The breast or the bottle? Determinants of infant feeding behaviors.

Although various trends have placed breastfeeding in and out of vogue, in the twentieth century the greater availability of human milk substitutes mandates that a woman choose her infant's feeding method. It appears that intrapsychic factors or life experiences, as well as certain social conditions, influence that choice. For example, the economic state of society historically has had significant impact on the role of women and the value placed on woman's unique biologic contributions. Likewise, personality and attitudinal factors also may act as potential mediators of observed differences between lactating and nonlactating mothers in their mother-infant interactions. Finally, once the decision to breastfeed or bottle-feed has been made and carried through, additional physiologic mechanisms may mediate conscious behavioral intentions. The phenomenon of human lactation, then, is sensitive to a variety of interrelated factors that can be grouped as follows: (1) individual personality, (2) social forces, and (3) psychophysiologic mechanisms. An in-depth understanding of the specific factors that affect a woman's decision to breastfeed will have far-reaching implications for future educational and interventional programs.