome of health. Oh wait....

I work as a WIC breastfeeding peer counselor. That means I am a woman who has breastfed her children and now I offer information and support to WIC moms who want to breastfeed. WIC moms are often young or have lower education levels. Very often they are in the process of earnings degrees. I am not a certified lactation consultant or educator, although both types of professionals are available for more "complicated" situations. My role is basically to be an example of someone who has done it - which in some communities is almost completely lacking. I DO NOT pressure or shame ANYONE into breastfeeding. Those moms that express an interest in trying are sent my way, and I help them in any way I can.

@ OP "Breastfeeding, however, is a big job. Even if a newborn takes to breastfeeding without any problems (some mothers struggle mightily with less-than-cooperative infants), mothers must feed their children around the clock (they now recommend every two hours, 24-hours a day for newborns). If it takes a half hour to settle the baby down and fill it up, you’ve got an hour and a half before the next feeding time."

I think statements like this one plant yet another seed that breastfeeding is an incredibly daunting task - especially for those who do not have women close to them who they can emulate. It is true that learning to feed at the breast can be a challenge for some mothers and babies. But to suggest that a baby could/would refuse to cooperate with his/her own nourishment is....well....ridiculous. Babies are designed to feed at the breast and are almost always willing and able to do so. Finding the right position for a particular baby might be a matter of trial and error and sometimes requires the guidance and support of someone with some experience. Suggesting that it is common for babies to "refuse the breast" is perpetuating an extremely damaging myth.

Also, focusing on the early breastfeeding relationship, as if it reflects what is typical of the entire (ideally) year also serves to exaggerate the difficulty of breastfeeding. Babies do need to feed often in the first few weeks. We recommend 8-12 times per day - more during the day and less at night. This helps mom and baby learn the skills they need, helps the baby gain weight, and perhaps most importantly, establishes a strong, responsive milk supply. Once that investment is made, most babies need to nurse much less often, and for much less time per feeding. There is, of course, a considerable investment of time and energy involved with formula feeding (managing bottles, keeping supply on hand, etc.), but that is very often overlooked in these types of discussions.

"Breastfeeding is widely believed to carry significant health advantages for infants and the American Academy of Pediatrics (AAP) would like to see all mothers breastfeed their children for at least 12 months, with no supplemental food for the first six."

You mean that formula feeding carries disadvantages for the health of the child in question (something which has grave implications when you consider that formal, useful support for breastfeeding in the workplace (which poorer people can't opt out of!) is very much class-based) compared to breastfeeding, which is biologically normal.

Breastfeeding is normal for all mammals. Formula feeding is the option. Breastfeeding doesn't make smarter, or healthier babies. It doesn't ward off allergies or diabetes. Formula feeding is linked to allergies, and diabetes, and 10 points lower on IQ tests. (Is it 10 points? Something like that.)

I am. 20 year old African American student and I have a ten moth old, and I plan to nurse until 24 months. Because I want to and hopefully I can. And I am mostly like not going to give my baby cow milk.
Goat milk is actually healthier.

I respect your analysis of the data. I also appreciate your insight about how race and class impact breeastfeeding. However, your first few paragraphs imply that that you know very little about breastfeeding and did not consult with any reliable resources about human lactation and breastfeeding before writing this. You make some very good points at the expense of accurate information about breastfeeding.

There is no "they" who "now" recommend how babies must be fed. Feeding babies when they are hungry is a biological norm that has kept the human race alive for hundreds of thousands of years. That approach to feeding is not something that a group of self-proclaimed experts recently decided to createp. Your statements show that this country's culture of formula feeding is the norm by which you measure breastfeeding.

Feeding a baby the biologically normal way (breastfeeding when the baby shows signs of hunger) means you're less likely to take half hour to "settle the baby down and fill it up." However, waiting until a scheduled bottle feeding will result in needing a lot of time to get the baby calm and ready for a feeding.

It's disappointing that this post reflects misinformation and bias against breastfeeding.

so I did not read all of the comments but I do know in other cultures they don't have options so all they can do is what they know and that's breast feeding in a lot of other places they don't have running water let alone breast pumps common sense people ... Education. I am almost certain that in many other cultures formula feeding is frowned upon and personally in my family it is and we are African Americans some of us are educated and others where not giving the same opportunity(in my family)but when it comes down to the meat and potatoes of it our family believes that there are enough chemicals being pumped in our food, water, and air the least we can do is give our child what god has given to us that's the gift to provide a supply of food to keep that baby happy and healthy... just my two cent>>>

Can we hear from someone who is black? Or from one of these groups with low numbers please? I feel like many of these comments are speculative and don't give us real perspective. Feminist issues and opinions can vary considerably across class and racial lines. Thanks.

There ARE some for whom breastfeeding does not work, like for me and my daughter. She would eat 5 minutes, and then fall asleep, despite tons of measures taken to wake her up. I have eczema, and having her latch and unlatch that much resulted in bloody nipples within days. She failed to get more interested in eating more, even though I kept trying. She took 3 weeks to get back to birth weight and was lethargic. Babies can actually fail to get hungry if not getting enough after a couple of weeks. When I realized that she was not thriving and eating way less than normal, I went to the bottle and formula, at about 3 1/2 weeks. My daughter is 11 now, is sick significantly less than her peers, was just placed in advanced math and got a perfect score on her schools standardized science test, and did I mention she reads at least at a HS senior level? Breastfeeding IS hard, even for those who have it easier than we did, to say otherwise is not true and makes moms with situations like mine be judged.