Breastfeeding in public

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Woman nursing her infant at pro breastfeeding conference in Spain

Breastfeeding in public is the practice of nursing children with breastmilk in public. Cultural acceptance of the practice varies widely and are related to but not entirely determined by cultural acceptance of public female toplessness. Breastfeeding in public is forbidden in some jurisdictions, not addressed by law in others, and recognized as a legal right in public and the workplace in others.

Even though it is legal or tolerated in some locations, some mothers may nevertheless be reluctant to breastfeed in public,[1][2] due to other people's objections to the practice.[3]

There have been a number of incidents reported in the media where the owners of establishments or their customers have objected to or forbid breastfeeding. Sometimes mothers choose to avoid further attention and just leave, but some mothers have responded with protests or, if the practice is permitted by law, have taken legal action. Companies have sometimes apologised after the fact.[4] When breastfeeding women have been criticized, the mothers have sometimes organizing a "nurse-in" or a breastfeeding flash-mob, where groups of nursing mothers have gathered at the offending premises and nursed their babies simultaneously.

In 2006, the editors of US Babytalk magazine received many complaints from readers after the cover of the August issue depicted a baby nursing at a bare breast. Even though the model's nipple was not shown, readers—many of them mothers—wrote that the image was "gross". In a follow-up poll, one-quarter of 4,000 readers who responded thought the cover was negative. Babytalk editor Susan Kane commented, "There's a huge puritanical streak in Americans." In a 2004 survey conducted by the American Dietetic Association, 43% of the 3,719 respondents believed women ought to have the right to breast-feed in public.[5] In some public places and workplaces, rooms for mothers to nurse in private have been designated.

Attitudes by continent and country[edit]


In many areas of Africa breastfeeding in public is the norm. Babies are commonly carried on a mother's back in a length of cloth and merely moved to the front for feeding. The nursing mother may shield the view of the baby nursing, but generally no attempt is made to hide the baby and the mother's breast from view. When a baby is seen crying in public it is assumed that the woman with the infant is not the child's mother, since it is normally thought that she would feed the infant if she were the mother.[6]


The Sex Discrimination Act 1984 prohibits discrimination against a woman on account of her breastfeeding, including in public.[7] State legislation differs, but it remains illegal to discriminate against women breastfeeding in public as a protected attribute in five States and by proxy from other existing legislation in the remaining States.[8]

The Australian Breastfeeding Association, founded in Melbourne, Victoria in 1964 as the Nursing Mothers' Association, is a source of breastfeeding information and support and together with many health professionals, encourages mothers to breastfeed their babies, if necessary also in public places.[8]

In February 2003, Kirstie Marshall, member of the Victorian Legislative Assembly, was ejected from Parliament for breastfeeding her 11-day-old baby on the basis that the baby was "a stranger" not entitled to be in the Chamber. As a result, a special room was set up for use by nursing mothers.[citation needed]


In Canada, Section 28 of the Canadian Charter of Rights and Freedoms gives equal rights and freedoms to men and women, without explicitly mentioning breastfeeding. INFACT Canada (Infant Feeding Action Coalition) is a national non-governmental organization that aims to protect infant and young child health as well as maternal well-being through the promotion and support of breastfeeding and optimal infant feeding practices.[9] It is an organization that provides support and education for Canadian mothers.

Outside of degrading or dehumanizing purposes, law regards the breasts of women in Canada as equal to the breasts of men in Canada. See Topfreedom in Canada.[citation needed]

A woman asked in 2009 at a shop by an employee to stop breastfeeding publicly, supported by a manager, later received an apology and acknowledgement of customers' right to breastfeed.[10]

A worker at the YMCA in St. John's told a breastfeeding mother to leave the premises. The mother was in a private change room, which required a fee every month, feeding her seven-month-old daughter. YMCA CEO Jason Brown apologized, stating "This situation has caused us to reflect and review, and certainly we see no reason why there should be a restriction to women breastfeed their babies in the adult-only change room."[11]

Inuit People[edit]

Inuit children have the lowest breastfeeding rates amongst Canadian Aboriginal populations, far lower than the Canadian average. According to a 2006 statistics report, 24% of Inuit children have never been breastfed. There have been health promotion programs created in order to increase the knowledge of the benefits of breastfeeding amongst Inuit women.[12]


In Shanghai, breastfeeding in public is considered embarrassing by some, but it is also accepted by many. There have been calls for the establishment of babycare facilities in public places.[13][14] Traditionally, breastfeeding in public has been a non-issue in China.


Public breastfeeding is legal and widely accepted.[citation needed]


While public breastfeeding is widely accepted, especially since the Movement of 1968 when public "Nurse-Ins" (German: Still-Inns) were common, there is no legislation that specifically addresses breastfeeding in public.[15]

Paragraph 2 Article 6 of the Basic Law for the Federal Republic of Germany provides that "the care and upbringing of children as the natural right of parents" while paragraph 4 "entitles every mother to the protection and care of the community".[16]

Later, acceptance for public breastfeeding appears to have decreased and, according to surveys, an increasing number of mothers try to avoid breastfeeding in public whenever possible. In a Bundestag session a breastfeeding member of the SPD party had to leave the floor after members of the Christian Democratic Union complained that they felt disturbed by her.[17]


Public breastfeeding is widespread and uncontroversial.[citation needed]


India has no legal statute dealing with breastfeeding. Prevalence and social acceptance vary from region to region.[citation needed]


Discreet breastfeeding in public is accepted in Malaysia.[18]


Nepal has no any laws about public breastfeeding. Public breastfeeding is common and widely accepted. It is not uncommon to see mothers breastfeeding their babies in public buses, parks, restaurants, hospitals etc. in Nepal. In Nepalese society, breastfeeding a child is a must for the mothers. Mother's who don't or are unable to breastfeed their child are considered to be 'bokshi' - 'witch', and a lot of social stigma is attached to it.[citation needed] In Hinduism, religion of majority of Nepalese, mother's milk is considered to be extremely sacred. Similarly, in Nepalese society phrases like "amako dudh piyeko/khayeko" - "one who has drank his mother's milk" indicates masculinity among men and their ability to be brave and courageous in the face of danger.[citation needed]


Public breastfeeding is common and widely social accepted. There are no laws against public breastfeeding. Dutch law states that when an employee wishes to breastfeed her baby the employer is obligated to provide the first nine months after the birth a suitable nursing room and allow for 25% of work time to be spend on feeding the baby or pumping while on pay. After the first nine months the employer is still required to assure conditions for breastfeeding are met (like timely breaks, nursing rooms, safe environment, etc.) but does not have to pay anymore for the time spend on breastfeeding or pumping.[19]

New Zealand[edit]

Breastfeeding is encouraged and public breastfeeding is common. In fact, bottle feeding has been so widely discouraged that public bottle feeding may make a mother feel more uncomfortable than public breastfeeding. Many shopping centers provide "parent's rooms" where mothers may change and feed their infants in comfort.[6]


Public breastfeeding is widespread and uncontroversial.[citation needed]


In the Philippines, breastfeeding is protected by various laws, such as the Expanded Breastfeeding Promotion Act of 2009[20] and the Milk Code of the Philippines (Executive Order 51).[21] Mothers are allowed to breastfeed in public. Employers are required to allow lactating employees breaks to breastfeed or express breastmilk. The law also states that the intervals should not be less than a total of forty (40) minutes for every eight (8) hour working period.[22] Offices, public establishments such as malls and schools, and government institutions are required to establish lactation stations separate from the bathroom, where mothers can breastfeed their babies or express milk. The Milk Code prohibits the advertising of infant formula or bottle teats for infants under two years old.

Saudi Arabia[edit]

Women in Saudi Arabia only breastfeed their infants discreetly. It is prohibited for women to show any part of the body in public except the face and the hands.[23][24]

Sierra Leone[edit]

Sierra Leone has the highest infant mortality rate in the world. During a goodwill trip to the country, actress Salma Hayek breastfed on camera a hungry week-old infant whose mother could not produce milk.[25] She said she did it to reduce the stigma associated with breastfeeding and to encourage infant nutrition.[26]

South America[edit]

In most areas of South America breastfeeding is the norm and public breastfeeding is common in buses, parks, malls, etc. It is less common to see public bottle feeding than breastfeeding. While women are seldom seen nursing in upscale restaurants or on the streets of large cities, nursing is encouraged and thought of as normal and a nursing mother's breasts are not viewed as sexual objects. [6]


Public breastfeeding is legal and widely accepted.


The Public Breastfeeding Act since November 2010 safeguards the right to breastfeed in public, while lactation rooms are set up to deal with privacy and to provide access to hot water and power supplies, with fines against interfering with a mother's right to breastfeed.[27] After evicting a breastfeeding mother from the National Palace Museum on 18 July 2012 and enraging many Taiwanese website users,[28] the supposedly offending employee and her employer were both fined 6000 new Taiwan dollars (about 200 United States dollars), said the Department of Health, Taipei City Government (Chinese: 臺北市政府衛生局), but the Museum would appeal.[29]

United Kingdom[edit]

Breastfeeding in public (restaurants, cafes, libraries etc.) is protected under the Sex Discrimination Act 1975 under the provision of goods, facilities and services section. If the child is under six months old, the mother has additional protection under a 2008 amendment to the act which protects maternity rights. This is superseded by the Equality Act 2010 which clarifies that a business must not discriminate against a woman who is breastfeeding a child of any age in a public place.[30][31] Her companion(s) are also protected by this act.

A 2004 UK Department of Health survey found that 84% (about five out of six people) find breastfeeding in public acceptable if done discreetly; however, 67% (two out of three) of mothers were worried about general opinion being against public breastfeeding.[32] To combat these fears in Scotland, the Scottish Parliament passed legislation safeguarding the freedom of women to breastfeed in public in 2005.[33] The legislation allows for fines of up to £2500 for preventing breastfeeding of a child up to the age of two years old in public places,[34][35]

United States[edit]

In the United States, legislation regarding breastfeeding varies from state to state and a limited federal law only applies to federal government premises. A United States House of Representatives appropriations bill (HR 2490) contained an amendment specifically permitting breastfeeding[36] was signed into law on September 29, 1999. It stipulated that no government funds may be used to enforce any prohibition on women breastfeeding their children in Federal buildings or on Federal property. Further, a Federal law also enacted in 1999 specifically provides that "a woman may breastfeed her child at any location in a federal building or on federal property, if the woman and her child are otherwise authorized to be present at the location."[37]

Section 4207 of the Patient Protection and Affordable Care Act amended the Fair Labor Standards Act and required employers to provide a reasonable break time for an employee to breastfeed her child if it is less than one year old.[38] The employee must be allowed to breastfeed in a private place, other than a bathroom. The employer is not required to pay the employee during the break time.[38] Employers with fewer than 50 employees are not required to comply with the law if doing so would impose an undue hardship to the employer based on its size, finances, nature, or structure of its business.[39]

A number of incidents of harassment of nursing mothers which gained media attention prompted a number of U.S. states to act. All 50 states have passed legislation that either explicitly allows women to breastfeed in public, or exempts them from prosecution for public indecency or indecent exposure for doing so.[40][41]

Recent controversies[edit]

Breastfeeding at work in Canada[edit]

Under the Canadian Charter of Rights and Freedoms women are protected against discrimination, but Canada was one of the only countries that did not have paid breastfeeding breaks. Although over 86% of mothers breastfeed, many of them are forced to stop due to work restrictions.[42]

Public breastfeeding in the US[edit]

There have been incidents of owners of premises, or people present, objecting to or forbidding breastfeeding. In some cases the mothers have left. In other cases, where a law guaranteeing the right to breastfeed has been broken, legal action has been taken. Some companies have even apologised after the fact.[4] One woman not allowed to breastfeed despite showing the Kentucky, USA law that gave the right[43] left, but later organized several "nurse-in" protests in front of the restaurant and other public places.[44]

In June 2007, Brooke Ryan was dining in a booth at the rear of an Applebee's restaurant when she began to breastfeed her seven-month-old son. Although she attempted to be discreet, another patron complained to the manager about indecent exposure. Both a waitress and the manager asked her to cover up. She handed him a copy of the Kentucky law that permitted public breastfeeding, but he would not relent. She opted to feed her son in her car, and later organized "nurse-out" protests in front of the restaurant and other public locations.[45] Most U.S. states (40 as of January 2009) have laws clarifying a woman's right to breastfeed in public.[46]

In 2008 a woman in New Orleans put a tent over her truck at a street festival so she could nurse her daughter privately. She was cited by police for an "unauthorized booth" and removed from the street festival.[47][48][49]

Babytalk magazine cover[edit]

In 2006, the editors of US Babytalk magazine received many complaints from readers after the cover of the August issue depicted a baby nursing at a bare breast. Even though the model's nipple was not shown, readers—many of them mothers—wrote that the image was "gross". In a follow-up poll, one-quarter of 4,000 readers who responded thought the cover was negative. Babytalk editor Susan Kane commented, "There's a huge puritanical streak in Americans." In a 2004 survey conducted by the American Dietetic Association, only 43% of the 3,719 respondents believed women ought to have the right to breast-feed in public.[5]

Mother & Baby magazine[edit]

In June, 2010, a deputy editor for the leading UK parenting magazine Mother & Baby set off a storm of protest when she described breastfeeding as "creepy." Kathryn Blundell told readers that she bottlefed her child from birth because, "I wanted my body back [and] to give my boobs at least a chance to stay on my chest rather than dangling around my stomach." She upset readers when she wrote about her breasts, "They're part of my sexuality, too – not just breasts, but fun bags. And when you have that attitude (and I admit I made no attempt to change it), seeing your teeny, tiny, innocent baby latching on where only a lover has been before feels, well, a little creepy." The anti-breastfeeding tone of her article prompted six complaints to the British Press Complaints Commission and set off considerable online debate. The magazine also received dozens of messages of support.[50]

Barbara Walters[edit]

In 2005 US television presenter Barbara Walters remarked on her talk show The View that she felt uncomfortable sitting next to a breastfeeding mother during a flight. Her comments upset some viewers who began organizing protests over the internet. A group of about 200 mothers staged a public "nurse in" where they breastfed their babies outside ABC's headquarters in New York.[51]

Target store protest[edit]

In December, 2011, Michelle Hickman was breastfeeding her infant at the back of a Target store in Houston, Texas. Although covered, she was asked by two employees to move to a fitting room. Hickman said one of the employees told her, "You can get a ticket and be reported for indecent exposure." She reported the harassment on Facebook, and in response a number of mothers organized public "nurse-ins" at Target stores across the United States in cities including Houston, Knoxville, and Decatur, Illinois.[52] Trace Gallagher on FoxNews reported on the protest, and female host of America Live Megyn Kelly commented, “You know, I got a lot of thoughts on this, Trace.” She explained, “Let me just put it this way: I used to feel a lot differently before I had babies and you’re breastfeeding; they need to be fed and then sometimes they don’t like the cover. And before you know it, you're Megyn Kelly and you’re showing your breasts to a whole plane.”[53]

Breastfeeding in uniform in the US military[edit]

In May 2012, two Air Force National Guard service members stationed at Fairchild Air Force Base, Washington chose to participate in a staged breastfeeding awareness campaign, hosted by the Mom2Mom of Fairchild Breastfeeding Support Group by being photographed breastfeeding in their uniforms. There was talk of these women being a disgrace to the uniform, and it had been compared in the debate to defecating or urinating in uniform while in public.[54] The photographs became an instant online frenzy and were spread world wide. Photographer Brynja Sigurdardottir, another military spouse, staged and photographed the photos in question. She removed the photos from her online website and Facebook fan page in order to calm the frenzy. The intention was to raise awareness and support for women who breastfeed, inside and outside of the military lifestyle. However, with the controversy of the photographs and online publication, the message was quickly lost among critics.

The US military protects women in uniform by allowing them to defer deployments for 4 to 12 months after childbirth for breastfeeding purposes. Breastfeeding service members are provided regular breaks to breastfeed or pump while on duty, and are provided with a comfortable and private place to do so.[54]

Facebook controversy[edit]

Facebook has come under fire for removing photos of mothers breastfeeding their children, citing offensive content in violation of the Facebook Terms of Service.[55] Facebook claimed that these photos violated their decency code by showing an exposed breast, even when the baby covered the nipple. This action was described as hypocritical, since Facebook took several days to respond to calls to deactivate a paid advertisement for a dating service that used a photo of a topless model.[56]

The breastfeeding photos controversy continued following public protests and the growth in the online membership in the Facebook group titled "Hey, Facebook, breastfeeding is not obscene! (Official petition to Facebook)."[57] In December 2011 Facebook removed photos of mothers breastfeeding and, after public criticism, restored them. The company said it had removed the photos because they violated the pornographic rules in the company's terms and conditions.[58] During February, 2012, the company once again removed photos of mothers breastfeeding. Founders of a Facebook group "Respect the Breast" reported that "women say they are tired of people lashing out at what is natural and what they believe is healthy for their children."[59]


Arguments include: Since not everyone shares the same moral values, or dress standards, using an inexpensive nursing cover or blanket is not really difficult.[citation needed] It's comparable to someone who plays their music loudly; while often legal and enjoyable for the listener, the music is not appreciated by all those around them.[citation needed] They also may use the point that urinating or defecating is also natural therefore should be allowed in public (which, in addition to public breast feeding, actually has also become a norm in some European counties such as the Netherlands).[60][not in citation given]

See also[edit]


  1. ^ Wolf, J.H. (2008). "Got milk? Not in public!". International breastfeeding journal 3 (1): 11. doi:10.1186/1746-4358-3-11. PMC 2518137. PMID 18680578. 
  2. ^ "Breastfeeding Legislation in the United States: A General Overview and Implications for Helping Mothers". LEAVEN 41 (3): 51–4. 2005. 
  3. ^ Jordan, Tim; Pile editor-first2=Steve, eds. (2002). Social Change. Blackwell. p. 233. ISBN 9780631233114. 
  4. ^ a b Barsch, Sky (2006-11-14). "Woman alleges she was kicked off Burlington flight for breast-feeding". Burlington Free Press. Retrieved 2007-01-24. 
  5. ^ a b "Eyeful of breast-feeding mom sparks outrage". Associated Press. 2006-07-27. Retrieved 25 November 2011. 
  6. ^ a b c "Breastfeeding in public around the world". 007 Breasts. Retrieved 15 October 2014. 
  7. ^ Sex Discrimination Act 1984, s.7AA.
  8. ^ a b "Breastfeeding in public - your legal rights". Australian Breastfeeding Association. 
  9. ^ Sterken, Elisabeth. "INFACT Canada". Retrieved 12 March 2014. 
  10. ^ "Walmart apologizes for asking B.C. mom to stop breastfeeding, Ann Hui, The Vancouver Sun 18 July 2009.". 
  11. ^ "YMCA changes breastfeeding policy following complaint". CBC News. Feb 28, 2014. Retrieved 13 March 2014. 
  12. ^ Asuri, Sirisha (2011). Early Inuit child health in Canada. Report 2, Breastfeeding among Inuit in Canada. Ottawa: Inuit Tapiriit Kanatami. pp. 5–8. 
  13. ^ "Congress to consider privacy issue". 
  14. ^ "Breastfeeding in public". 
  15. ^ [1] Breastfeeding in Public, T-Online 18 November 2009
  16. ^ [2] Art 6 GG - German Basic Law
  17. ^ [3] Breastfeeding prohibited - Breastfeeding in public,
  18. ^ [4] Tips for breastfeeding in public: sharing experiences in Malaysia
  19. ^ " kenniscentrum voor borstvoeding - artikelen- Borst & Baan - Borst & Baan en de wet". 
  20. ^ "R.A. No. 10028". 
  21. ^ "E.O. No. 51". 
  22. ^ "Chronicles of a Nursing Mom: More on the Legal Rights of Breastfeeding and Working Women". 
  23. ^ Riordan, Jan (2005). "The Cultural Context of Breastfeeding". Breastfeeding and Human Lactation. Sudbury, Mass.: Jones and Bartlett. pp. 718–719. ISBN 0-7637-4585-5. 
  24. ^ "Dimensions of Human Behavior". 
  25. ^ Thomson, Katherine (February 10, 2009). "Salma Hayek Breastfeeds African Baby (VIDEO)". Retrieved May 10, 2009. 
  26. ^ "Celebs Who Breastfeed in Public". Retrieved August 1, 2001. 
  27. ^ "Public Breastfeeding Act". Ministry of Justice (Republic of China). 2010-11-24. Retrieved 2011-08-26. 
  28. ^ Liu Yunting (July 23, 2012). "Taipei Museum Faces Investigation for Evicting Breastfeeding Mother". Translated from Shenzhen Evening News. All-China Women's Federation. Retrieved August 14, 2012. 
  29. ^ "Taiwan museum fined for stopping breastfeeding mum". From AFP, posted at Borneo Post Online. August 15, 2012. Retrieved August 14, 2012. 
  30. ^ Equality Act 2010: What do I need to know?
  31. ^ "Equality Act 2010". Office of Public Sector Information. 2010-04-08. Retrieved 2010-08-27. 
  32. ^ "Myths stop women giving babies the best start in life" (Press release). UK Department of Health. 2004-05-10. Retrieved 2007-02-16. 
  33. ^ "Breastfeeding etc. (Scotland) Act 2005". Queen's Printer for Scotland. 2005-02-10. Retrieved 2007-01-24. 
  34. ^ "MSPs approve breastfeeding move". BBC News. 2004-09-23. Retrieved 2007-01-24. 
  35. ^ "The Breastfeeding etc. (Scotland) Act 2005: Advice for Employers". 
  36. ^ "Breastfeeding Amendment". 
  37. ^ "Treasury and General Government Appropriations Act, 2000". Retrieved 13 July 2012.  section 647.
  38. ^ a b Patient Protection and Affordable Care Act. Government Printing Office. Page 459.
  39. ^ Landau, Elizabeth (April 9, 2010). "Breastfeeding rooms hidden in health care law". CNN. 
  40. ^ "Breastfeeding Laws". Breastfeeding State Laws. NCSL. March 2010. Retrieved 14 September 2010. 
  41. ^ Wiehl, Lis (2006-06-22). "Indecent Exposure". 
  42. ^ Heymann, Jody (7 Oct 2013). "Breastfeeding breaks at work pay off; Canada is in the minority of countries that do not guarantee women paid breaks to feed infants at work,". The Ottawa Citizen. Retrieved 11 March 2014. 
  43. ^ "Summary of Enacted Breastfeeding Legislation Kentucky". Retrieved 21 February 2014. 
  44. ^ Applebee's, woman in dispute over breast-feeding at the Wayback Machine (archived January 1, 2008)
  45. ^ "Breastfeeding Protest Targets Restaurant Chain". Breastfeeding Protest Targets Restaurant Chain. 10 September 2007. Retrieved 21 February 2014. 
  46. ^ "50 State Summary of Breastfeeding Laws". National Conference of State Legislatures. November 2008. Retrieved 7 January 2009. 
  47. ^ "Mom's Breastaurant". 
  48. ^ "Mom's Breastaurant", Catherine P. Businelle, Mothering, January/February 2008, p. 62
  49. ^ "Milpitas woman creates retreat for nursing moms", Wes Bowers, Milpitas Post, August 14, 2008, p. 38
  50. ^ Rock, Lucy (26 June 2010). "Breastfeeding is 'creepy', says parenting magazine". The Observer. Retrieved 25 November 2011. 
  51. ^ 'Lactivists' Taking Their Cause, and Their Babies, to the Streets
  52. ^ "Breastfeeding Moms Stage 'Nurse-In' Protest at Target Stores Worldwide". FoxNews. December 28, 2011. Retrieved 10 February 2012. 
  53. ^ Jonathon M. Seidl. "Megyn Kelly Reveals Past Airplane Breastfeeding Flub On-Air". The Blaze. 
  54. ^ a b Weinstein, Adam. "Mother of All Wars: The Battle to Breastfeed in Uniform". Mother Jones. Retrieved 25 May 2013. 
  55. ^ "Episode 2: Breastfeeding and the Right to Go Topless". Lex Appeal. 2010-07-31. 
  56. ^ "Facebook ban incurs 'lactivist' wrath". The Sydney Morning Herald. 2007-09-07. 
  57. ^ "Protests mount over Facebook ban on breast-feeding photos; bigger turnout online than in Palo Alto". Mercury News. December 27, 2008. 
  58. ^ McGinty, Bill (December 30, 2011). "Facebook apologizes for removing breastfeeding photo". WCNC.COM. Retrieved February 17, 2012. 
  59. ^ McGinty, Bill (February 16, 2012). "Photos on breastfeeding Facebook page removed again". WCNC.COM. Retrieved 17 February 2012. 
  60. ^ "Urinating, Amsterdam". Retrieved 26 March 2015. 

External links[edit]

  • Hannan, A.; Li, R; Benton-Davis, S; Grummer-Strawn, L (2005). "Regional Variation in Public Opinion About Breastfeeding in the United States". Journal of Human Lactation 21 (3): 284–8. doi:10.1177/0890334405278490. PMID 16113017.