- There is a lack of knowledge about specific benefits of breastfeeding and the risks associated with not breastfeeding.
- For instance, only a quarter of the U.S. public agreed that feeding a baby with infant formula instead of breast milk increases the chances the baby will get sick.
- Moreover, mothers need to know what challenges to expect from breastfeeding, as well as what difficulties have been exaggerated. 

Lack of knowledge

- Women with family and friends who have successfully breastfed are more like to breastfeed as well.
- Fathers can positively or negatively influence woman's decision to breastfeed.
- Women with  partners who are informed about the benefits of breastfeeding are more likely still be breastfeeding at six months. 

Poor family and social support

- US studies have shown that there is a lack of support for breastfeeding in public places. 
- Embarrassment stems from mothers being asked to stop breastfeeding or to leave public spaces, as well as the perception of breasts as sexual objects.
- For many women, this embarrassment leads them to stop breastfeeding completely. 

Embarrassment

- Common issues with breastfeeding include sore nipples, engorged breasts, mastitis, leaking milk, pain, and failure to latch on by the infant.
- Mothers also tend to wean infants off of breastfeeding due to concerns about insufficient milk supply. 

Lactation Problems

- Mothers that are employed often have trouble finding time to breastfeed, especially if onsite childcare is unavailable with their employer.
- Another significant barrier to breastfeeding is a lack of maternity leave.

Employment and Child Care

- Providers of maternal and child care often underestimate their influence on their patients' breastfeeding behaviors.
- Support for breastfeeding education and adequate hospital facilities for women who are breastfeeding are often not prioritized.
- Infants are oftentimes unnecessarily recommended supplemental feeding.
- Separating mothers from their babies during their hospital stay has a negative effect on breastfeeding,  but only 57 percent of U.S. hospitals and birth centers allowed newborns to stay in the same room as their mothers.

Barriers Related to Health Services

Refer to shared socially determined consensual expectation regarding appropriate and acceptable behavior in a given context. Social norms carry an evaluative quality, leading to negative judgment for those who violate them without a valid explanation.

Social Norms

- According to the Surgeon General, the main barriers to breastfeeding include lack of knowledge, social norms, poor family and social support, embarrassment, lactation problems, returning to work, and inadequate access to health services.


California Polytechnic State University, San Luis Obispo

- Breastfeeding has psychological and physical benefits for both mothers and infants
- Its immunological benefits are considered to be the most effective preventive means of reducing the death rate of children under five years old. 

Breastfeeding

Office of the Surgeon General (US); Centers for Disease Control and Prevention (US); Office on Women's Health (US). The Surgeon General's Call to Action to Support Breastfeeding. Rockville (MD): Office of the Surgeon General (US); 2011. Barriers to Breastfeeding in the United States. Available from: https://www.ncbi.nlm.nih.gov/books/NBK52688/

The Surgeon General's Call to Action to Support Breastfeeding

Barriers to Breastfeeding in the US

Breastfeeding library

Hormones involved in breastfeeding are meant to ensure that is occures, that enough milk is produced, and that the mothers are able to tolerate the process. Some mothers are able to find enjoyment in breastfeeding, though many find it irritating, frustrating or unpleasant. Hormones involved in breastfeeding also can trigger the fight or flight mechanism within the mother, allowing them to better protect their child if necessary.

Some of the hormones that are involved are oxytocin and prolactin.

Hormones in breastfeeding

With D-MER, the mother experiences dysphoria during milk ejection or breast feeding.  It is reported as a sudden change in emotions when feeding occures. It typically disappears within 10 minutes after the beginning of feeding. This is different from postpartum depression because it lasts for a short time directly after the beginning of feeding. 

Dysphoric Milk-Ejection Reflex (D-MER)

Skin-to-Skin contact between a parent and child during breastfeeding is able to increase oxytocin and decrease stress in the parent and child. Contact soon after birth is heavily correlated to reduced stress.  In the child, there is a decreased sympathetic nervous system response.Babies are also less afraid and more social with the mother.

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