Social learning is critical to breastfeeding success: Evidence from rural Namibian pastoralists.

Background and objectives: Lactation is one of the defining features of mammals, yet many humans struggle with breastfeeding. One reason for this is that humans are unique among mammals in the degree of learning and support that they require to breastfeed successfully. Despite this, we know little about how social learning impacts breastfeeding, particularly outside the influence of biomedical systems. Methodology: Qualitative and systematic interviews were conducted with 128 Namibian women on infant feeding norms and practices. Structured statements were analyzed with cultural consensus analysis to determine whether a single cultural model exists and to identify variance in individual cultural competencies. Results: Cultural consensus analysis revealed a single cultural model for breastfeeding, with strong and consistent norms and a significant role for social learning. Both learning and instinct were invoked in women's responses, speaking to the necessary and expected role of intensive support in the early postpartum period. Women also noted steep learning curves and clear expectations about infant feeding, which led to nearly universal breastfeeding and clear paths for troubleshooting difficulties. Conclusions and implications: The breastfeeding support that Himba mothers receive is part of the legacy of assisted reproduction in humans. However, the features of intensive teaching and learning shown here are lacking in western models of infant feeding and postpartum care. These data suggest that protracted breastfeeding difficulties may result from a mismatch between the evolved socioecology of breastfeeding and current norms and practices that hinder social learning and impair support pathways.