Article: “Too Old” and “Too Cold”: Discomfort Towards Photographs of Breastfeeding Beyond Infancy and Public Breastfeeding in Nova Scotia, Canada

Abstract

Background: Social norms and public perception of breastfeeding are well-established predictors of breastfeeding outcomes; however, little is known about perceptions of breastfeeding beyond infancy or public breastfeeding among the public in Nova Scotia, Canada. Research Aim: To explore public opinion about breastfeeding beyond infancy and public breastfeeding. Methods: In this cross-sectional study participants were recruited from public spaces in Nova Scotia, Canada. Using photo elicitation methods, participants ( N = 229) viewed six photographs of breastfeeding children aged 2 weeks, 13 months, and 2.5 years, one photograph captured at home, and the other in a public space (a café, a store, or outdoors). Participants were asked to score their self-rated comfort with each photograph on a 10.0 cm visual analog scale and asked to share their feelings about each photograph (open-ended responses). Results: Mean ( SD) visual analog scale comfort scores for photographs differed by location (private, 7.9 [2.2]; public, 7.3 [2.6]; p < .05) and child age (2 weeks, 8.5 [2.0]; 13 months, 7.5 [2.6]; 2.5 years, 6.9 [3.0]; p < .05). Participants who identified as women and parents self-reported significantly higher comfort with all photographs, while younger participants and urban dwellers were generally less comfortable. Open-ended responses varied considerably, but a higher proportion of negative comments were reported for older children feeding in public spaces (e.g., 2.5-year-old in public: “Inappropriate. Indecent. Abnormal.”). Conclusion: Given the importance of social norms in supporting breastfeeding, future public health campaigns should strive to normalize breastfeeding beyond infancy, and in public spaces.

Breastfeeding in Canada: predictors of initiation, exclusivity, and continuation from the 2017–2018 Canadian Community Health Survey

“…Of those who were still breastfeeding at 6 months, most noted child's readiness for solids, mother's return to work/school, or a predetermined plan to stop as rationale for breastfeeding cessation; however, the taboo of breastfeeding beyond infancy could also be at play. We recently found that members of the general public were significantly less comfortable viewing breastfeeding photographs of older children, with negative reactions such as "too big to suck breast" elicited from a photograph of a 13-month old breastfeeding at home (Chan and Whitfield 2022). Unfortunately, this taboo may be pervasive even among healthcare professionals: in a recent cross-sectional study in the UK, US, Australia, and Canada (n = 59 581), 49% of women did not share their plan for breastfeeding beyond 12 months with their child's healthcare provider (Keim et al 2022).…”

The influence of bystander presence on evaluations of public breastfeeding among adults in the United States

“…To our knowledge, this is the first study that systematically manipulated the presence (and gender) of bystanders in photographs of the same breastfeeding women in the same locations. Although others [ 12 , 13 , 15 ] have examined reactions to images of public breastfeeding, the lack of standardization across photographs (resulting in confounding factors, including the woman’s expression and body position, amount of breast exposure, proximity to bystanders, age of child) limited the ability to draw conclusions about the role of each factor in shaping evaluations of public breastfeeding. In contrast, we can be more certain that the differences observed in the current study are due to the variables of interest.…”

Dual modality feeders: a group of human milk feeders with unique practices and needs

“…In Nova Scotia, provincial policy and public health messaging widely promote breast-feeding, but sociocultural norms and structural supports remain inadequate (22) . Nova Scotians are still largely uncomfortable with public breast-feeding (23) , and appropriate lactation spaces are lacking (24) . What is more, public health messages are generally aimed at promoting breast-feeding rather than supporting infant feeding activities and, hence, routinely overlook the unique challenges and required supports of DMF.…”