Sally Wendkos Olds, a Long Island grandmother who breastfed her three daughters, wrote the first edition of the classic The Complete Book of Breastfeeding, Workman Press, in 1971. The fourth edition, which Wendkos Olds co-wrote with Laura Marks, M.D., and Marvin S. Eiger, M.D., will be published by Workman Publishing in early 2010. She speaks with us about how things have changed since the 1970s.

Did women not know about the benefits of breastfeeding because their moms didn’t breastfeed?
For close to 50 years – from the 1920s to the 1970s – relatively few American women nursed. 1971 marked the lowest level of breastfeeding ever in the US. These generations of women grew up with no one to help them learn how to breastfeed. Breastfeeding is natural, yes, but it is a learned skill for both mother and baby.

What differences have you seen in new moms today compared to the new moms you interviewed from the earlier editions? Today, many more women begin to nurse their babies and are willing to go through the learning period of the first few weeks to establish a smooth breastfeeding relationship. They're more aware of the health benefits and appreciate the money-saving aspects of nursing.

Also, more women are going back to work soon after childbirth than before, and many of them continue to breastfeed even while holding down a full-time job. Today's moms have the advantage of getting help from lactation consultants (LC), a relatively new profession. Most hospitals have an LC on staff, and many are in private practice. It's an excellent investment after delivery to forestall future problems and resolve small problems.

Are more women breastfeeding today?
For many years, the nursing mother was the nonconformist, a member of a minority group, a ‘hippie.’ By 1971, formula feeding had become the norm, with only 25 percent of women nursing. Since then, the long-term trend away from breastfeeding has been reversed, so that today about three out of four new mothers nurse their babies right after birth, according to a CDC report about babies born in 2004.

Among infants born in 2004, exclusive breastfeeding up to three months after birth was 31% and through six months was 11%. We like to think that the advice and encouragement of the first book helped to accelerate the trend toward the rediscovery of breastfeeding. The American Academy of Pediatrics recommends exclusive nursing for six months (no other milk or food) and continued nursing till one year and as long after that as mother and baby want to. 

What are the reasons why women don’t breastfeed?
Some reasons are that they are modest and neither want to nurse publicly nor run into another room whenever people are around; they have to go back to work and don’t want to start something they can’t finish, they’re afraid they won’t know whether their baby is getting enough to eat, or their husbands or partners don’t want them to.