Breastfeeding in the industrialized world. Review of the literature

Since the Industrial Revolution there has been an almost continuous decline in breastfeeding in North-America and western Europe. But the last years numerous studies report that breastfeeding is regaining popularity. The social forces responsible for this are a back-to-nature movement, ecological concerns, breastfeeding support groups and a renewed interest by scientists, the health profession and national and international organizations. Many determinants of child feeding behaviour have been analyzed extensively: ethnic and cultural background, socioeconomic and employment status, maternal (age, parity, marital status) and child (sex, birthweight) characteristics, maternal knowledge and attitudes, health care management. Still the relative influence of these factors can only be estimated, partly because of a lack of an accurate methodology. The reasons mentioned with regard to weaning often indicate a lack of confidence intensified by deficiencies in information and support systems. The negative influence of the infant food industry on breastfeeding behaviour cannot be disregarded. Clearly the promotion of breastfeeding in our society is a policy matter, requiring positive action in the field of health education; legislation, research and the reorganization of health services.