Attitudes Toward Breastfeeding in Social Settings and Breastfeeding Beyond Infancy in US Mothers

Despite recent progress on breastfeeding indicators in the United States, breastfeeding remains stigmatized in certain contexts; for example, breastfeeding beyond infancy and breastfeeding in public. The purpose of this study was to assess and identify correlates of attitudes toward breastfeeding in social settings and breastfeeding beyond infancy among US mothers.

In this cross-sectional study, a nationwide sample of US mothers of children between the ages of 1 and 4 years (N = 881) completed an online survey. We used multivariable logistic regression to assess associations between sociodemographic and infant feeding intention variables and odds of: 1) low support for breastfeeding in social settings, 2) agreeing it is appropriate to breastfeed a 1-to-2-year-old toddler, and 3) agreeing it is appropriate to breastfeed a 2-to-4-year-old child.

Intention to exclusively formula-feed was associated with low support for breastfeeding in social settings (OR = 1.89, 95% CI [1.23, 2.89]) and reduced odds of agreeing it is appropriate to breastfeed a 1-to-2-year-old toddler (OR = 0.32, 95% CI [0.21, 0.50) or 2-to-4-year-old child (OR = 0.35, 95% CI [0.20, 0.61). Non-Hispanic Black (NHB) and Hispanic race and ethnicity were associated with increased odds of low support for breastfeeding in social settings (OR = 2.20, 95% CI [1.39, 3.47 and OR = 1.58, 95% CI [1.05-2.38], respectively). However, Hispanic ethnicity was associated with increased support for breastfeeding a 2-to-4-year-old child (OR =1.64, 95% CI [1.07-2.50]).

There are opportunities to shift attitudes toward breastfeeding in public and breastfeeding beyond infancy. Future research should investigate the directionality of the relationship between these attitudes and infant feeding intentions.