Promoting breast feeding: a national perspective.

The promotion of breast feeding is 1 of 17 nutrition objectives set out in the Public Health Service's Objectives for the Nation. Trends in breast feeding for the last 30 years are reviewed. While the proportion of mothers breast feeding in the overall American population has been steadily increasing, there is still much to be accomplished in order to meet the 1990 national breast feeding objective. Low-income women still lag behind middle-and upper-income women in starting and maintaining breast feeding. Several sources of barriers to breast feeding exist: society, the health care profession, and the family. In addition, economic and cultural barriers further inhibit breast feeding efforts of low-income women. Efforts to promote breast feeding have been initiated at national, State, and local levels, as well as in the private sector. A summary of key initiatives at all levels is given. Future directions for breast feeding promotion include (a) increasing educational efforts directed to pregnant women and their families, (b) changing the routines and practices in hospitals, (c) improving and increasing the support systems available to breast feeding women, (d) providing education to all health professionals in maternal and infant health care, (e) increasing the scope of efforts and media used to educate the general public, (f) increasing the acceptance by employers of the need for workplace accommodation for breast feeding women, and (g) continuing research efforts. One way to address the challenges ahead is to link up with other community organizations and agencies. The Healthy Mothers, Healthy Babies Coalition is one vehicle for this purpose.