Do Children See Breastfeeding?

By Jennie Bever Babendure, PhD, IBCLC

With the recent push to Bring Breastfeeding back to Sesame Street, and deletion of breastfeeding images by Facebook, this month’s article seems particularly timely. In countries where the act of breastfeeding is often done behind closed doors and breastfeeding imagery is controversial—what do children say about how babies are fed?

In the Dec 2011 issue of BIRTH, Angell, Alexander and Hunt explore this issue looking at infant feeding awareness in primary school children¹.  In this small pilot study in southern England, 56 children ages 5/6, 7/8 and 10/11 were read a story about a hungry newborn baby, and asked to finish it with drawings and text about how the baby would be fed, then invited to talk about their work with a researcher.

36% of the children depicted breastfeeding, with 13% of 5/6 and 7/8 year-olds and 83% of the 10/11 year-olds referring to breastfeeding in their drawings or text.  The younger children tended to be confident and articulate in their descriptions of breastfeeding, while the 10/11 year olds were more hesitant. The 10/11 year-olds were more likely to illustrate mothers in awkward poses in their drawings, and to use euphemisms and gestures to describe breastfeeding.   They were also more likely to indicate they had learned about breastfeeding in school, while the younger children demonstrated detail from personal experience.

Formula was depicted by 55% of children evenly distributed across age groups, many of whom also described breastfeeding or solid foods. Although the researchers identified little difference between the responses of boys and girls, the impact of school-based teaching was evident in the responses of the 10/11 year-olds as children from urban schools seem to have more detailed working knowledge of breastfeeding gained from school curricula than did rural school children.

This study is consistent with others that demonstrate a greater awareness of bottle feeding among both children and adults.  The authors point out that while bottle feeding imagery is everywhere, most children and adults in the UK have never seen a friend or family member breastfeed.  I would venture to guess that the same is true in the US.   Despite the fact that my 5 year old son has been proudly pointing out nipples on mother animals in his picture books since he was old enough to talk, and has a good working knowledge of the mechanics of a breast pump, I was a bit surprised to learn that I am the only person he has ever seen breastfeed.

Importantly for the authors and for breastfeeding advocates, these findings demonstrate a real opportunity.   In spite of the awkwardness of the 10/11 year olds in discussing breastfeeding, the school-specific differences in breastfeeding knowledge suggests that they are receptive to learning about infant feeding.   Angell, Alexander and Hunt conclude that in the UK, an evidence-based standardized infant feeding curriculum in primary school may be a promising first step to breaking down culturally entrenched barriers and increasing the success of later breastfeeding promotion efforts.  Should the US and other countries follow suit, this type of education could have wide-reaching influence both on attitudes towards breastfeeding and on public health for generations to come.

1. Angell C, Alexander J, Hunt JA. How Are Babies Fed? A Pilot Study Exploring Primary School Children’s Perceptions of Infant Feeding. Birth 2011;38(4):346-353.

Jennie Bever Babendure, PhD, IBCLC

I am a mother of 2 active boys and an Assistant Research Professor in the College of Nursing and Health Innovation at Arizona State University. As breastfeeding researcher, I am constantly scanning the literature for articles that guide my research and inform my clinical practice. One of my goals is to increase the evidence base of our profession as lactation consultants. I feel it is important for lactation professionals to be aware of and contribute to breastfeeding research, especially when so much of it is fascinating! As an ongoing contributor to Lactation Matters, it is my hope that you will find the articles I highlight as interesting and informative as I do, and that you will use them to guide you in the important work of lactation professionals and breastfeeding advocates.