The Imperative to Breastfeed: An Australian Perspective

  • Athena Sheehan
  • Virginia Schmied


Australia is considered to have a high breastfeeding initiation rate. Research has demonstrated that the main reason that many women choose to breastfeed their baby is based on their understanding that ‘breast is best’. This is not surprising given that the benefits of breastfeeding are broadly promoted and a number of strategies have been deliberately employed globally, nationally and locally to actively support and promote breastfeeding. In this chapter, we argue that in Australia there is now a well-constructed cultural imperative to breastfeed. The message of ‘breast is best’ is powerful and is transmitted through public health and professional discourses and increasingly within the broader social and cultural context influencing the personal decisions and experiences of women. Most women in Australia make the decision to initiate breastfeeding, yet many women abandon the practice within the first 6 weeks following the birth of their baby. It appears that personal commitment, prenatal preparation and support to initiate breastfeeding is not always enough to sustain breastfeeding. In this chapter, we assert that the current investment in promoting and supporting women to initiate breastfeeding in Australia is having little impact on the longevity of breastfeeding and, for many women, appears to be causing a high level of emotional distress. We argue that the current public health policy, professional and social investment in breastfeeding initiation may be better directed at providing appropriate support in the weeks following birth for women who wish to breastfeed (see also Chapter 5 in this volume).


Exclusive Breastfeed Infant Feeding Formula Feeding Good Mother Public Health Nutrition 
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  1. Australian Breastfeeding Association. (2004).Australian breastfeeding leadership plan. Australian Breastfeeding Association, Glen Iris, Australia.Google Scholar
  2. Australian Breastfeeding Association. (2007). Submission by the Australian Breastfeeding Association to the Parliamentary Inquiry into Breastfeeding. Retrieved 1 May 2009, from
  3. Australian Government. (2008). Breastfeeding. Retrieved 13 August 2009, from
  4. Australian Government. (2009).Advisory panel on the marketing in Australia of infant formula (APMAIF). Retrieved 5 June 2009, from
  5. Australian Institute of Family Studies. (2008). Growing up in Australia: The longitudinal study of Australian children: 2006–07 annual report, 2008. Retrieved 27 June 2008, from
  6. Bartlett, A. (2005).Breastwork. Sydney: University of New South Wales Press.Google Scholar
  7. Benis, M. M. (2002). Are pacifiers associated with early weaning from breastfeeding.Advances in Neonatal Care, 2(5), 259–266.PubMedGoogle Scholar
  8. Blum, L. M. (1999).At the breast. Boston: Beacon Press.Google Scholar
  9. Bottorff, J. (1990). Persistence in breastfeeding: A phenomenological investigation.Journal of Advanced Nursing, 15, 201–209.PubMedCrossRefGoogle Scholar
  10. Cantrill, R., Creedy, D., & Cooke, M. (2003). An Australian study of midwives’ breast-feeding knowledge.Midwifery, 19, 310–317.PubMedCrossRefGoogle Scholar
  11. Carter, P. (1995).Feminism, breasts and breast-feeding. Basingstoke: Macmillan.CrossRefGoogle Scholar
  12. Commonwealth Department of Health and Aged Care. (2001). National breastfeeding strategy summary report [Electronic Version], 26. Retrieved 5 June 2009, from
  13. Commonwealth of Australia. (2007).The best start: Report on the inquiry into the health benefits of breastfeeding. Canberra: Commonwealth of AustraliaGoogle Scholar
  14. Cooke, M., Sheehan, A. & Schmied, V. (2003). A description of breastfeeding experiences, breastfeeding satisfaction and weaning in the first three months after birth.Journal of Human Lactation, 19(2), 145–156.PubMedCrossRefGoogle Scholar
  15. Cooke, M., Schmied, V., & Sheehan, A. (2007). An exploration of the relationship between postnatal distress and maternal role attainment, breastfeeding problems and breastfeeding cessation in Australia.Midwifery, 23(1), 66–76.PubMedCrossRefGoogle Scholar
  16. Coreil, J., Bryant, C. A., Westover, B. J., & Bailey, M. A. (1995). Health professionals and breastfeeding counselling: Client and provider views.Journal of Human Lactation, 11(4), 265–271.PubMedCrossRefGoogle Scholar
  17. Department of Health and Aging. (2006). Breastmilk makes Australia stronger. Retrieved 3 August 2010, from
  18. Duffield, C., Roche, M., & Merrick, E. T. (2006). Methods of measuring nursing workload in Australia.Collegian, 13(1), 16–22.PubMedCrossRefGoogle Scholar
  19. Dykes, F. (2005). ‘Supply’ and ‘demand’: Breastfeeding as labour.Social Science and Medicine, 60, 2283–2293.PubMedCrossRefGoogle Scholar
  20. Dykes, F. (2006).Breastfeeding in hospital: Mothers, midwives and the production line. London: Routledge.Google Scholar
  21. Dykes, F., & Griffiths, H. (1998). Societal influences upon initiation and continuation of breastfeeding.British Journal of Midwifery, 6(2), 76–80.Google Scholar
  22. Fallon, T., Crepinsek, M., Hegney, D., & O’Brien, M. (2005). The Baby- Friendly Hospital Initiative and breastfeeding duration: Relating the evidence to the Australian context.Birth Issues, 14(3), 90–95.Google Scholar
  23. Furber, C. M., & Thomson, A. M. (2007). Midwives in the UK: An exploratory study of providing newborn feeding support for postpartum mothers in the hospital.Journal of Midwifery and Women’s Health, 52(2), 142–147.PubMedCrossRefGoogle Scholar
  24. Gartner, L., Morton, J., & Lawrence, R. A. (2005). Breastfeeding and the use of human milk.Pediatrics, 115(2), 496–506.PubMedCrossRefGoogle Scholar
  25. Gerrard, A. (2001). Breast-feeding in Norway: Where did they go right?British Journal of Midwifery, 9(5), 294–295.Google Scholar
  26. Greenwood, K., & Littlejohn, P. (2002). Breastfeeding intentions and outcomes of adolescent mothers in the Starting Out program.Breastfeeding Review, 10(3), 19–23.PubMedGoogle Scholar
  27. Hailes, J. F., & Wellard, S. J. (2000). Support for breastfeeding in the first postpartum month: Perceptions of breastfeeding women.Breastfeeding Review, 8(3), 5–9.PubMedGoogle Scholar
  28. Hauck, Y. L., Langton, D., & Coyle, K. (2002). The path of determination: Exploring the lived experience of breastfeeding difficulties.Breastfeeding Review, 10(2), 5–12.PubMedGoogle Scholar
  29. Hawkins, S., Lamb, K., Cole, J., & Law, C. (2008). Influence of moving to the UK on maternal health behaviours: Prospective cohort study.British Medical Journal, 336(7652), 1052–1055.PubMedCrossRefGoogle Scholar
  30. Hector, D., King, L., & Webb, K. (2004).Overview of recent interventions to promote and support breastfeeding. Retrieved June 18, 2009, from
  31. Hill, P. D., Humenick, S. S., Brennan, M. L., & Woolley, D. (1997). Does early supplementation affect long-term breastfeeding?Clinical Pediatrics, 36(6), 345–350.PubMedCrossRefGoogle Scholar
  32. Hoddinott, P., & Pill, R. (1999). Qualitative study of decisions about infant feeding among women in East End of London.British Medical Journal, 318(7175), 30–34.PubMedCrossRefGoogle Scholar
  33. Hoddinott, P., & Pill, R. (2000). A qualitative study of women’s views about how health professionals communicate about infant feeding.Health Expectations, 3, 224–233.PubMedCrossRefGoogle Scholar
  34. Homer, C., Sheehan, A., & Cooke, M. (2002). Initial infant feeding decisions and duration of breastfeeding in women from English, Arabic and Chinese-speaking backgrounds in Australia.Breastfeeding Review, 10(2), 27–32.PubMedGoogle Scholar
  35. Kirkham, M., Stapleton, H., Thomas, G., & Curtis, P. (2002). Checking not listening: How midwives cope.British Journal of Midwifery, 10(7), 447–450.Google Scholar
  36. Kramer, M. S., Barr, R. G., Dagenais, S., Yang, H., Jones, P., Ciofani, L., et al. (2001). Pacifier use, early weaning, and cry/fuss behavior: A randomized controlled trial.JAMA, 286(3), 322–326.PubMedCrossRefGoogle Scholar
  37. Law, J. (2000). The politics of breastfeeding: Assessing risk, dividing labor.Signs: Journal of Women in Culture and Society, 25(2), 407–450.CrossRefGoogle Scholar
  38. Leff, E. W., Gagne, M. P. & Jefferis, S. C. (1994). Maternal perceptions of successful breastfeeding.Journal of Human Lactation, 10(2), 99–104.CrossRefGoogle Scholar
  39. Lupton, D. (1993). Risk as moral danger: The social and political functions of risk discourse in public health.International Journal of Health Services, 23(3), 425–435.PubMedCrossRefGoogle Scholar
  40. Lupton, D. (2000). ‘A love/hate relationship’: The ideals and experiences of first-time mothers.Journal of Sociology, 36(1), 50–63.CrossRefGoogle Scholar
  41. Marild, S., Hansson, S., & Jodal, U. (2004). Protective effect of breastfeeding against urinary tract infection.Acta Paediatrica, 93(2), 164–168.PubMedCrossRefGoogle Scholar
  42. Maushart, S. (1997).The mask of motherhood. Sydney: Vintage.Google Scholar
  43. McInnes, R.J., & Chambers, J.A. (2008). Supporting breastfeeding mothers: qualitative synthesis.Journal of Advanced Nursing, 62(4), 407–427.Google Scholar
  44. McVeigh, P. (2005). The World Health Organization code of marketing of breastmilk substitutes and subsequent resolutions (The WHO Code).The NSW Health Bulletin, 16(3–4), 67–68.PubMedCrossRefGoogle Scholar
  45. Moore, T., Gauld, R., & Williams, S. (2007). Implementing Baby Friendly Hospital Initiative Policy: The case of New Zealand public hospitals.International Breastfeeding Journal, 2(8). Retrieved from
  46. Murphy, E. (1999). ‘Breast is Best’: Infant feeding decisions and maternal deviance.Sociology of Health & Illness, 21(2), 187–208.CrossRefGoogle Scholar
  47. Murphy, E. (2000). Risk, responsibility and rhetoric in infant feeding.Journal of Contemporary Ethnography, 29(3), 291–325.CrossRefGoogle Scholar
  48. NHMRC. (2003).The dietary guidelines for children and adolescents in Australia incorporating the Infant Feeding Guidelines for Health Workers. Canberra: NHMRC.Google Scholar
  49. NSW Department of Health. (2006). Breastfeeding in NSW: Promotion, Protection and Support. Retrieved 13 August 2009, from
  50. NSW Health. (2004). Eat Well NSW, NSW Health’s strategic directions for public health nutrition 2003–2007. Retrieved 13 August 2009, from
  51. Nutbeam, D., Wise, M., Bauman, A., Harris, E., & Leeder, S. (1993).Goals and targets for Australia’s health in the Year 2000 and beyond. Canberra: Australian Government Publishing Service.Google Scholar
  52. Oddy, W. H. (2001). Breastfeeding protects against illness and infection in infants and children: A review of the literature.Breastfeeding Review, 9(2), 11–18.PubMedGoogle Scholar
  53. Palmer, G. (1993).The politics of breastfeeding. London: Pandora.Google Scholar
  54. Pincombe, J., Baghurst, P., Antoniou, G., Peat, B., Henderson, A., & Reddin, E. (2008). Baby Friendly Hospital Initiative practices and breast feeding duration in a cohort of first-time mothers in Adelaide, Australia.Midwifery, 24(1), 55–61.PubMedCrossRefGoogle Scholar
  55. Quigley, M., Kelly, Y., & Sacker, A. (2007). Breastfeeding and hospitalization for diarrheal and respiratory infection in the United Kingdom Millennium Cohort Study.Pediatrics, 110(4), e837–e842.CrossRefGoogle Scholar
  56. Riordan, J. M., Woodley, G. & Heaton, K. (1994). Testing validity and reliability of an instrument which measures maternal evaluation of breastfeeding.Journal of Human Lactation, 10(4), 231–235.PubMedCrossRefGoogle Scholar
  57. Rossiter, J. C. (1992). Attitudes of Vietnamese women to baby feeding practices before and after immigration to Sydney, Australia.Midwifery, 8, 103–112.PubMedCrossRefGoogle Scholar
  58. Rossiter, J. C. (1994). The effect of a culture specific education program to promote breastfeeding among Vietnamese women in Sydney.International Journal of Nursing Studies, 31(4), 369–379.PubMedCrossRefGoogle Scholar
  59. Sadauskaite-Kuehne, V., Ludvigsson, J., Padaiga, Z., Jasinskiene, E., & Samuelsson, U. (2004). Longer breastfeeding is an independent protective factor against development of type 1 diabetes mellitus in childhood.Diabetes/Metabolism Research and Reviews, 20(2), 150–157.PubMedCrossRefGoogle Scholar
  60. Schmied, V., & Barclay, L. (1999). Connection and pleasure, disruption and distress: women’s experience of breastfeeding.Journal of Human Lactation, 15(4), 325–334.PubMedCrossRefGoogle Scholar
  61. Schmied, V., & Lupton, D. (2001). Blurring the boundaries: Breastfeeding and maternal subjectivity.Sociology of Health & Illness, 23(2), 234–250.CrossRefGoogle Scholar
  62. Schmied, V., Sheehan, A., & Barclay, L. (2001). Contemporary breast-feeding policy and practice: Implications for midwives.Midwifery, 17, 44–54.PubMedCrossRefGoogle Scholar
  63. Schmied, V., Gribble, K., Sheehan, A., Dykes, F., Cioffi, J., & Taylor, C. (2009a).The problem of breastfeeding in implementation of WHO/UNICEEF BFHI. Paper presented at the Nutrition and Nurture in Infancy and Childhood: Bio-Cultural Perspectives Conference, Grange over Sands, Cumbria, 8–10 September 2009.Google Scholar
  64. Schmied, V., Beake, S., Sheehan, A., McCourt, C., & Dykes, F. (2009b).A meta-synthesis of women’s perceptions and experiences of breastfeeding support. (No. SR208). Adelaide: Joanna Briggs Institute.Google Scholar
  65. Schwartz, K., D’Arcy, H. J. S., Gillespie, B., Bobo, J., Longeway, M., & Foxman, B. (2002). Factors associated with weaning in the first 3 months postpartum.The Journal of Family Practice, 51(5), 439–444.PubMedGoogle Scholar
  66. Shakespeare, J., Blake, F., & Garcia, J. (2004). Breast-feeding difficulties experienced by women taking part in a qualitative interview study of postnatal depression.Midwifery, 20, 251–260.PubMedCrossRefGoogle Scholar
  67. Sheehan, A. (2006).Complex decisions: Deconstructing best. A grounded theory study of infant feeding decisions in the first six weeks post-birth. Unpublished PhD thesis, University of Technology, Sydney, Australia.Google Scholar
  68. Sheehan, A., Schmied, V., & Cooke, M. (2003). Australian women’s stories of their baby-feeding decisions in pregnancy.Midwifery, 19, 259–266.PubMedCrossRefGoogle Scholar
  69. Sheehan, A., Schmied, V., & Barclay, L. (2010) Complex decisions: Theorizing women’s infant feeding decisions in the first 6 weeks after birth.Journal of Advanced Nursing, 66(2), 371–380.Google Scholar
  70. Stein, J., Dykes, F., & Bramwell, R. (2000). Breast-feeding: Midwives meeting mothers in the middle.British Journal of Midwifery, 8(4), 239–245.Google Scholar
  71. Tsianakas, V. & Liamputtong, P. (2007). Infant feeding beliefs and practices among Afghan women living in Melbourne, Australia. In P. Liamputtong (Ed.),Childrearing & infant care issues: A cross-cultural perspective (pp. 249–273). New York: Nova Science Publishers.Google Scholar
  72. Ullah, S., & Griffiths, P. (2003). Does the use of pacifiers shorten breastfeeding duration in infants?British Journal of Community Nursing, 8(10), 458–463.PubMedGoogle Scholar
  73. UNICEF (2009). The Baby-Friendly Hospital Initiative. Retrieved 14 August 2009, from
  74. Wall, G. (2001). Moral constructions of motherhood in breastfeeding discourse.Gender & Society, 15(4), 592–610.CrossRefGoogle Scholar
  75. World Health Organization (1981).International code of marketing of breast-milk substitutes. Unpublished manuscript, Geneva: World Health Organization.Google Scholar
  76. World Health Organization (1989).Protecting, promoting and supporting breast-feeding: The special role of maternity services. Geneva: World Health Organization.Google Scholar
  77. World Health Organization (2007).Evidence on the long-term effects of breastfeeding: Systematic reviews and meta-analysis. Geneva: World Health Organization.Google Scholar
  78. World Health Organization & UNICEF. (1991a).Innocenti Declaration. On the protection, promotion and support of breastfeeding. Florence: UNICEF.Google Scholar
  79. World Health Organization & UNICEF (1991b).Take the Baby Friendly Initiative! New York: UNICEF.Google Scholar
  80. World Health Organization & UNICEF. (2003).Global strategy for infant feeding and young child feeding. Retrieved July 4, 2009, from

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  1. 1.Faculty of Nursing and Health, Avondale CollegeWahroongaAustralia
  2. 2.School of Nursing and Midwifery, University of Western SydneyPenrithAustralia

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