La Leche League: 70 Years of Collaboratively Developing Breastfeeding Knowledge to Support Mothers

La Leche League (LLL) was founded in 1956 in Illinois by seven mothers: Mary Ann Cahill, Edwina Froehlich, Mary Ann Kerwin, Viola Lennon, Marian Tompson, Betty Wagner, and Mary White. At that time in the United States of America, formula feeding was the norm; breastfeeding was not widely encouraged by the medical community; and the transmission of knowledge and support among women had significantly declined. During a parish picnic, while they were breastfeeding their babies, White and Tompson were approached by several women who told them they had wanted to breastfeed but had been unable to do so due to a lack of advice and support. Based on this experience, White and Tompson concluded that a mother wishing to breastfeed needs practical information, encouragement, and the experience of other women who have breastfed—was undoubtedly worth far more than any medical assistance. The first LLL meeting officially took place on 17 October 1956, at Mary White’s home. It was an immediate success. The “Milk League” (“la leche” means “the milk” in Spanish) was born, and classified ads were published in local newspapers to promote the upcoming support meetings.

Mother-to-Mother Support

The core principle of the “LLL model” is mother-to-mother support: women with breastfeeding experience are trained and accredited as Leaders who volunteer their time to support other mothers. This model is something of an innovation in a world where the social fabric has frayed. It is also a means of returning to time-honored practices now validated by research. 

LLL recognizes that while breastfeeding is certainly a biological phenomenon, its success depends heavily on the related factors of social environment, hospital practices, the information available for parents, as well as  the support provided to mothers. With this in mind, the LLL model was developed. The organization drafted a constitution in 1963 and officially became La Leche League International (LLLI) in June 1964.

In 1964, LLLI established an accreditation program for its Leaders within an ethical framework to ensure that the same principles of support could be passed on from one group to another. The “LLL model” spread rapidly around the world. In 1998, an LLLI representative told the World Health Assembly that the organization had more than 7,000 volunteer leaders, helped several hundred thousand women each year, and was active in more than 60 countries (LLL France).

The Dissemination of Knowledge on Breastfeeding

Another major achievement for LLLI is in publishing. In 1958, the first edition of The Womanly Art of Breastfeeding was published and sold over 10,000 copies within the year. A significantly expanded edition debuted in 1963. Since then, the book has been regularly revised, translated, and reprinted, selling over three million copies in its various editions. The 9th edition, The Art of Breastfeeding, was published in 2024.

In addition to its main reference book, LLL produces a variety of additional resources, including many produced locally in different countries (and languages) for mothers, families, and even for healthcare professionals. Several websites (e.g., the LLLI website) also supplement print publications, and serve as veritable online encyclopedias of breastfeeding information. These publications and websites have helped LLL restore a culture of breastfeeding that had been partially lost in industrialized Western societies, while also contributing to the ongoing development of international expertise on breastfeeding.

Influencing Health Policies

LLLI has enjoyed many local achievements, while also becoming a key partner for international institutions and has advocated for three main ideas that have gradually been incorporated into public policy:

• protecting breastfeeding from commercial practices that could compromise it;
• changing hospital practices that prevent or complicate the initiation of breastfeeding;
• considering social support for families as a component of health policy.

Specific examples of success in this advocacy include working together with the World Health Organization (WHO), United Nations International Children’s Emergency Fund (UNICEF), and various civil society organizations to support  the International Code of Marketing of Breast-Milk Substitutes adopted by the World Health Assembly in 1981. This code sought to limit promotional practices by manufacturers of breastmilk substitutes that might discourage breastfeeding (World Health Organization). LLLI also supported the 1990 Innocenti Declaration on the Protection, Promotion, and Support of Breastfeeding and the Baby-Friendly Hospital Initiative launched by WHO and UNICEF in 1991, which aimed to transform maternity ward practices to facilitate the initiation and continuation of breastfeeding. (Iris)

We can also celebrate four major global contributions by the organization:

• reviving the circulation of practical knowledge about breastfeeding;
• creating a large-scale model of mutual support among mothers;
• contributing to the cultural shift that has made breastfeeding visible and legitimate once again;
• having built an international network capable of advocating for breastfeeding mothers before health institutions.

In 2021, WHO and UNICEF reported that the rate of exclusive breastfeeding had increased by 50% worldwide over the past forty years, benefiting some 900 million children. LLL is a major player in this cultural and health revolution.