Less Than Half of Mothers Breastfeed at Six Months; African American Mothers Have Lowest Rates of Recommended Breastfeeding Duration; Laws Enacted

The American Academy of Pediatrics recognizes breastfeeding and human milk as the "normative standards for infant feeding." Given the documented health benefits, the Academy recommends exclusive breastfeeding for six months, followed by continued breastfeeding for at least 12 months as complementary foods are introduced. However, less than half of U.S. mothers are breastfeeding at six months (45 percent), according to a report released by the CDC. Less than a quarter of mothers (23 percent) are breastfeeding at twelve months in accordance with the American Academy of Pediatrics recommendation. This may indicate that all mothers need more support to continue breastfeeding. Although rates of breastfeeding at six months increased by more than 13 percent among African American mothers, this group still had the lowest rates of breastfeeding duration, indicating that they still need more, targeted support.


To better understand breastfeeding trends and differences among African American, Caucasian, and Hispanic infants born from 2000 to 2008, the CDC analyzed National Immunization Survey data from 2002 to 2011. Across all groups, the percentage of mothers who start and continue breastfeeding is rising. From 2000 to 2008, mothers who started breastfeeding increased more than four percentage points. During that same time, the number of mothers still breastfeeding at six months jumped nearly 10 percentage points, from 35 percent in 2000 to nearly 45 percent in 2008.


In addition to increases among all groups, gaps in breastfeeding rates between African American and Caucasian mothers are narrowing.  The gap narrowed from 24 percentage points in 2000 to 16 percentage points in 2008.


“Breastfeeding is good for the mother and for the infant – and the striking news here is, hundreds of thousands more babies are being breastfed than in past years, and this increase has been seen across most racial and ethnic groups,” said CDC Director Tom Frieden, M.D., M.P.H. “Despite these increases, many mothers who want to breastfeed are still not getting the support they need from hospitals, doctors, or employers. We must redouble our efforts to support mothers who want to breastfeed.”


A number of factors and characteristics influence a woman's breastfeeding intentions. Characteristics associated with lower breastfeeding prevalence among women include younger age, lower income, less maternal education, and unmarried status. However, even when accounting for factors such as socioeconomic status and maternal education, racial/ethnic differences in breastfeeding persist. This persistent gap in breastfeeding rates between African American women and women of other races and ethnicities might indicate that African American women are more likely to encounter unsupportive cultural norms, perceptions that breastfeeding is inferior to formula feeding, lack of partner support, and an unsupportive work environment. All breastfeeding women need support, but specific interventions might be needed among populations with lower breastfeeding prevalence.


Although there is no single solution to increasing support for breastfeeding women, the 2011 Surgeon General's Call to Action to Support Breastfeeding outlines a number of actions aimed at increasing societal support for women who choose to breastfeed. The report suggests that as communities, employers, health-care providers, governments, and nonprofit organizations implement strategies to support breastfeeding, all women who choose to breastfeed will benefit. Strategies to increase breastfeeding support for minority women include 1) increasing support for nonprofit organizations that promote breastfeeding in minority communities and 2) increasing the number of International Board Certified Lactation Consultants from minority communities.


The CDC's Guide to Breastfeeding Interventions also offers recommendations and program examples to assist states, territories, and communities in supporting mothers to begin and continue breastfeeding. Two projects currently funded by CDC aim to increase support for breastfeeding women by improving hospital practices related to breastfeeding and increasing community support available to breastfeeding women. The Best Fed Beginnings project provides support to 89 hospitals to improve maternity care practices to support breastfeeding women and to move the hospitals toward Baby-Friendly designation. Hospitals located in states known to have breastfeeding differences and serving low-income and minority populations were given preference. In addition, the CDC awarded funds to six state health departments to develop community breastfeeding support systems in minority populations. Grantees will collaborate with community-based organizations to address the challenges that breastfeeding mothers encounter after hospital discharge to establish and maintain breastfeeding.


Research shows breastfeeding can help reduce childhood obesity and protect babies from several medical issues. Benefits are particularly noticeable when mothers exclusively breastfeed for the baby’s first six months and continue breastfeeding up to two years of age with appropriate, complementary foods. Mothers can legally breastfeed in public in every state, and federal law permits working mothers a reasonable time to express breast milk in a private setting at the workplace. See the Compendium of Laws below.


See the CDC Announcement


See the CDC Report


See the CDC Public Health Law Program’s Compendium of Laws Related to Breastfeeding