Promoting breastfeeding in rural communities: breast is best and bottle is a last resort

'Breast is best and bottle is a good second best' has been a common infant nutrition axiom in Australia in recent times. The impact of the widespread recognition of breastfeeding as the most appropriate form of infant nutrition for the first six months of life has been softened by this almost favourable premise about the suitability of artificial feeding. The promotion of breastfeeding becomes that much more difficult if bottle feeding is seen to be, and promoted as, a comparable alternative to breastfeeding by health professionals and the broader community. There is accumulating evidence to suggest that this is not the case, and that infant feeding with artificial formulas increases the risk of short- and long-term morbidity and mortality. This review of breastfeeding promotion challenges health professionals in rural Australia to adopt the more appropriate axiom that 'breast is best and bottle is a last resort'.