A certain attitude and lifestyle is needed if breast feeding is to be successful. It must have priority over all other activities save the very basic ones. The rural environment provides a situation in which breast feeding can flourish . With urbanisation and the accompanying change in lifestyle breast feeding becomes very difficult. Since successful breast feeding needs strong motivation, the change in attitude of urbanised wives makes it even more unlikely. The Singapore experience demonstrates this convincingly; even though awareness of the benefits of breast feeding is widespread, the motivation to breast feed is not. Remedial measures should take into consideration the need to motivate the mother and family, the prevention of commercial infant food companies influencing public opinion, and incentives for the working mothers to breast feed.
PIP: In the last 2 generations milk substitutes have been increasingly used for the early nurture of infants, resulting in a decline in the incidence of breastfeeding initially in the developed countries and currently in the developing countries. The nature of breastfeeding itself requires a certain attitude and lifestyle, if success is to be ensured. Close proximity of mother and infant is necessary at most times of the day and at least at certain times of the night. This places constraints on the mother, restricting her activities. Social activities and work will have to be limited to those which allow breastfeeding to continue in the usual manner or at least almost so. To be successful, breastfeeding must have priority over all but the most basic activities. Breastfeeding is the most economical means of nurturing the infant. In the rural environment which is often present in developing countries, breastfeeding calls for little change in lifestyle. With urbanization that often occurs in such countries, the extended family, traditional practices, as well as close proximity of mother and infant -- factors encouraging breastfeeding -- are diluted or lost. Lifestyle changes make breastfeeding difficult since a great deal of adaptation and even sacrifice is necessary. This situation is further aggravated by the persuasive advertisements of infant food companies with claims of their infant formulae being able to meet all the requirements of the infant as well as conveniently freeing the mother from the infant. The attitude of the employer and authorities is also an important factor affecting the incidence and duration of breastfeeding. In rapidly developing countries with emphasis on efficiency and productivity often little consideration is given to matters outside the occupation, profession, or business. Under such circumstances, even the encouragement to breastfeed by medical authorities will usually not meet with much positive response. As Singapore progressed with rapid industrialization and urbanization, women were encouraged to play an active role in the country's economic life, and the number of women actively employed increased tremendously. In the 1980 census, about 39% of the adult female population was economically active compared with 73% of males. Fertility decreased markedly. With a focus on increased productivity and efficiency, maternity leave was granted for only 1/2 months. Breastfeeding declined alarmingly during this period as Singapore was improving its economic standing. Yet, breast milk remains the best food for infants with few exceptions. The contraceptive effect of breastfeeding is also helpful in spacing out pregnancies. Measures to encourage breastfeeding should consider 3 factors: the mother and family; the infant food companies; and the authorities and employer. Strong motivation of the mother towards breastfeeding can be realized only if she is convinced of its merits and benefits and her fears laid to rest.