The resurgence of breastfeeding in the United States

To update reported rates of breastfeeding through 1995 and to compare rates in 1995 with those from 1989.

The Ross Laboratories Mothers' Survey, first conducted in 1955, is a large, national, mail survey designed to determine patterns of milk feeding to 6 months of age. Questionnaires are mailed to a representative sample of mothers when their infants are 6 months of age. In 1989, 196 000 questionnaires were mailed, and in 1995, 720 000 questionnaires were mailed. Mothers were asked to recall the type of milk fed to their infants immediately after birth, in the hospital, and during each of the first 6 months of age. The rates of breastfeeding in the hospital and at 6 months of age were evaluated.

The Ross Laboratories Mothers' Survey demonstrates recent increases in both the initiation of breastfeeding and continued breastfeeding at 6 months of age. Comparing rates in 1989 and 1995, the initiation of breastfeeding increased more than 14% (from 52.2% to 59.7%). There was a 19.3% increase in the rate of breastfeeding at 6 months of age (from 18.1% to 21.6%). The increases in breastfeeding were observed across all sociodemographic groups but were greater among groups that have historically been less likely to practice breastfeeding: women who were black, younger (<25 years of age), in the lowest income group (<$10 000), no more than grade school educated, primiparous, and living in the South Atlantic region of the United States; women who had infants of low birth weight; women who were employed full time outside the home; and women who participated in the Women, Infants, and Children supplemental food program. Nevertheless, breastfeeding was most common in the western states and among women who were older, college educated, and multiparous, did not enroll in the Women, Infants, and Children program, were not employed outside the home, had infants of normal birth weight, and had higher disposable incomes.

The sharp increase in rates of breastfeeding among groups that are less likely to breastfeed is encouraging. However, these groups are still the least likely to initiate breastfeeding. Educational efforts that extol positive attitudes about breastfeeding must be continued to support mothers who are young, poor, and less educated.