Frankly I think the only way we can sort out bf rates is by teaching kids the difference between breastmilk and formula in schools as part of personal development classes. Not just benefits/costs, but the biological differences. That is a big lightbulb moment, when you compare a dead fortified whey powder with a living celled human fluid.
I reached this conclusion last week when buying follow on milk for my almost 6 monther (I cannot exclusively pump for him for a year. I am not "manning up" for that as it is hell and I would actually rather like to start spending that 30 hours a week with him and not a pump) and a pregnant woman asked me the difference between powder and tetrapaks, and when I said she could avoid the hassle altogether by bf, wrinkled up her face and said "eww, no way".
Get a bunch of teenage girls and explain the difference before guilt, parenting, peer pressure etc. kicks in and at least it will be a more genuine choice. People just don't know the difference - and once they do, there is no decent help to make it possible. I once had a board certified lactation consultant spend two hours try to get my son to biologically nurture, because she was too unprofessional to confess that she hadn't divided his tongue tie properly four weeks earlier. She then let me pay her another 70 quid for the privilege. I had a total of 13 people try to teach me how to bf, and their statements were equally contradictory and equally definitive, and none worked, until the JR in Oxford managed it in minutes - and further, noted that in his case it was always going to be incredibly hard as he had further undiagnosed oral abnormalities. My experience of the help available is that a little respect for the mothers being thus "helped" might go a long way: my son learned to suck at all from a bottle. This medically proven fact for babies with his problems, might, had the "experts" not scoffed at me suggesting it, helped them diagnose him. Yet not one of these experts told me that huge breasted, giant nippled women might find a larger pump shield more comfortable - and at least two of them were hiring the damn things.
Bf can be hard and horrible. The impact this has on the mother, and her relationship with her baby, can be awful. I hated my son because bf him was so unremittingly disgusting (and yeah, bleeding, agonised nipples for months on end pretty much fits that) I felt he was a vampiric little fucker who had destroyed my life. I knew enough to know this was depression, that I had to find a way to hide it from him, and my mother pulled my weight so that all he ever saw was a soft faced, gentle mummy. The hatred was taken out on pillows. But not everyone has a saint of a mother who is willing to put their life on hold to ensure the baby is bf. Without that, my son would have been better off on formula.
Promoting bf is important, of course it is. But the way people do it is actually a turn off. I have stuck to ebm because I know the scientific evidence, and frankly much of the proselytising has made me want to give him formula as a two fingered salute. I know bf mothers get hassle in public - but my mother and I heard a woman in IKEA tell her dining companions "she'll have him on chips next" when I began to fish out the bottle. Of ebm. I also had a man (clearly very well up on bf issues) sneer at me in Starbucks. It is not just bf women who are judged.
Women need the importance taught at school, and they need a lactation consultant trained by the JR, NOT the frankly USELESS and in some cases actually negligent crew I have encountered under the aegis of the board certified lactation consultancy ilndustry. The latter trashed my initial six months of motherhood, and if I'd been less bloody minded would have condemned my little guy to formula. Ironic, no?