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What Do Undergraduates Think about Breastfeeding?

Written by Robin Kaplan, M.Ed., IBCLC

Photo by j.o.h.n. walker via Flickr

It is well known that in the United States, breastfeeding rates are somewhat discouraging. With only 35% of babies exclusively breastfeeding at 3 months and 44.3% receiving any breast milk at all at 6 months, as a nation we are not meeting the standards set forth by the American Academy of Pediatrics nor the World Health Organization. As we continue to look at ways in which we can increase our breastfeeding rates, one suggestion has been to examine the breastfeeding education taught to nonpregnant youth.

An article in the upcoming issue of the Journal of Human Lactation explores this issue. Kavanaugh, et al. surveyed 248 nonpregnant undergraduate youth at a large research university in Tennessee to determine their breastfeeding knowledge, attitudes, prior exposure, and breastfeeding intent (For subscribers to The Journal of Human Lactation, you can read the full text of the paper here).

The most significant findings from the study were:

  • Over 90% of the participants agreed that breastfeeding should be started soon after birth and that breast milk and formula were not the same. However, only about 50% of the participants knew that breastfeeding can reduce a mother’s risk of cancer and that formula-fed infants are ill more often than breastfed babies.
  • While a majority of the participants believed that breastfeeding was cheaper and healthier than formula, an astounding number felt that breastfeeding in public was embarrassing and unacceptable (71% female, 47.7% male) as well as inconvenient and painful (47.8 female, 33.8% male).
  • Those who had been breastfed as infants scored significantly higher on breastfeeding knowledge and positive attitude towards breastfeeding than those who were unsure or had not been breastfed.
  • The majority of the participants (80%) intended to breastfeed/support a partner to breastfeed in the future.

So where do we go from here? How do we change the attitudes of children, adolescents, and young nonpregnant adults about breastfeeding?

  • This research study is limited in its generalization due to the sample of the participants, therefore we need more wide spread, longitudinal studies of adolescents and young adults’ breastfeeding knowledge and attitudes.
  • We need better support and legislation to protect breastfeeding in public. If breastfeeding in public becomes the norm, as it is in MANY other countries, it should decrease the perception that it is embarrassing, unacceptable, and inconvenient. It’s time we start seeing more of this:

    Photo via

    and less of this:

    Photo by Kate Gulbranson (@hygeiakate)

  • Additional curriculum, like the one pioneered in NY State, that promotes breastfeeding as the norm, in human development and nutrition classes for children, adolescents and college students. The bulk of the content could focus on the benefits of breastfeeding (for both mother and baby), the hazards of formula, and the superior nutritional components of breast milk.
  • A recommendation, per the authors (which I personally think is brilliant), it also to educate our youth about appropriate infant development and behavior. The authors concluded that if our youth understood how often an infant/toddler needed to breastfeed and that covering with a blanket was not always feasible (especially with an older infant who wants to see the world around him/her), that they might stop viewing a breastfeeding mother as being immodest when breastfeeding in public. Also, since an infant typically breastfeeds every few hours, it is irrational to expect this mother to stay at home for every feeding.

What recommendations would you add to this list? How does your community make breastfeeding the norm?

Robin Kaplan received training to be a Certified Lactation Educator and an International Board Certified Lactation Consultant from UCSD. She holds a Masters in Education from UCLA, a multiple-subjects teacher credential from UCLA, and a BA in Psychology from Washington University in St. Louis, MO. In 2009, Robin started her own business, the San Diego Breastfeeding Center, where she offers in-home breastfeeding consultations, free weekly support groups, breastfeeding classes, and online support through her business blog.  In addition to her private practice, Robin was the founding Co-editor of the International Lactation Consultant Association’s (ILCA) blog, Lactation Matters, and a regular contributor to ILCA’s E-Globe newsletter.  She also is the host/producer of The Boob Group online radio show, which launches on July 2, 2012, and the Director of Marketing for  Robin lives in her native San Diego, where she enjoys cooking, hiking, trying new trendy restaurants, and traveling with her family.

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15 Responses to What Do Undergraduates Think about Breastfeeding?

  1. Colette 21 June 2012 at 12:08 #

    Awesome blog… as usual, Robin! Keep up the great work! Our education committee is working on getting into the high school health classes. As usual, there are those unexpected obstacles! I won’t be deterred!!

  2. Doraine Bailey 21 June 2012 at 12:29 #

    A strategy we’ve been using in Lexington, Kentucky at area universities and community colleges is to incorporate a presentation on breastfeeding into any courses where we can build the slightest bit of relevance. The easy ones are the OB/Ped classes for 2-year and 4-year RN courses and dietetics courses such as nutrition across the lifecycle and maternal/child nutrition. Slightly further out are human development classes (including those preparing early childhood teachers/caregivers), public health classes on maternal/child health, and anthropology/sociology courses and human family structure/culture. New ‘untilled’ territory could include business school courses on human resources, worksite wellness and health benefits; law school courses addressing worksite health and benefits; Home economics/family consumer sciences/cooperative extension courses; and other allied health courses such as speech therapy. Outside of the course work, ALL providers of higher education (public and private) should establish lactation support systems for faculty, staff, and students. Liz Brooks did a nice Lactation matters entry on this in 2011. To see a fabulous example of how one University does it, visit the lactation pages of the University of Kentucky’s WorkLife program ( And such support doesn’t have to stop at the campus edges: look for satellite operations that could also be covered by the institutions’ worksite lactation policies, including Cooperative Extension offices, health education centers (for professionals and for providing clinical services), managed lands, etc..

    I’ve been creatively seeking to incorporate SOMETHING about breastfeeding into high school, community college, and university classes for years. I frequently have students see me out in the community who remember my single presentation on breastfeeding and how it changed their perspective as a student of that profession as well as in their individual choices — and this has been true of both male and female students. So, it’s great to continue to see the effects of the small cycles of change from many small talks to diverse groups at a time in their lives when they’re soaking in a lot of information and ideas!

  3. Tory 22 June 2012 at 18:15 #

    Ugh!!! Babies do NOT dream of manufactured plastic!!!! Gross!

    • Gretchen Kindberg 27 June 2012 at 00:40 #

      I thought the SAME thing! And if I’m not mistaken, that’s a Target BABY sign hanging overhead….

  4. lisa 22 June 2012 at 19:38 #

    Here’s what needs to happen:
    1) doctors need to be educated in medical school about breastfeeding. Even a 2 hour class would be helpful. Right now, they get zero education.
    2) during the human growth and development units in health class, add this to the curriculum. To do this, it needs to be added to the national and state standards. Teachers need to be properly educated, preferably by an IBCLC.

    • Gretchen Kindberg 27 June 2012 at 00:41 #

      It should also be added to the sex education curriculum taught to elementary, junior high/middle school, and high school kids. The earlier we start, the better the outcome!

  5. Susan 22 June 2012 at 19:50 #

    Since TN has only recently changed the law to allow public breastfeeding past a year, it’s perhaps not surprising that many feel public breastfeeding is inappropriate. Sad, but I suppose understandable if they’re surrounded by that attitude. Hopefully the tide is turning.

  6. C Nuyen 22 June 2012 at 20:24 #

    Part of the problem is the message we directly get from our doctors and nurses … I was asked why I was still nursing my 2 , then 3 year old with funny looks countless times. I was even warned to stop all together while pregnant – with a healthy pregnancy. I have always felt I had to constantly defend myself breast feeding my toddler. I weaned naturally at year 3 after the new baby came. She is now nursing away.

  7. Ahmie 23 June 2012 at 20:14 #

    Doraine Bailey I wanna be like you when I “grow up”. I’m expecting my 4th child about 3 weeks before I’m scheduled to receive my MA in Sociology this December then planning on going on for my PhD in Social Psychology the following fall, and I’m investigating Lactation Educator certification in my “spare” time. I breastfed all three of my already-born children exclusively for more than 6mo each and the older two didn’t wean until they were 2.5 years old when I was pregnant with the next one. Unfortunately I lost my milk supply during a bad cold that lasted over a month (possibly pertussis, was coughing until I felt like I was going to black out and the only thing that suppressed the cough at all was prescription narcotics) when my 3rd child was about 20mo, so he weaned early. I am hoping he comes back to tandem with the new baby in November/December. My 3rd son was born at the end of my 1st year of graduate school. As a breastfeeding mother who was also a student, universities could ALSO make some strides in being more accomodating to those challenges. 2hr long classes 30min away from home when the baby is only 3mo and exclusively breastfeeding… and the assistant dean decided to take a hard-line stance on “no babies in the building” so I couldn’t even have a friend hold him in the common area outside the class for me (never mind special needs preschoolers were coming into a lab just down the hall so it’s not like children aren’t safe and permitted in the building!). I was so angry that I wound up switching universities.

  8. tracie p 23 June 2012 at 23:23 #

    A young girl on twitter was complaining about a woman bfeeding in the restaurant where she was eating. She added “isn’t that like indecent exposure or something?” I tweeted back that it was a legally protected right in over 40 states to bfeed in public. Such a sad mentality! Hopefully she’ll think twice about judging next time. Great post.

  9. Keiki's Day Out 25 June 2012 at 10:54 #

    I was pregnant my senior year of college at the University of Hawaii. Coincidentally, I also need 3 extra “whatever” credits and so I signed up for a Human Growth and Development class. I had a breast reduction when I was 17 due to worsening scoliosis (I was 5’2″ 120 lbs, and overflowing out of FF bras) and I was afraid I could breastfeed. While in the class, we again went over breastfeeding, including the benefits for the mother. I was more determined than ever that I HAD to be able to do it, even though after talking with other women that had a reduction, I wasn’t sure if I could. I was even afraid to buy things like a BOPPY or a MY BREAST FRIEND or nursing bras as I didn’t know if I’d be able to. Around 37 weeks I leaked colostrum and was so happy. I’m happy to say my daughter was exclusively breastfed till 6 months, at which point I started giving her steamed until mush fruit and vegetable. She two years old and two months and still nurses once a day, just before dinner. That said, I also breastfed in public like it was nobody’s business (or maybe, everybody’s business?) and got over that real quick because I’m one of those people that just can’t stay cooped up inside. I think more can be done to normalize breastfeeding in public because if you’re really serious about breastfeeding exclusively for 6 months, then there are going to be times where you have to breastfeed in public.

  10. sarah c 25 June 2012 at 18:34 #

    I was a breastfeeding mother through my undergraduate years in college. I actually contacted my dean and they set a room aside for me to breastfeed in. It\’s extremely sad that women have to be ashamed about breastfeeding. It is so good for babies and the mommies. I’ve been in so many arguments with people who believe breastfeeding is inappropriate etc. I also have realized there are many people in this world who will support breastfeeding 100%. Attitudes need to change breastfeeding is natural, formula ISN’T.

  11. Emily 25 June 2012 at 20:58 #

    I teach ballet to teenagers and I nurse in front of my students all the time. I think it’s really important for them to see how normal and convenient it is. I’ve also done the Roots of Empathy program with both of my kids and I’ve nursed in front of the kids in those classes. The kids talk about normal infant development and how important breastfeeding is. In my daughter’s RoE class (grade 4 students), I was nursing her in front of the class and one of the girls said to the boy next to her, who was watching us in a very relaxed, nonchalant way: “ew, don’t WATCH”. He looked at her with a puzzled expression and asked: “Why not? She’s just eating!” I piped up and said to the girl: “This is the normal way for babies to eat. This is what breasts are for.” It started an interesting conversation.

  12. kristin 25 June 2012 at 21:50 #

    i dont not think it is up to schools to teach our children everything. But find it very upsetting that not once was breastmilk/breastfeeding brought up during any sexual education or health classes in highschool. All i remember my teacher saying is “some women will get pregnant just because it makes their boobs larger”
    No information shared on how a womens body lactates, whats in breastmilk, how babies salvia communicates with the breast ect.
    i know this was talking about undergraduates but i think education needs to be shared far far earlier from witnessing to education that simply touches the iceberg on why women lactate and how great it is for our babies.

  13. Everett Moshos 14 November 2013 at 12:21 #

    I myself experienced a miscarriage at around 10 weeks on 24th, November, 2012. This is despite an ultrasound test at 8 weeks that showed a normal and health fetus. I bled for around 2 weeks following the miscarriage. I received my normal menstrual period on 27th, December, 2012; approximately 20 days after I stopped bleeding due to miscarriage. I went for a pregnancy test after the period and it was negative. In January, we started trying for the first time to get pregnant and yes, after five weeks I tested positive. I could not be able to express my joy at getting pregnant again after a miscarriage that fast and easy.

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