From “Nurturing” to “Indecent”: Discomfort Towards Photographs of Breastfeeding Among Adults in Nova Scotia, Canada

Abstract

Abstract Objectives Although the World Health Organization recommends continued breastfeeding for 2 years and beyond, adherence rates are low in Canada and the United States. One major barrier to following this recommendation is an unsupportive culture and social stigma around breastfeeding. Our objective was to assess attitudes towards photographs of breastfeeding children of varying ages and locations among the general population in Nova Scotia, Canada. Methods In a self-administered questionnaire, participants recruited in public spaces were asked to react to six photographs depicting women breastfeeding children aged 2 weeks, 13 months and 30 months in both private (e.g., home) and public (e.g., store) locations. Participants self-rated their comfort levels using a visual analog scale (VAS; scale from 0 [not at all comfortable] to 10 [very comfortable]), and also provided open-ended qualitative reactions to the images. Sociodemographic information was also collected. Results We surveyed 229 participants (60% women, 40% men). Mean age was 44 years (range 19–95 years), 73% self-identified as white, and 77% were born in Canada. The majority of participants were parents (69%), and 69% of parents reported that their children were breastfed. Mean (95% CI) self-rated comfort differed significantly by location and child age. VAS scores indicated higher comfort for images in private locations (7.9, 7.7–8.1) compared to public locations (7.3, 7.0–7.5; P = 0.001), and for images of younger (8.5, 8.3–8.7) compared to older children (6.9, 6.6–7.2; P < 0.001). Women and parents had higher comfort with all images compared to men and non-parents (P < 0.05). Younger participants (19–29 years) were less comfortable with images of public breastfeeding compared to older participants (P < 0.05). Text-based reactions suggest lower approval of images of public breastfeeding and increased child age, but varied highly, including comments from “nurturing” to “indecent”. Conclusions Comfort and acceptance of breastfeeding among adults in Nova Scotia is influenced by location and child age. Negative perceptions of public breastfeeding and continued breastfeeding into young childhood may affect adherence to global breastfeeding recommendations. Funding Sources Mount Saint Vincent University New Scholars Grant, CN Student Research Internship.