Breastfeeding: It Takes a Village

The 8 ^th volume of Breastfeeding Medicine is being launched with this issue. Breastfeeding as a field of science is firmly launched. Established investigators are searching for additional knowledge with a variety of tools. It has been known for centuries that human milk is for human infants. The last century taught us that it is the ideal for growth and development and has the additional ability to protect against illness and disease. What is still unknown is how, why, and under what circumstances milk is actually produced that makes it perfect for the human infant. Not all the constituents have been isolated and identified. There are hundreds. The good news is that researchers in the fields of biochemistry, immunology, infectious disease, and nanophysiology are hard at work searching for new information. Clinicians are studying the physiology and psychology of lactation. Sociologists, anthropologists, and even economists are exploring the impact of breastfeeding on the infant, the mother, the family, and society.

It takes a vast community to fit all these roles. Breastfeeding Medicine is honored to have the opportunity to publish this work. It is proud to say that it has a rich store of manuscripts to share. It should be pointed out again that as soon as a manuscript has been reviewed, revised, and accepted it is uploaded in electronic form so there is no delay in making available new work and important data. The number of articles in print has been increased in each issue, and the number of issues was increased a year ago to six per year. The Editors and the Editorial Board are most appreciative of the work of all our authors. The editors are most grateful to our reviewers who work diligently to make sure all the published work meets the high standards that have been set. The names of the reviewers for 2012 are listed on page 145.

That breastfeeding is a public health issue, not just a matter of personal choice, is the strong declaration of the American Academy of Pediatrics in its policy statement. ¹ In this issue, the New York State Department of Health responds to this and reports its hospital policy changes and the resultant increase in the initiation and duration of breastfeeding in the state. ² Policy changes are an effective way of initiating permanent change in the population, the authors confirm.

Social and psychological issues are generously represented in this issue headed by a report by Kendall-Tackett et al., ³ who studied postpartum stresses and symptoms in 994 women who had been sexually assaulted and compared those women who breastfed, mixed-fed, and formula-fed. A total of 6,410 participated in the online survey. Women who had been assaulted had more problems, but these women did better if they breastfed.

When the success of breastfeeding was examined in mothers with symptoms of depression in 197 women by Annagür et al., ⁴ an association was found between depressive symptoms and difficulty in breastfeeding. The authors recommend that clinicians pay attention to symptoms of depression when lactation is going poorly.

More is the better when it comes to the duration of breastfeeding in the minds of those who support breastfeeding. But is it? Can it impact the mother's perceptions? We know it provides many health benefits for the infant. Dowling and Brown ⁵ have examined the experiences of women who chose to breastfeed longer. The investigators looked at two qualitative datasets that had recorded the attitudes and reported experiences of women who breastfed beyond 6 months in the United Kingdom. They combined results from direct interviews and open-ended questionnaires. The mothers reported much criticism and many challenges. It was clear that public policy that recommends breastfeeding for at least a year and longer requires education of the value of long breastfeeding to the infant for not only the mother, but also healthcare professionals.

The breastfeeding norm is not yet firmly established for individual mothers, their families, their communities, the professionals who support them, or the public at large. Thank you to the readers, the authors, all the staff at Mary Ann Liebert, Inc. Publishers and all who support breastfeeding and breastfeeding mothers for your efforts to create the best village for breastfeeding.