Among infants born in 2019, around 83% of infants received some breastmilk at birth, but by 6 months of age, a little more than half were receiving any breast milk, while about a quarter were receiving breast milk exclusively.
Roughly 20% of mothers living in the Southeast breastfeed till six months. Meanwhile, more than 32% of mothers in Oregon, Montana, Minnesota, Colorado, and Vermont breastfeed through the same period. Notably, these states are among those with some version of mandatory family leave policies, while Southeastern states with the fewest mothers breastfeeding till six months—including Mississippi, Alabama, Florida, Georgia, and South Carolina—do not. Even in states with mandated family leave policies, those policies are not always paid.
Variations in breastfeeding rates throughout the nation reveal the impacts of individual state policies for parental leave. How much or how long someone breastfeeds also depends on their family dynamic, at-home support, the number of children in the house, and their level of education. A review of studies published in a 2023 issue of the journal Midwifery shows that lacking knowledge or confidence can contribute to lower rates of breastfeeding in terms of initiation and duration.
Breastfeeding rates also diverge along racial and economic lines. Non-Hispanic Black infants are less likely to be breastfed at all compared to their counterparts, and infants who are eligible to receive nutritional support through the Special Supplemental Nutrition Program for Women, Infants, and Children, known as WIC, are less likely to be breastfed than infants who are ineligible for these services. What’s more, young mothers aged 20-29 are less likely to breastfeed than mothers 30 and older.
Many mothers from marginalized communities face numerous obstacles to meeting breastfeeding goals, including but not limited to unsupportive hospital practices and policies, and a lack of insurance coverage for support services like pregnancy education, lactation consultants, and doula services.
Breastfeeding is also expensive. The annual cost of formula is $2,280, whereas breastfeeding for one year may run more than $10,500 in direct and hidden costs, according to a 2023 study from the Yale School of Medicine. These expenses include higher food intake for nursing parents, vitamin supplementation, breastfeeding or pumping supplies, and, crucially, time.
For families living at or below the federally established poverty threshold—$25,820 for a family of three—spending nearly $11,000 to breastfeed isn’t feasible. This is especially true when WIC, which does provide breastfeeding support, is the nation’s largest purchaser of infant formula. Each state contracts with a single brand of infant formula provided through state WIC agencies, which competitively bid rebate contracts with formula manufacturers and pass those savings (or free formula) along to new parents.
Returning to work can also stymie breastfeeding for full-time working mothers, who tend to breastfeed for shorter periods than their part-time or unemployed counterparts. Hourly wage workers face even more significant barriers than white-collar workers: They have less control over schedules set by managers, and their employers may dock their pay for pumping breaks.
