by Adam Spangler
December 16, 2008

A few decades ago the American Academy of Pediatrics (AAP) stated what proponents have been saying for years: Breastfeeding is the preferred method of infant feeding as it provides ideal nutrition and optimal health outcomes. After the AAP released its statement, research funding increased as did the number of breastfeeding mothers, a survey completed in 1995 proved.

A new study by the AAP, however, shows that past successes are being stripped away, breastfeeding again fighting an uphill battle toward overall acceptance.

From November 2003 through May 2004, 875 pediatricians shared their opinions, practices, and recommendations related to breastfeeding. Also placed under the microscope were doctors’ personal breastfeeding experience and its effect on their work.

Nearly every finding was a surprise to the authors. Overall, compared with 13 years ago, 2004 found pediatricians lost faith that breastfeeding benefits outweighed difficulties or inconveniences. Meaning, doctors were quicker on average to tell new mothers that breastfeeding was not necessary if mothers found it even uncomfortable. Worsening the outlook, fewer doctors believed that nearly all mothers should be able to successfully breastfeed and follow the original medical recommendations.

The most glaring data point found that 51 percent of mothers exclusively breastfed at seven days yet only 14 percent at six months. How that relates exactly to the fact that more doctors are finding more reasons not to recommend breastfeeding is unclear, but the data is alarming to breastfeeding proponents. Even when imperfect conditions were compatible with breastfeeding—lengthy time requirements, immaturity, low milk supply, irritated nipples—the doctors more so than ever advised mothers to cease breastfeeding.

But the findings weren’t all negative. At the time of delivery 59 percent of mothers breastfed their infants in 1995; in 2004 that jumped to 74 percent. At six months, the percentage went from 22 percent in 1995 to 42 percent in 2004—but it’s important to note this is not exclusive breastfeeding, rather only some breastfeeding combined with formula feeding. But pediatricians were more likely to recommend exclusive breastfeeding, especially if they had personal experience with the feeding method.

So what does it all mean?

The researchers conclusions sound like a paradox: “Although pediatricians seem better prepared to support breastfeeding, their attitudes and commitment have deteriorated.”

The lone silver lining and thus maybe the only solution, the study alludes, is personal experience. And so the recommendations of the researchers focus on that:

“Personal experience continues to have a tremendous effect,” the authors state, “on the advice to breastfeed and the clinical experience with breastfeeding management… Given the changing demographics of pediatricians and new work hours for pediatric residents, more pediatricians may be starting families early in their careers and attending to the needs of their children. Providing worksite accommodations for residents and young pediatricians to facilitate a positive experience with breastfeeding may be one method to enhance future attitudes and skills about breastfeeding. Pediatricians may also serve as role models for mothers contemplating infant feeding decisions.”

But they go on to conclude that “creative strategies need to be developed to enable more pediatricians, regardless of personal experience, to adopt practice behaviors that support exclusive breastfeeding… Practical solutions must be developed to improve pediatricians’ beliefs so that mothers can successfully meet their breastfeeding goals.”

To see it for yourself is always the best education, but first-person experience isn’t always possible with the unique act of breastfeeding. So what are the options for these creative strategies and practical solutions? In a culture rife with immaturity and ignorance in the realm of health and sex, not to mention a billion-dollar infant formula industry pushing their products, breastfeeding proponents are left with little choice but to target doctors working on the front lines of infant care.

Maybe a study of those doctors—not their feelings, but the doctors themselves (age, sex, ethnicity, education, experience)—is due, because indeed finding the right doctors is pertinent to patients making the right decisions. Making the best decision for a baby should be something mothers understand without a doctor’s input, but the reality is, short of making infant formula available by prescription only to ensure it is used only by those who truly need it, the education of both doctor and patient is the only option to make mothers take baby to the breast instead of the supermarket.