title: Breastfeeding

text: If weaning is begun at 12 months or later it is not necessary to switch to infant formula or "toddler formula" as is sold commercially. At 12 months it is recommended that the baby be switched to whole cow's milk. Reduced-fat or skim milk generally isn't appropriate before age 2 because it doesn't have enough fat or calories to promote early brain development.


title: Breastfeeding

text: If the mother was experiencing lactational amenorrhea her periods will begin to return as she begins to wean, along with the return of her fertility.


title: Breastfeeding

text: Lactation consultants are trained to assist mothers in preventing and solving breastfeeding difficulties such as sore nipples and low milk supply. They commonly work in hospitals, physician or midwife practices, public health programs, and private practice. Lactation consultants may earn their Certified Lactation Counselor (CLC) or their International Board Certified Lactation Consultant (IBCLC) by the Academy of Lactation Policy and Practice and/or the International Board of Lactation Consultant Examiners, respectively. While lay people may take a course, study independently, and sit for their CLC exam, the IBCLC prerequisites are more robust in terms of the hours of experience required to sit for the exam. Thus, many IBCLCs work in the healthcare setting where they may acquire these hours. Exclusive and partial breastfeeding are more common among mothers who gave birth in hospitals that employ International Board Certified Lactation Consultants (IBCLC), thus the U.S. Surgeon General recommends that all communities have access to IBCLC services.


title: Breastfeeding

text: Medical conditions that do not allow breastfeeding are fairly rare. Infants that are otherwise healthy uniformly benefit from breastfeeding, however, extra precautions should be taken or breastfeeding avoided in circumstances including certain infectious diseases and medical conditions.


title: Breastfeeding

text: A breastfeeding child can become infected with HIV. Factors such as the mother's viral load complicate breastfeeding recommendations for HIV-positive mothers. The World Health Organization highlights the possibility of breastfeeding in mothers on anti-viral therapy and with undetectable viral loads, especially in areas where access to clean water is poor and where death from infectious diseases is common, citing low transmission rates when the mother is on anti-viral therapy. They also recommend that national authorities in each country decide which infant feeding practice should be promoted by their maternal and child health services to best avoid HIV transmission from mother to child. However, the CDC continues to recommend against HIV-positive mothers breastfeeding in the United States. Infant formula should only be given if this can be safely done.


title: Breastfeeding

text: Human T-Lymphotrophic Virus (HTLV) is able to be passed through breastmilk from mother to child. The worldwide rate of transmission through breastmilk is estimated to be 3.9–27%, and this risk is increased by high maternal viral load and prolonged periods of breastfeeding. Current data demonstrates that while breastfeeding for less than six months does not, independently, increase risk of HTLV-1 transmission, not breastfeeding during that time "does" decrease risk of transmission. As such, CDC recommends against breastfeeding when mothers have HTLV Types I or II. Recognizing the importance of breastfeeding in more resource-poor areas of the world, the World Health Organization recommends shortening the duration of breastfeeding, or avoiding breastfeeding where possible.


title: Breastfeeding

text: Mothers with Marburg virus or Ebola should not breastfeed their infants or feed them with expressed breastmilk.


title: Breastfeeding

text: Infants whose mothers have suspected untreated tuberculosis (TB) should be isolated from their mothers to reduce risk of transmission. As such, these infants should not be breastfed during this time and until the mother has been treated appropriately for 2 weeks and is no longer contagious. However, these infants may be fed expressed breastmilk from their mother. Transmission of TB through breastmilk, without an isolated breast infection caused by the Tuberculosis bacteria ("Mycobacterium tuberculosis"), has never been documented in the scientific literature. Mothers who do have an isolated breast infection caused by "Mycobacterium tuberculosis", termed tuberculous mastitis, should not feed their infants with their own breastmilk, even if it is fed by bottle.


title: Breastfeeding

text: Herpes simplex virus (HSV) is the virus that causes genital herpes and oral cold sores, and it can be very dangerous to infants. The CDC advises to continue breastfeeding if there are no open/active lesions on the breast and other lesions covered.


title: Breastfeeding

text: Varicella zoster is the virus responsible for chickenpox and shingles (also known as herpes zoster). The CDC advises that breastfeeding is safe to continue as long as the breasts are clear of lesions, also emphasizing that if pumping or hand expressing milk, proper hand-hygiene should be used to minimize transfer.


title: Breastfeeding

text: In May 2020, WHO and UNICEF stressed that the ongoing COVID-19 pandemic was not a reason to discontinue breastfeeding. They recommend that women should continue to breastfeed during the pandemic even if they have confirmed or suspected COVID-19 because evidence indicates that it is not likely that COVID-19 can be transmitted through breast milk. A study published in 2021 found that, while SARS-CoV-2 RNA may be found in some samples of breastmilk from recently infected mothers, the breastmilk does not contain infectious virus and is not considered a transmission risk factor. Mothers who have suspected or confirmed diagnoses of COVID-19 should thoroughly wash their hands and wear a well-fitting mask prior to breastfeeding their infant, or express breastmilk and feed the infant by bottle.


title: Breastfeeding

text: Mothers who smoke or use other tobacco products can breastfeed their infants, according to La Leche League, the CDC, and the Royal Women's Hospital (Australia). However, it is important to note that maternal tobacco use may decrease milk supply. Additionally, tobacco smoking, regardless of feeding method, increases risk of SIDS and respiratory illnesses. Thus, attempting to decrease tobacco use or even cease helps to minimize tobacco exposure to infants and maximize the benefits of breastfeeding. Tobacco cessation products, such as nicotine patches and other medications, like bupropion, are able to be used by breastfeeding mothers.


title: Breastfeeding

text: When breastfeeding, alcohol may be consumed in moderation and does not require "Pumping-and-Dumping" (pumping and discarding breastmilk). Alcohol crosses from the blood to the breastmilk by diffusion. Thus, the concentration of alcohol in the breastmilk is approximately equal to the concentration in the maternal bloodstream at any given time. As the mother's liver processes the alcohol, more and more alcohol is pulled out of the breastmilk and back into the bloodstream. Thus, it is suggested to wait 2 hours after drinking before nursing or pumping. In the case of infrequent binge drinking, it has been shown that infants consume through breastmilk only a fraction of the alcohol their mothers have ingested. While a minute, clinically insignificant amount of alcohol may be absorbed into the infant's bloodstream, it is unlikely that this amount would cause any noticeable cognitive or neuromotor effects.


title: Breastfeeding

text: The data on the use of marijuana during breastfeeding is limited, however, in part due to our lack of knowledge in this area, the CDC recommends against using marijuana or marijuana-containing products, including CBD, during breastfeeding. The main active ingredient in marijuana, tetrahydrocannabinol (THC), can be found in breastmilk anywhere from six days to more than six weeks after marijuana use. There is limited data on the long term effects of this exposure on the infant, however some studies have voiced concern regarding delayed motor development in infants exposed to THC.


title: Breastfeeding

text: Mothers utilizing recreational drugs, such as cocaine, methamphetamines, PCP, and heroin, should not breastfeed.


title: Breastfeeding

text: Most medications are compatible with continuing to breastfeed. Many medicines pass into breastmilk in small amounts, however, very few medications actually reach the infant and are absorbed in a way that would actually impact the infant. Several characteristics of medications, including size and pH of the medication molecule and how well the medication is absorbed in the GI tract, influence how much of a medication may reach, and may ultimately be absorbed, by the infant. In addition to the effects on the infant, many medications are known to significantly suppress milk production, including pseudoephedrine, diuretics, and contraceptives that contain estrogen.


title: Breastfeeding

text: There are several resources to assist medical professionals in determining which medications are safe for pregnancy and breastfeeding. While patients are able to use these resources as well, they are targeted toward medical professionals. Patients should be encouraged to consult a lactation specialist or a medical provider trained in breastfeeding medicine if any concerns arise. Two helpful resources are listed below.


title: Breastfeeding

text: "Pumping-and-dumping" is the concept of expressing breastmilk and discarding it due to a medication or substance "tainting" the breastmilk. It was once believed that drinking alcohol or taking any medications, even medicines like ibuprofen, required pumping-and-dumping. However, this is no longer the case. Pumping-and-dumping, or stopping breastfeeding altogether, is only required in very rare circumstances, such as with radioactive medications or chemotherapy.


title: Breastfeeding

text: If a parent is concerned with a possible milk contaminant, they can express and save the breastmilk until they are able to consult with a lactation specialist or another medical professional trained in breastfeeding medicine.


title: Breastfeeding

text: Galactosemia is a metabolic disorder that prevents the infant from breaking down galactose, which is one of the two components of lactose, a type of sugar found in milk. Lactose is also found in breastmilk, so infants with galactosemia should not breastfeed.


title: Breastfeeding

text: A mother may "express" her milk (remove milk from breasts) for storage and later use. Expression may occur manually with hand expression, or by using a breast pump.


title: Breastfeeding

text: Mothers express milk for multiple reasons. Expressing breast milk can maintain a mother's milk supply when she and her child are apart. A sick baby who is unable to nurse can take expressed milk through a nasogastric tube. Some babies are unable or unwilling to nurse. Maternal breastmilk is the food of choice for premature babies; these infants may be fed maternal milk through tubes, supplemental nursing systems, bottles, spoons or cups until they develop satisfactory ability to suck and swallow breast milk. Some women donate expressed breast milk (EBM) to others, either directly or through a milk bank. This allows mothers who cannot breastfeed to give their baby the benefits of breast milk. While informally-shared breastmilk does carry the nutritional benefits of breastmilk, this breastmilk is most often not pasteurized or screened, and thus carries with it the risk of transmitting diseases or medications that are unsafe for infants. Parents considering directed or informal milk sharing should discuss this option with their doctor, and they should be familiar with the donors medical history and milk handling practices. Use of informally-shared (unscreened, not pasteurized) milk from an anonymous donor is discouraged by the Academy of Breastfeeding Medicine.


title: Breastfeeding

text: Babies feed differently with artificial nipples than from a breast. With the breast, the infant's tongue massages the milk out rather than sucking, and the nipple does not go as far into the mouth. Drinking from a bottle takes less effort and the milk may come more rapidly, potentially causing the baby to lose desire for the breast. This is often referred to as "nipple confusion" or "nipple preference". While some infants do experience this preference for the bottle, many infants do not and will be able to alternate between bottle and breast without issue.


title: Breastfeeding

text: "Exclusively expressing" and "exclusively pumping" are terms for a mother who exclusively feeds her baby expressed milk. Exclusively pumping is poorly studied in the literature, especially in recent years. However, from available evidence, it appears to be fairly uncommon, with only approximately 7% of study participants reporting exclusive pumping.


title: Breastfeeding

text: Breastmilk may be stored for various amounts of time depending on storage temperature and conditions. The content and quality of expressed milk changes over time as it is stored, particularly when frozen. For example, there is a decrease in the ability of breastmilk to kill bacteria when it is stored in the refrigerator for more than 48 hours. Additionally, the quantity of fat, protein, and calories in breastmilk decreases when the milk is frozen for more than 3 months. While several components of breastmilk change over time, inflammatory factors (cytokines) and maternal antibodies, and growth factors are thought to be stable for at least 6 months when the breastmilk is frozen. Storage guidelines, according to the CDC, La Leche League International and the Academy of Breastfeeding Medicine, are noted in the table below.


title: Breastfeeding

text: Expressed breastmilk can be stored in freezer storage bags, containers made specifically for breastmilk, a supplemental nursing system, or a bottle ready for use. Parents should avoid using storage containers which contain bisphenol A (BPA). Additionally, use of polyethylene containers have been shown to decrease the immune benefits of breastmilk, including its ability to kill bacteria and the maternal antibodies it contains, by up to 60%.


title: Breastfeeding

text: It is not only the mother who may breastfeed her child. She may hire another woman to do so (a wet nurse), or she may share childcare with another mother (cross-nursing). Both of these were common throughout history. It remains popular in some developing nations, including those in Africa, for more than one woman to breastfeed a child. Shared breastfeeding is a risk factor for HIV infection in infants. Shared nursing can sometimes provoke negative social reactions in the English-speaking world.


title: Breastfeeding

text: It is possible for a mother to continue breastfeeding an older sibling while also breastfeeding a new baby; this is called "tandem nursing". During the late stages of pregnancy, the milk changes to colostrum. While some children continue to breastfeed even with this change, others may wean. Most mothers can produce enough milk for tandem nursing, but the new baby should be nursed first for at least the first few days after delivery to ensure that it receives enough colostrum.


title: Breastfeeding

text: Breastfeeding triplets or larger broods is a challenge given babies' varying appetites. Breasts can respond to the demand and produce larger milk quantities; mothers have breastfed triplets successfully.


title: Breastfeeding

text: Re-lactation is the process of restarting breastfeeding. In developing countries, mothers may restart breastfeeding after a weaning as part of an oral rehydration treatment for diarrhea. In developed countries, re-lactation is common after early medical problems are resolved, or because a mother changes her mind about breastfeeding.


title: Breastfeeding

text: Re-lactation is most easily accomplished with a newborn or with a baby that was previously breastfeeding; if the baby was initially bottle-fed, the baby may refuse to suckle. If the mother has recently stopped breastfeeding, she is more likely to be able to re-establish her milk supply, and more likely to have an adequate supply. Although some women successfully re-lactate after months-long interruptions, success is higher for shorter interruptions.


title: Breastfeeding

text: Techniques to promote lactation use frequent attempts to breastfeed, extensive skin-to-skin contact with the baby, and frequent, long pumping sessions. Suckling may be encouraged with a tube filled with infant formula, so that the baby associates suckling at the breast with food. A dropper or syringe without the needle may be used to place milk onto the breast while the baby suckles. The mother should allow the infant to suckle at least ten times during 24 hours, and more times if he or she is interested. These times can include every two hours, whenever the baby seems interested, longer at each breast, and when the baby is sleepy when he or she might suckle more readily. In keeping with increasing contact between mother and child, including increasing skin-to-skin contact, grandmothers should pull back and help in other ways. Later on, grandmothers can again provide more direct care for the infant.


title: Breastfeeding

text: These techniques require the mother's commitment over a period of weeks or months. However, even when lactation is established, the supply may not be large enough to breastfeed exclusively. A supportive social environment improves the likelihood of success. As the mother's milk production increases, other feeding can decrease. Parents and other family members should watch the baby's weight gain and urine output to assess nutritional adequacy.


title: Breastfeeding

text: A WHO manual for physicians and senior health workers citing a 1992 source states: "If a baby has been breastfeeding sometimes, the breastmilk supply increases in a few days. If a baby has stopped breastfeeding, it may take 1–2 weeks or more before much breastmilk comes."


title: Breastfeeding

text: Induced lactation, also called "adoptive lactation", is the process of starting breastfeeding in a woman who did not give birth. This usually requires the adoptive mother to take hormones and other drugs to stimulate breast development and promote milk production. In some cultures, breastfeeding an adoptive child creates milk kinship that builds community bonds across class and other hierarchal bonds.


title: Breastfeeding

text: Support for breastfeeding is universal among major health and children's organizations. WHO states, "Breast milk is the ideal food for the healthy growth and development of infants; breastfeeding is also an integral part of the reproductive process with important implications for the health of mothers."


title: Breastfeeding

text: Breastfeeding is associated with a lowered risk of a number of diseases in both mothers and babies. Comparing infants that were exclusively breastfed for at least 3 months with never-breastfed infants, the American Academy of Pediatrics reported that in the first year of life breastfed babies averaged about $400 in savings of health care costs.


title: Breastfeeding

text: Early breastfeeding is associated with fewer nighttime feeding problems. Early skin-to-skin contact between mother and baby improves breastfeeding outcomes and increases cardio-respiratory stability. Some studies show that breastfeeding aids general health, growth and development in the infant. Infants who are not breastfed are at mildly increased risk of developing acute and chronic diseases, including lower respiratory infection, ear infections, bacteremia, bacterial meningitis, botulism, urinary tract infection and necrotizing enterocolitis. Breastfeeding may protect against sudden infant death syndrome, insulin-dependent diabetes mellitus, Crohn's disease, ulcerative colitis, childhood lymphoma, allergic diseases, digestive diseases, obesity, or childhood leukemia later in life. and may enhance cognitive development. The CDC reports that infants who are breastfed have reduced risks of ear infections, obesity, type 1 diabetes, asthma, SIDS, and lower respiratory, and gastrointestinal infections.


title: Breastfeeding

text: It is hard however to distinguish the importance of breastfeeding per se and other correlated socioeconomic factors (breastfeeding is more frequent in richer families with higher educations). Comparing breastfed and non-breastfed siblings in a given family drastically decreases the association between breastfeeding and long-term child well-being.


title: Breastfeeding

text: The average breastfed baby doubles its birth weight in 5–6 months. By one year, a typical breastfed baby weighs about times its birth weight. At one year, breastfed babies tend to be leaner than formula-fed babies, which improves long-run health.


title: Breastfeeding

text: The Davis Area Research on Lactation, Infant Nutrition and Growth (DARLING) study reported that breastfed and formula-fed groups had similar weight gain during the first 3 months, but the breastfed babies began to drop below the median beginning at 6 to 8 months and were significantly lower weight than the formula-fed group between 6 and 18 months. Length gain and head circumference values were similar between groups, suggesting that the breastfed babies were leaner.


title: Breastfeeding

text: Breast milk contains several anti-infective factors such as bile salt stimulated lipase (protecting against amoebic infections) and lactoferrin (which binds to iron and inhibits the growth of intestinal bacteria).


title: Breastfeeding

text: Exclusive breastfeeding until six months of age helps to protect an infant from gastrointestinal infections in both developing and industrialized countries. The risk of death due to diarrhea and other infections increases when babies are either partially breastfed or not breastfed at all. Infants who are exclusively breastfed for the first six months are less likely to die of gastrointestinal infections than infants who switched from exclusive to partial breastfeeding at three to four months.


title: Breastfeeding

text: During breastfeeding, approximately 0.25–0.5 grams per day of secretory IgA antibodies pass to the baby via milk. This is one of the important features of colostrum. The main target for these antibodies are probably microorganisms in the baby's intestine. The rest of the body displays some uptake of IgA, but this amount is relatively small.


title: Breastfeeding

text: Maternal vaccinations while breastfeeding is safe for almost all vaccines. Additionally, the mother's immunity obtained by vaccination against tetanus, diphtheria, whooping cough and influenza can protect the baby from these diseases, and breastfeeding can reduce fever rate after infant immunization. However, smallpox and yellow fever vaccines increase the risk of infants developing vaccinia and encephalitis.


title: Breastfeeding

text: The World Health Organization reports that babies who receive no breast milk are almost six times more likely to die by the age of one month than those who are partially or fully breastfed. Access to healthcare is the single critical determinant of survival or death for the infant.


title: Breastfeeding

text: The protective effect of breastfeeding against obesity is consistent, though small, across many studies. A 2013 longitudinal study reported less obesity at ages two and four years among infants who were breastfed for at least four months.


title: Breastfeeding

text: In children who are at risk for developing allergic diseases (defined as at least one parent or sibling having atopy), atopic syndrome can be prevented or delayed through 4-month exclusive breastfeeding, though these benefits may not persist.


title: Breastfeeding

text: Breastfeeding or introduction of gluten while breastfeeding don't protect against celiac disease among at-risk children. Breast milk of healthy human mothers who eat gluten-containing foods presents high levels of non-degraded gliadin (the main gluten protein). Early introduction of traces of gluten in babies to potentially induce tolerance doesn't reduce the risk of developing celiac disease. Delaying the introduction of gluten does not prevent, but is associated with a delayed onset of the disease.


title: Breastfeeding

text: About 14 to 19 percent of leukemia cases may be prevented by breastfeeding for six months or longer. However, breastfeeding is also the primary cause of adult T-cell leukemia/lymphoma, as the HTLV-1 virus is transmitted through breastmilk.


title: Breastfeeding

text: Breastfeeding is associated with a lower chance of developing diabetes mellitus type 1 in the offspring. Breastfed babies also appear to have a lower likelihood of developing diabetes mellitus type 2 later in life.


title: Breastfeeding

text: Breastfeeding may decrease the risk of cardiovascular disease in later life, as indicated by lower cholesterol and C-reactive protein levels in breastfed adult women. Breastfed infants have somewhat lower blood pressure later in life, but it is unclear how much practical benefit this provides.


title: Breastfeeding

text: A 1998 study suggested that breastfed babies have a better chance of good dental health than formula-fed infants because of the developmental effects of breastfeeding on the oral cavity and airway. It was thought that with fewer malocclusions, breastfed children may have a reduced need for orthodontic intervention. The report suggested that children with a well rounded, "U-shaped" dental arch, which is found more commonly in breastfed children, may have fewer problems with snoring and sleep apnea in later life. A 2016 review found that breastfeeding protected against malocclusions.


title: Breastfeeding

text: Breastfeeding duration has been correlated with child maltreatment outcomes, including neglect and sexual abuse.


title: Breastfeeding

text: It is unclear whether breastfeeding improves intelligence later in life. Several studies found no relationship after controlling for confounding factors like maternal intelligence (smarter mothers were more likely to breastfeed their babies). However, other studies concluded that breastfeeding was associated with increased cognitive development in childhood, although the cause may be increased mother–child interaction rather than nutrition.


title: Breastfeeding

text: Oxytocin, a hormone released during breastfeeding, may play a role in maternal-infant attachment and bonding, potentially via decreased anxiety and stress.


title: Breastfeeding

text: Exclusive breastfeeding usually delays the return of fertility through lactational amenorrhea, although it does not provide reliable birth control. Breastfeeding may delay the return to fertility for some women by suppressing ovulation. Mothers may not ovulate, or have regular periods, during the entire lactation period. The non-ovulating period varies by individual. This has been used as natural contraception, with greater than 98% effectiveness during the first six months after birth if specific nursing behaviors are followed.


title: Breastfeeding

text: During the third stage of labor, the time between the delivery of the baby and the passage of the placenta, and the fourth, the final stage of birth, excessive blood loss can endanger the life of the mother. When the newborn nurses the mother secretes oxytocin which causes the uterus to cramp and reduce blood loss. Nursing also causes the uterus to cramp for a number of days postpartum, helping it to return to its pre-pregnancy size. Some women report moderate to severe pain, especially women who have given birth several times, during a nursing session for the first few days following delivery.


title: Breastfeeding

text: It is unclear whether breastfeeding causes mothers to lose weight after giving birth. The National Institutes of Health states that it may help with weight loss.


title: Breastfeeding

text: Breastfeeding is also associated with a lower risk of type 2 diabetes among mothers who practice it. Longer duration of breastfeeding is associated with reduced risk of hypertension.


title: Breastfeeding

text: For breastfeeding women, long-term health benefits include reduced risk of breast cancer, ovarian cancer, and endometrial cancer. According to the American Heart Association, breastfeeding also reduces the risk of maternal heart disease and stroke.


title: Breastfeeding

text: A 2011 review found it unclear whether breastfeeding affects the risk of postpartum depression. Later reviews have found tentative evidence of a lower risk among mothers who successfully breastfeed, though it is unknown whether breastfeeding decreases depression, or whether depression decreases breastfeeding.


title: Breastfeeding

text: Dysphoric milk ejection reflex (D-MER) is a condition in which breastfeeding women develop negative emotions that begin just before the milk letdown reflex and last less than a few minutes.


title: Breastfeeding

text: It may recur with every letdown, including unexpected letdowns when the baby is not feeding. It presents as an emotional reaction but may also produce physical feelings such as nausea. It is different from postpartum depression and other known psychological conditions. A 2019 study reported a prevalence rate of 9.1%. As off 2021, very little research has been done and many health care providers and lactation practitioners remain barely able to recognize the syndrome. An October 2021 review of literature published to that date suggested that the lack of up-to-date information "makes it necessary to educate mothers because educated mothers are usually better at handling postpartum situations if they are prepared in advance." There is as yet no medication to treat the symptoms although women have reported that they have found it of benefit to learn that they are not alone and that the symptoms were not "just in their head".


title: Breastfeeding

text: The majority of mothers intend to breastfeed at birth. Many factors can disrupt this intent. Research done in the US shows that information about breastfeeding is rarely provided by a women's obstetricians during their prenatal visits and some health professionals incorrectly believe that commercially prepared formula is nutritionally equivalent to breast milk. Many hospitals have instituted practices that encourage breastfeeding, however a 2012 survey in the US found that 24% of maternity services were still providing supplements of commercial infant formula as a general practice in the first 48 hours after birth. "The Surgeon General's Call to Action to Support Breastfeeding" attempts to educate practitioners.


title: Breastfeeding

text: A review found that when effective forms of support are offered to women, exclusive breastfeeding and duration of breastfeeding are increased. Characteristics of effective support includes ongoing, face-to-face support tailored to fit their needs. It may be offered by lay/peer supporters, professional supporters, or a combination of both. This review contrasts with another large review that looked at education programs alone, which found no conclusive evidence of initiation of breastfeeding or the proportion of women breastfeeding either exclusively or partially at 3 months and 6 months.


title: Breastfeeding

text: Positive social support in essential relationships of new mothers plays a central role in the promotion of breastfeeding outside of the confines of medical centers. Social support can come in many incarnations, including tangible, affectionate, social interaction, and emotional and informational support. An increase in these capacities of support has shown to greatly positively effect breastfeeding rates, especially among women with education below a high school level.


title: Breastfeeding

text: Some mothers that have used lactation rooms have taken to leaving sticky notes to not only thank the businesses that have provided them but to support, encourage, and praise the nursing moms who use them.


title: Breastfeeding

text: In the social circles surrounding the mother, support is most crucial from the male partner, the mother's mother, and her family and friends. Research has shown that the closest relationships to the mother have the strongest impact on breastfeeding rates, while negative perspectives on breastfeeding from close relatives hinder its prevalence.


title: Breastfeeding

text: Work is the most commonly cited reason for not breastfeeding. In 2012 Save the Children examined maternity leave laws, ranking 36 industrialized countries according to their support for breastfeeding. Norway ranked first, while the United States came in last. Maternity leave in the US varies widely, including by state. The United States does not mandate paid maternity leave for any employee however the Family Medical Leave Act (FMLA) guarantees qualifying mothers up to 12 weeks unpaid leave although the majority of US mothers resume work earlier. A large 2011 study found that women who returned to work at or after 13 weeks after childbirth were more likely to predominantly breastfeed beyond three months.


title: Breastfeeding

text: Women are less likely to start breastfeeding after caesarean delivery compared with vaginal delivery.


title: Breastfeeding

text: Breastfeeding can generally be attempted after breast augmentation or reduction surgery, however prior breast surgery is a risk factor for low milk supply.


title: Breastfeeding

text: A 2014 review found that women who have breast implant surgery were less likely to exclusively breast feed, however it was based on only three small studies and the reasons for the correlation were not clear.


title: Breastfeeding

text: A large follow-up study done in 2014 found a reduced rate of breastfeeding in women who had undergone breast augmentation surgery, however again the reasons were unclear. The authors suggested that women contemplating augmentation should be provided with information related to the rates of successful breastfeeding as part of informed decision making when contemplating surgery.


title: Breastfeeding

text: Prior breast reduction surgery is strongly associated with an increased probability of low milk supply due to disruption to tissues and nerves. Some surgical techniques for breast reduction appear to be more successful than others in preserving the tissues that generate and channel milk to the nipple. A 2017 review found that women were more likely to have success with breastfeeding with these techniques.


title: Breastfeeding

text: Transgender persons can attempt breastfeeding even after top surgery, which is a possible sex reassignment surgery. Mammary tissue regrowth and lactation can occur for transgender individuals who wish to breastfeed their infants.


title: Breastfeeding

text: Breastfeeding mothers should inform their healthcare provider about all of the medications they are taking, including herbal products. Nursing mothers may be immunized and may take most over-the-counter drugs and prescription drugs without risk to the baby but certain drugs, including some painkillers and some psychiatric drugs, may pose a risk.


title: Breastfeeding

text: The US National Library of Medicine publishes "LactMed," an up-to-date online database of information on drugs and lactation. Geared to both healthcare practitioners and nursing mothers, LactMed contains over 450 drug records with information such as potential drug effects and alternative drugs to consider.


title: Breastfeeding

text: Some substances in the mother's food and drink are passed to the baby through breast milk, including mercury (found in some carnivorous fish), caffeine, and bisphenol A.


title: Breastfeeding

text: Undiagnosed maternal celiac disease may cause a short duration of the breastfeeding period. Treatment with the gluten-free diet can increase its duration and restore it to the average value of the healthy women.


title: Breastfeeding

text: Mothers with all types of diabetes mellitus normally use insulin to control their blood sugar, as the safety of other antidiabetic drugs while breastfeeding is unknown.


title: Breastfeeding

text: Women with polycystic ovary syndrome, which is associated with some hormonal differences and obesity, may have greater difficulty with producing a sufficient supply to support exclusive breastfeeding, especially during the first weeks.


title: Breastfeeding

text: The rates of breastfeeding in the African-American community remain much lower than any other race, for a variety of proposed reasons. These include the legacy of wet nursing during slavery, higher rates of poor perinatal health, higher stress levels, less access to support, and less flexibility in the workplace. While for other races as socio-economic class raises rates of breastfeeding also go up, for the African-American community breastfeeding rates remain consistently low regardless of socio-economic class.


title: Breastfeeding

text: There are also racial disparities in access to maternity care practices that support breastfeeding. In the US, primarily African-American neighborhoods are more likely to have facilities (such as hospitals and female healthcare clinics) that do not support breastfeeding, contributing to the low rate of breastfeeding in the African-American community. Comparing facilities in primarily African American neighborhoods to ones in primarily White neighborhoods, the rates of practices that support or discourage breastfeeding were: limited use of supplements (13.1% compared with 25.8%) and rooming-in (27.7–39.4%)


title: Breastfeeding

text: Low-income mothers are more likely to have unintended pregnancies. Mothers whose pregnancies are unintended are less likely to breastfeed.


title: Breastfeeding

text: Especially the combination of powdered formula with unclean water can be very harmful to the health of babies. In the late 1970s, there was a boycott against Nestle due to the great number of baby deaths due to formula. Dr. Michele Barry explains that breastfeeding is most imperative in poverty environments due to the lack of access of clean water for the formula. The Lancet study in 2016 discovered that universal breastfeeding would prevent the deaths of 800,000 children as well as save $300,000,000.


title: Breastfeeding

text: Some women feel discomfort when breastfeeding in public. Public breastfeeding may be forbidden in some places, not addressed by law in others, and a legal right in others. Even given a legal right, some mothers are reluctant to breastfeed, while others may object to the practice.


title: Breastfeeding

text: The use of infant formula was thought to be a way for western culture to adapt to negative perceptions of breastfeeding. The breast pump offered a way for mothers to supply breast milk with most of formula feeding's convenience and without enduring possible disapproval of nursing. Some may object to breastfeeding because of the implicit association between infant feeding and sex. These negative cultural connotations may reduce breastfeeding duration.


title: Breastfeeding

text: Maternal guilt and shame is often affected by how a mother feeds her infant. These emotions occur in both bottle- and breast- feeding mothers, although for different reasons. Bottle feeding mothers may feel that they should be breastfeeding. Conversely, breastfeeding mothers may feel forced to feed in uncomfortable circumstances. Some may see breastfeeding as, "indecent, disgusting, animalistic, sexual, and even possibly a perverse act." Advocates (known by the neologism "lactivists") use "nurse-ins" to show support for breastfeeding in public. One study that approached the subject from a feminist viewpoint suggested that both nursing and non-nursing mothers often feel maternal guilt and shame with formula feeding mothers feeling that they are not living up to the ideals of woman and motherhood and nursing mothers concerned that they are transgressing "cultural expectations regarding feminine modesty." The authors advocate that women be provided with education on breastfeeding's benefits as well as problem-solving skills, however there is no conclusive evidence that breastfeeding education alone improves initiation of breastfeeding or the proportion of women breastfeeding either exclusively or partially at 3 months and 6 months.


title: Breastfeeding

text: All 50 states, the District of Columbia, Puerto Rico and the Virgin Islands have laws that allow a mother to breastfeed her baby in any public or private location. In the United States, the Friendly Airports for Mothers (FAM) Act was signed into law in 2019 and the requirements went into effects in 2021. This law requires all large and medium hub airports must provide a private, non-bathroom lactation space in each terminal building.


title: Breastfeeding

text: Some commercial establishments provide breastfeeding rooms, although laws generally specify that mothers may breastfeed anywhere, without requiring a special area. Despite these laws, many women in the United States continue to be publicly shamed or asked to refrain from breastfeeding in public. In the United Kingdom, the Equality Act 2010 makes the prevention of a woman breastfeeding in any public place discrimination under the law. In Scotland, it is a criminal offense to try to prevent a woman feeding a child under 24 months in public.


title: Breastfeeding

text: While laws in the U.S. that passed in 2010 which required that nursing mothers who had returned to work be given a non-bathroom space to express milk and a reasonable break time to do so, as of 2016 the majority of women still did not have access to both accommodations.


title: Breastfeeding

text: In 2014, newly elected Pope Francis drew worldwide commentary when he encouraged mothers to breastfeed babies in church. During a papal baptism, he said that mothers "should not stand on ceremony" if their children were hungry. "If they are hungry, mothers, feed them, without thinking twice," he said, smiling. "Because they are the most important people here."


title: Breastfeeding

text: Globally, about 38% of babies are exclusively breastfed during their first six months of life. In the United States, the rate of women beginning to breastfeed was 76% in 2009 increasing to 83% in 2015 with 58% still breastfeeding at 6 months, although only 25% were still breastfeeding exclusively. African-American women have persistently low rates of breastfeeding compared to White and Hispanic American women. In 2014, 58.1% of African-American women breastfeed in the early postpartum period, compared to 77.7% of White women and 80.6% of Hispanic women. In 2019, 84.1% of U.S women giving birth initiated breastfeeding, with 87.4%, 85.5%, 73.6%, 90.3% and 83.1% of Hispanic, White, African-American, Asian and Multiracial mothers initiating, respectively. Rates of initiation among African-American mothers varied widely by state, with lows under 53% and highs over 90%.


title: Breastfeeding

text: Rates in the United Kingdom were the lowest in the world in 2015 with only 0.5% of mothers still breastfeeding at a year, while in Germany 23% are doing so, 56% in Brazil and 99% in Senegal.


title: Breastfeeding

text: In Australia, for children born in 2004, more than 90% were initially breastfed. In Canada for children born in 2005–06, more than 50% were only breastfed and more than 15% received both breastmilk and other liquids, by the age of 3 months.


title: Breastfeeding

text: In the Egyptian, Greek and Roman Empires, women usually fed only their own children. However, breastfeeding began to be seen as something too common to be done by royalty, and wet nurses were employed to breastfeed the children of the royal families. This extended over time, particularly in western Europe, where noble women often made use of wet nurses. Lower-class women breastfed their infants and used a wet nurse only if they were unable to feed their own infant. Attempts were made in 15th-century Europe to use cow or goat milk, but these attempts were not successful. In the 18th century, flour or cereal mixed with broth were introduced as substitutes for breastfeeding, but this provided inadequate nutrition. The appearance of improved infant formulas in the mid 19th century and its increased use caused a decrease in breastfeeding rates, which accelerated after World War II, and for some in the US, Canada, and UK, breastfeeding was seen as uncultured. From the 1960s onwards, breastfeeding experienced a revival which continued into the 2000s, though negative attitudes towards the practice were still entrenched in some countries up to 1990s.


title: Breastfeeding

text: In languages around the world, the word for "mother" is something like "mama". The linguist Roman Jakobson hypothesized that the nasal sound in "mama" comes from the nasal murmur that babies produce when breastfeeding.


title: Breastfeeding

text: Breastfeeding is less costly than alternatives, but the mother generally must eat more food than she would otherwise. In the US, the extra money spent on food (about US $ each week) is usually about half as much money as the cost of infant formula. According to the CDC, breastfeeding mothers need an extra 450 to 500 calories per day compared to their pre-pregnancy caloric intake.


title: Breastfeeding

text: Breastfeeding reduces health care costs and the cost of caring for sick babies. Parents of breastfed babies are less likely to miss work and lose income because their babies are sick. Looking at three of the most common infant illnesses, lower respiratory tract illnesses, otitis media, and gastrointestinal illness, one study compared infants that had been exclusively breastfed for at least three months to those who had not. It found that in the first year of life there were 2033 excess office visits, 212 excess days of hospitalization, and 609 excess prescriptions for these three illnesses per 1000 never-breastfed infants compared with 1000 infants exclusively breastfed for at least 3 months. However, in a study of over 140,000 newborns in the first month of life, exclusively breastfed newborns had higher hospital readmission rates than those exclusively formula fed, and those exclusively breastfed also had more neonatal outpatient visits compared to those exclusively formula fed.


title: Breastfeeding

text: There are controversies and ethical considerations surrounding the means used by public campaigns which attempt to increase breastfeeding rates, relating to pressure put on women, and potential feeling of guilt and shame of women who fail to breastfeed; and social condemnation of women who use formula. In addition to this, there is also the moral question as to what degree the state or medical community can interfere with the self-determination of a woman: for example in the United Arab Emirates the law requires a woman to breastfeed her baby for at least 2 years and allows her husband to sue her if she does not do so.


title: Breastfeeding

text: It is widely assumed that if women's healthcare providers encourage them to breastfeed, those who choose not to will experience more guilt. Evidence does not support this assumption. On the contrary, a study on the effects of prenatal breastfeeding counselling found that those who had received such counselling and chosen to formula-feed denied experiencing feelings of guilt. Women were equally comfortable with their subsequent choices for feeding their infant regardless of whether they had received encouragement to breastfeed.


title: Breastfeeding

text: Preventing a situation where women are denied agency and/or stigmatized for formula use is also seen as important. In 2018, in the UK, a policy statement from the Royal College of Midwives said that women should be supported and not stigmatized, if after being given advice and information, they choose to formula feed.


title: Breastfeeding

text: Social marketing is a marketing approach intended to change people's behavior to benefit both individuals and society. When applied to breastfeeding promotion, social marketing works to provide positive messages and images of breastfeeding to increase visibility. Social marketing in the context of breastfeeding has shown efficacy in media campaigns.


title: Breastfeeding

text: Some oppose the marketing of infant formula, especially in developing countries. They are concerned that mothers who use formula will stop breastfeeding and become dependent upon substitutes that are unaffordable or less safe. Through efforts including the Nestlé boycott, they have advocated for bans on free samples of infant formula and for the adoption of pro-breastfeeding codes such as the International Code of Marketing of Breast-milk Substitutes by the World Health Assembly in 1981 and the Innocenti Declaration by WHO and UNICEF policy-makers in August 1990. Additionally, formula companies have spent millions internationally on campaigns to promote the use of formula as an alternative to mother's milk. Giving out gift bags that contain infant formula to women as they leave the hospital is also a marketing strategy. The U.S. Government Accountability Office has reported that women who receive formula samples at discharge are associated with lower breastfeeding rates than those who did not receive gift bags.


title: Breastfeeding

text: The Baby Friendly Hospital Initiative (BFHI) is a program launched by the World Health Organization (WHO) in conjunction with UNICEF in order to promote infant feeding and maternal bonding through certified hospitals and birthing centers. BFHI was developed as a response to the influence held by formula companies in private and public maternal health care. The initiative has two core tenets: the Ten Steps to Successful Breastfeeding and the International Code of Marketing of Breast-milk Substitutes. The BFHI has especially targeted hospitals and birthing centers in the developing world, as these facilities are most at risk to the detrimental effects of reduced breastfeeding rates. As of 2018, 530 hospitals in the United States hold the "Baby-Friendly" title in all 50 states. Globally, there are more than 20,000 "Baby-Friendly" hospitals worldwide in over 150 countries.


title: Breastfeeding

text: The first depiction of breastfeeding on television was in the children's program "Sesame Street", in 1977. With few exceptions since that time, breastfeeding on television has either been portrayed as strange, disgusting, or a source of comedy, or it has been omitted entirely in favor of bottle feeding.


title: Breastfeeding

text: In some cultures, people who have been breastfed by the same woman are milk-siblings who are equal in legal and social standing to a consanguineous sibling. Islam has a complex system of rules regarding this, known as "Rada (fiqh)". Like the Christian practice of godparenting, milk kinship established a second family that could take responsibility for a child whose biological parents came to harm. "Milk kinship in Islam thus appears to be a culturally distinctive, but by no means unique, institutional form of adoptive kinship."


title: Breastfeeding

text: In Western countries, differences in breastfeeding practices have also been observed according to the affiliation or practice of Christian religions; unaffiliated and Protestant women exhibit higher rates of breastfeeding.


title: Breastfeeding

text: Many mothers have to return to work a short time after their babies have been born. In the U.S. about 70% of mothers with children younger than three years old work full-time with 1/3 of the mothers returning to work within 3 months and 2/3 returning within 6 months. Working outside of the home and full-time work are significantly associated with lower rates of breastfeeding and breastfeeding for a shorter duration of time.


title: Breastfeeding

text: According to the Centers for Disease Control and Prevention, support for breastfeeding in the workplace includes several types of employee benefits and services, including writing corporate policies to support breastfeeding women; teaching employees about breastfeeding; providing designated private space for breastfeeding or expressing milk; allowing flextime to support milk expression during work; giving mothers options for returning to work, such as remote work, part-time jobs, and extended maternity leave; providing on-site or near-site child care; providing high-quality breast pumps; and offering professional lactation consultants.


title: Breastfeeding

text: Programs to promote and assist nursing mothers have been found to help maintain breastfeeding. In the United States the CDC reports on a study that "examined the effect of corporate lactation programs on breastfeeding behavior among employed women in California [which] included prenatal classes, perinatal counseling, and lactation management after the return to work". They found that "about 75% of mothers in the lactation programs continued breastfeeding at least 6 months, although nationally only 10% of mothers employed full-time who initiated breastfeeding were still breastfeeding at 6 months."


title: Breastfeeding

text: The U.S. Patient Protection and Affordable Care Act which was passed in 2010 requires that all nursing mothers be given a non-bathroom space to express milk and a reasonable break time to do so, however as of 2016 the majority of women still do not have access to both accommodations. A 2016 study found: "1) federal law does not address lactation space functionality and accessibility, 2) federal law only protects a subset of employees, and 3) enforcement of the federal law requires women to file a complaint with the United States Department of Labor. To address each of these issues, we recommend the following modifications to current law: 1) additional requirements surrounding lactation space and functionality, 2) mandated coverage of exempt employees, and 3) requirement that employers develop company-specific lactation policies."


title: Breastfeeding

text: In Canada, British Columbia and Ontario, provincial Human Rights Codes prevent against workplace discrimination due to breastfeeding. In British Columbia, employers are required to provide accommodation to employees who breastfeed or express breast milk. Although no specific requirements are mandated, under the Human Rights Code, accommodations suggested include paid breaks (not including meal breaks), private facilities that include clean running water, comfortable seating areas, and refrigeration equipment, as well as flexibility in terms of work-related conflicts. In Ontario, employers are encouraged to accommodate breastfeeding employees by providing additional breaks without fear of discrimination. Unlike in British Columbia, the Ontario Code does not include specific recommendations, and therefore leaves significant flexibility for employers.


title: Breastfeeding

text: Breastfeeding research continues to assess prevalence, HIV transmission, pharmacology, costs, benefits, immunology, contraindications, and comparisons to synthetic breast milk substitutes. Factors related to the mental health of the nursing mother in the perinatal period have been studied. While cognitive behavior therapy may be the treatment of choice, medications are sometimes used. The use of therapy rather than medication reduces the infant's exposure to medication that may be transmitted through the milk. In coordination with institutional organisms, researchers are also studying the social impact of breastfeeding throughout history. Accordingly, strategies have been developed to foster the increase of the breastfeeding rates in the different countries.


title: Latvian language

text: Latvian ( ), also known as Lettish, is an Eastern Baltic language belonging to the Baltic branch of the Indo-European language family, spoken in the Baltic region. It is the language of Latvians and the official language of Latvia as well as one of the official languages of the European Union. There are about 1.3 million native Latvian speakers in Latvia and 100,000 abroad. Altogether, 2 million, or 80% of the population of Latvia, speak Latvian. Of those, around 1.16 million or 62% of Latvia's population use it as their primary language at home, however excluding the Latgale Region it is spoken as a native language in villages and towns by over 90% of the population.


title: Latvian language

text: As a Baltic language, Latvian is most closely related to neighboring Lithuanian (as well as Old Prussian, an extinct Baltic language); however Latvian has followed a more rapid development. In addition, there is some disagreement whether Latgalian and Kursenieki, which are mutually intelligible with Latvian, should be considered varieties or separate languages.


title: Latvian language

text: Latvian first appeared in print in the mid-16th century with the reproduction of the Lord's Prayer in Latvian in Sebastian Münster's (1544), in Latin script.


title: Latvian language

text: Latvian belongs to the Baltic branch of the Indo-European language family. It is one of two living Baltic languages with an official status (the other being Lithuanian). The Latvian and Lithuanian languages have retained many features of the nominal morphology of Proto-Indo-European, though their phonology and verbal morphology show many innovations (in other words, forms that did not exist in Proto-Indo-European), with Latvian being considerably more innovative than Lithuanian. However Latvian has been also influenced by the Livonian language. For example, Latvian borrowed first-syllable stress from Finno-Ugric languages.


title: Latvian language

text: According to some glottochronological speculations, the Eastern Baltic languages split from Western Baltic (or, perhaps, from the hypothetical proto-Baltic language) between 400 and 600 CE. The differentiation between Lithuanian and Latvian started after 800 CE, with a long period of being one language but different dialects. At a minimum, transitional dialects existed until the 14th century or 15th century, and perhaps as late as the 17th century.


title: Latvian language

text: Latvian as a distinct language emerged over several centuries from the language spoken by the ancient Latgalian tribe assimilating the languages of other neighbouring Baltic tribes—Curonian, Semigallian and Selonian—which resulted in these languages gradually losing their most distinct characteristics. This process of consolidation started in the 13th century after the Livonian Crusade and forced christianization, which formed a unified political, economic and religious space in Medieval Livonia.


title: Latvian language

text: The oldest known examples of written Latvian are from a 1530 translation of a hymn made by Nikolaus Ramm, a German pastor in Riga. The oldest preserved book in Latvian is a 1585 Catholic catechism of Petrus Canisius currently located at the Uppsala University Library.


title: Latvian language

text: The first person to translate the Bible into Latvian was the German Lutheran pastor Johann Ernst Glück (The New Testament in 1685 and The Old Testament in 1691). The Lutheran pastor Gotthard Friedrich Stender was a founder of Latvian secular literature. He wrote the first illustrated Latvian alphabet book (1787) and the first encyclopedia “The Book of High Wisdom of the World and Nature” (; 1774), grammar books and Latvian–German and German–Latvian dictionaries.


title: Latvian language

text: Until the 19th century, the Latvian written language was influenced by German Lutheran pastors and the German language, because the upper class of local society was formed by Baltic Germans. In the middle of the 19th century the First Latvian National Awakening was started, led by “Young Latvians” who popularized the use of Latvian language. Participants in this movement laid the foundations for standard Latvian and also popularized the Latvianization of loan words. However, in the 1880s, when Czar Alexander III came into power, Russification started. During this period, some Latvian scholars suggested adopting Cyrillic for use in Latvian.


title: Latvian language

text: According to the 1897 Imperial Russian Census, there were 505,994 (75.1%) speakers of Latvian in the Governorate of Courland and 563,829 (43.4%) speakers of Latvian in the Governorate of Livonia, making Latvian-speakers the largest linguistic group in each of the governorates.


title: Latvian language

text: After the czar's death, around the start of the 20th century, nationalist movements re-emerged. In 1908, Latvian linguists Kārlis Mīlenbahs and Jānis Endzelīns elaborated the modern Latvian alphabet, which slowly replaced the old orthography used before. Another feature of the language, in common with its sister language Lithuanian, that was developed at that time is that proper names from other countries and languages are altered phonetically to fit the phonological system of Latvian, even if the original language also uses the Latin alphabet. Moreover, the names are modified to ensure that they have noun declension endings, declining like all other nouns. For example, a place such as Lecropt (a Scottish parish) is likely to become Lekropta; the Scottish village of Tillicoultry becomes Tilikutrija.


title: Latvian language

text: During the Soviet time (1940–1991), the policy of Russification greatly affected the Latvian language. Throughout this period, many Latvians and people of Latvia's other ethnicities faced deportation and persecution. Massive immigration from the Soviet republics of Russia, Ukraine, Belarus and others followed, largely as a result of Stalin's plan to integrate Latvia and the other Baltic republics into the Soviet Union by means of Russian colonization. As a result, the proportion of the ethnic Latvian population within the total population was reduced from 80% in 1935 to 52% in 1989. In Soviet Latvia, most of the immigrants who settled in the country did not learn Latvian. According to the 2011 census Latvian was the language spoken at home by 62% of the country's population.


title: Latvian language

text: After the re-establishment of independence in 1991, a new policy of language education was introduced. The primary declared goal was the integration of all inhabitants into the environment of the official state language while protecting the languages of Latvia's ethnic minorities.


title: Latvian language

text: Government-funded bilingual education was available in primary schools for ethnic minorities until 2019 when Parliament decided on educating only in Latvian. Minority schools are available for Russian, Yiddish, Polish, Lithuanian, Ukrainian, Belarusian, Estonian and Roma schools. Latvian is taught as a second language in the initial stages too, as is officially declared, to encourage proficiency in that language, aiming at avoiding alienation from the Latvian-speaking linguistic majority and for the sake of facilitating academic and professional achievements. Since the mid-1990s, the government may pay a student's tuition in public universities only provided that the instruction is in Latvian. Since 2004, the state mandates Latvian as the language of instruction in public secondary schools (Form 10–12) for at least 60% of class work (previously, a broad system of education in Russian existed).


title: Latvian language

text: The Official Language Law was adopted on 9 December 1999. Several regulatory acts associated with this law have been adopted. Observance of the law is monitored by the State Language Centre run by the Ministry of Justice.


title: Latvian language

text: To counter the influence of Russian and English, government organizations (namely the Terminology Commission of the Latvian Academy of Science and the State Language Center) popularize the use of Latvian terms. A debate arose over the Latvian term for euro. The Terminology Commission suggested or , with their Latvianized and declinable ending, would be a better term for euro than the widely used , while European Central Bank insisted that the original name "euro" be used in all languages. New terms are Latvian derivatives, calques or new loanwords. For example, Latvian has two words for "telephone"— and , the former being a direct translation into Latvian of the latter international term. Still, others are older or more euphonic loanwords rather than Latvian words. For example, "computer" can be either , . Both are loanwords; the native Latvian word for "computer" is , which is also an official term. However, now has been considered an appropriate translation, is also used.


title: Latvian language

text: There are several contests held annually to promote the correct use of Latvian. One of them is "Word of the year" () organized by the Riga Latvian Society since 2003. It features categories such as the "Best word", "Worst word", "Best saying" and "Word salad". In 2018 the word (instant payment) won the category of "Best word" and (influencer) won the category of "Worst word". The word pair of (stream) and (streaming) were named the best words of 2017, while as an unnecessary plural of the name for transport was chosen as the worst word of 2017.


title: Latvian language

text: There are three dialects in Latvian: the Livonian dialect, High Latvian and the Middle dialect. Latvian dialects and their varieties should not be confused with the Livonian, Curonian, Semigallian and Selonian languages.


title: Latvian language

text: The Livonian dialect of Latvian was more affected by the Livonian language substratum than Latvian in other parts of Latvia. It is divided into the Vidzeme variety and the Courland variety (also called "tāmnieku"). There are two syllable intonations in the Livonian dialect, extended and broken. In the Livonian dialect, short vowels in the endings of words are discarded, while long vowels are shortened. In all genders and numbers, only one form of the verb is used. Personal names in both genders are derived with endings – els, -ans. In prefixes "ie" is changed to "e". Due to migration and the introduction of a standardised language this dialect has declined. It arose from assimilated Livonians, who started to speak in Latvian and assimilated Livonian grammar into Latvian. There are no remaining native speakers of the Livonian language as the last native speaker Grizelda Kristiņa died in 2013, despite the Latvian Government attempts to preserve the dialect following the restoration of independence in 1990 and currently it is learned by some people only as a hobby.


title: Latvian language

text: The Middle dialect spoken in central and Southwestern Latvia is the basis of standard Latvian. The dialect is divided into the Vidzeme variety, the Curonian variety and the Semigallian variety. The Vidzeme variety and the Semigallian variety are closer to each other than to the Curonian variety, which is more archaic than the other two. There are three syllable intonations in some parts of Vidzeme variety of the Middle dialect, extended, broken and falling. The Curonian and Semigallian varieties have two syllable intonations, extended and broken, but some parts of the Vidzeme variety has extended and falling intonations. In the Curonian variety, "ŗ" is still used. The Kursenieki language, which used to be spoken along Curonian Spit, is closely related to the varieties of the Middle dialect spoken in Courland.


title: Latvian language

text: Upper Latvian dialect is spoken in Eastern Latvia. It is set apart from the rest of the Latvian by a number of phonetic differences. The dialect has two main varieties – Selonian (two syllable intonations, falling and rising) and Non-Selonian (falling and broken syllable intonations). There is a standard language, the Latgalian language, which is based on deep non-Selonian varieties spoken in the south of Latgale. The term "Latgalian" is sometimes also applied to all non-Selonian varieties or even the whole dialect. However, it is unclear if it is accurate to use the term for any varieties besides the standard language. While the term may refer to varieties spoken in Latgale or by Latgalians, not all speakers identify as speaking Latgalian, for example, speakers of deep Non-Selonian varieties in Vidzeme explicitly deny speaking Latgalian. It is spoken by approximately 15% of Latvia's population, however almost all of its speakers are also fluent in the standard Latvian language and they promote the dialect in popular culture in order to preserve their distinct culture. The Latvian Government since 1990 has also taken measures to protect the dialect from extinction.


title: Latvian language

text: The history of the Latvian language (see below) has placed it in a peculiar position for a language of its size whereby it is spoken by a large number of non-native speakers as compared to native speakers. The immigrant and minority population in Latvia is 700,000 people: Russians, Belarusians, Ukrainians, Poles, and others. The majority of immigrants came to Latvia between 1940 and 1991; supplementing pre-existing ethnic minority communities (Latvian Germans, Latvian Jews). The trends show that the proficiency of Latvian among its non-native speakers is gradually increasing. In a 2009 survey by Latvian Language Agency 56% percent of respondents with Russian as their native language described having a good knowledge of Latvian, whereas for the younger generation (from 17 to 25 years) the number was 64%.


title: Latvian language

text: The increased adoption of Latvian by minorities was brought about by its status as the only official language of the country and other changes in the society after the fall of the Soviet Union that mostly shifted linguistic focus away from Russian. As an example, in 2007, universities and colleges for the first time received applications from prospective students who had a bilingual secondary education in schools for minorities. Fluency in Latvian is expected in a variety of professions and careers.


title: Latvian language

text: Latvian grammar represents a classic Indo-European (Baltic) system with well-developed inflection and derivation. Primary word stress, with some exceptions in derivation and inflection, is on the first syllable. There are no articles in Latvian; definiteness is expressed by an inflection of adjectives. Basic word order in Latvian is subject–verb–object; however, word order is relatively free.


title: Latvian language

text: There are two grammatical genders in Latvian (masculine and feminine) and two numbers, singular and plural. Nouns, adjectives, and declinable participles decline into seven cases: nominative, genitive, dative, accusative, instrumental, locative, and vocative. There are six declensions for nouns.


title: Latvian language

text: There are three conjugation classes in Latvian. Verbs are conjugated for person, tense, mood and voice.


title: Latvian language

text: Latvian in Latin script was first based upon the German orthography, while the alphabet of the Latgalian dialect was based on the Polish orthography. At the beginning of the 20th century, it was replaced by a more phonologically consistent orthography.


title: Latvian language

text: The modern standard Latvian alphabet uses 22 unmodified letters of the Latin alphabet (all except ). It adds a further eleven characters by modification. The vowel letters , , and can take a macron to show length, unmodified letters being short; these letters are not differentiated while sorting (e.g. in dictionaries). The letters , and are pronounced , and respectively, while when marked with a caron, , they are pronounced , and respectively. The letters , written with a comma placed underneath (or above them for lowercase "g"), which indicate palatalized versions of representing the sounds , , and . Latvian orthography also contains nine digraphs, which are written . Non-standard varieties of Latvian add extra letters to this standard set.


title: Latvian language

text: Latvian spelling has almost one-to-one correspondence between graphemes and phonemes. Every phoneme corresponds to a letter so that the reader can almost always pronounce words by putting the letters together. There are only two exceptions to this consistency in the orthography: the letters represent two different sounds: /ɛ æ/ and /ɛː æː/. The second mismatch is that letter indicates both the short and long , and the diphthong . These three sounds are written as , and in Latgalian, and some Latvians campaign for the adoption of this system in standard Latvian. However, Latvian grammarians argue that and are found only in loanwords, with the /uo/ sound being the only native Latvian phoneme. The digraph was discarded in 1914, and the letters and have not been used in the official Latvian language since 1946. Likewise, the digraph was discarded in 1957, although , , and are still used in some varieties and by many Latvians living beyond the borders of Latvia. The letter is used only in Latgalian, where it represents , a sound not present in other dialects.


title: Latvian language

text: The old orthography was based on that of German and did not represent the Latvian language phonemically. At the beginning, it was used to write religious texts for German priests to help them in their work with Latvians. The first writings in Latvian were chaotic: there were twelve variations of writing "Š". In 1631 the German priest Georg Mancelius tried to systematize the writing. He wrote long vowels according to their position in the word – a short vowel followed by "h" for a radical vowel, a short vowel in the suffix and vowel with a diacritic mark in the ending indicating two accents. Consonants were written following the example of German with multiple letters. The old orthography was used until the 20th century when it was slowly replaced by the modern orthography.


title: Latvian language

text: In late 1992 the official Latvian computing standard LVS 8-92 took effect. It was followed by LVS 24-93 (Latvian language support for computers) that also specified the way Latvian language (alphabet, numbers, currency, punctuation marks, date and time) should be represented on computers. A Latvian ergonomic keyboard standard LVS 23-93 was also announced several months later, but it didn't gain popularity due to its need for a custom-built keyboard.


title: Latvian language

text: Nowadays standard QWERTY or the US keyboards are used for writing in Latvian; diacritics are entered by using a dead key (usually ', occasionally ~). Some keyboard layouts use the modifier key AltGr (most notably the Windows 2000 and XP built-in layout (Latvian QWERTY), it is also default modifier in X11R6, thus a default in most Linux distributions).


title: Latvian language

text: In the 1990s, lack of software support of diacritics caused an unofficial style of orthography, often called "translits", to emerge for use in situations when the user is unable to access Latvian diacritic marks (e-mail, newsgroups, web user forums, chat, SMS etc.). It uses the basic Modern Latin alphabet only, and letters that are not used in standard orthography are usually omitted. In this style, diacritics are replaced by digraphs – a doubled letter indicates a long vowel (as in Finnish and Estonian); a following "j" indicates palatalisation of consonants, i.e., a cedilla; and the postalveolars "Š", "Č" and "Ž" are written with "h" replacing the háček, as in English. Sometimes the second letter, the one used instead of a diacritic, is changed to one of two other diacritic letters (e.g. š is written as ss or sj, not sh), and since many people may find it difficult to use these unusual methods, they write without any indication of missing diacritic marks, or they use digraphing only if the diacritic mark in question would make a semantic difference. Sometimes an apostrophe is used before or after the character that would properly need to be diacriticised. Also, digraph diacritics are often used and sometimes even mixed with diacritical letters of standard orthography. Although today there is software support available, diacritic-less writing is still sometimes used for financial and social reasons. As "š" and "ž" are part of the Windows-1252 coding, it is possible to input those two letters using a numerical keypad. Latvian language code for cmd and .bat files - Windows-1257


title: Latvian language

text: Consonants in consonant sequences assimilate to the voicing of the subsequent consonant, e.g. apgabals or labs . Latvian does not feature final-obstruent devoicing.


title: Latvian language

text: Consonants can be long (written as double consonants) , or short. Plosives and fricatives occurring between two short vowels are lengthened: . Same with 'zs' that is pronounced as , šs and žs as .


title: Latvian language

text: Latvian also has 10 diphthongs, four of which are only found in loanwords (), although some diphthongs are mostly limited to proper names and interjections.


title: Latvian language

text: Standard Latvian and, with some exceptions in derivation and inflection, all of the Latvian dialects have fixed initial stress. Long vowels and diphthongs have a tone, regardless of their position in the word. This includes the so-called "mixed diphthongs", composed of a short vowel followed by a sonorant.


title: Latvian language

text: During the period of Livonia many Middle Low German words such as "amats" (profession), "dambis" (dam), "būvēt" (to build) and "bikses" (trousers) were borrowed into Latvian, while the period of Swedish Livonia brought loanwords like "skurstenis" (chimney) from Swedish. It also has loanwords from the Finnic languages, mainly from Livonian and Estonian. There are about 500-600 borrowings from Finnic languages in Latvian, for example: "māja" ‘house’ (Liv. "mōj"), "puika" ‘boy’ (Liv. "pūoga"), "pīlādzis" ‘mountain ash’ (Liv. "pī’lõg"), "sēne" ‘mushroom’ (Liv. "sēņ").


title: Latvian language

text: Loanwords from other Baltic language include "ķermenis" (body) from Old Prussian, as well as "veikals" (store) and "paģiras" (hangover) from Lithuanian.


title: Latvian language

text: The first grammar of the Latvian language is a short “Manual on the Latvian language” () by , published in 1644 in Riga.


title: Hunky Dory

text: Hunky Dory is the fourth studio album by English musician David Bowie, released on 17December 1971 through RCA Records. Following the release of his 1970 album, "The Man Who Sold the World", Bowie took time off from recording and touring. He settled down to write new songs, composing on piano rather than guitar as on earlier tracks. Following a tour of the United States, Bowie assembled a new backing band consisting of guitarist Mick Ronson, bassist Trevor Bolder and drummer Mick Woodmansey, and began to record a new album in mid-1971 at Trident Studios in London. Future Yes member Rick Wakeman contributed on piano. Bowie co-produced the album with Ken Scott, who had engineered Bowie's previous two records.


title: Hunky Dory

text: Compared to the guitar-driven hard rock sound of "The Man Who Sold the World", Bowie opted for a warmer, more melodic piano-based pop rock and art pop style on "Hunky Dory". His lyrical concerns on the record range from the compulsive nature of artistic reinvention on "Changes", to occultism and Nietzschean philosophy on "Oh! You Pretty Things" and "Quicksand"; several songs make cultural and literary references. He was also inspired by his stateside tour to write songs dedicated to three American icons: Andy Warhol, Bob Dylan and Lou Reed. The song "Kooks" was dedicated to Bowie's newborn son Duncan. The album's cover artwork, photographed in monochrome and subsequently recoloured, features Bowie in a pose inspired by actresses of the Hollywood Golden Age.


title: Hunky Dory

text: Upon release, "Hunky Dory" and its lead single "Changes" received little promotion from RCA who were wary that Bowie would transform his image shortly. Thus, despite very positive reviews from the British and American music press, the album initially sold poorly and failed to chart. It was only after the commercial breakthrough of Bowie's 1972 follow-up album "The Rise and Fall of Ziggy Stardust and the Spiders from Mars" that "Hunky Dory" itself became a commercial success, peaking at number three on the UK Albums Chart. Retrospectively, "Hunky Dory" has been critically acclaimed as one of Bowie's best works, and features on several lists of the greatest albums of all time. Within the context of his career, it is considered to be the album where "Bowie starts to become Bowie", definitively discovering his voice and style.


title: Hunky Dory

text: After David Bowie completed his third studio album, "The Man Who Sold the World", in May 1970, he became less active in both the studio and on stage. His contract with music publisher Essex had expired and his new manager Tony Defries was facing prior contractual challenges. Bowie was also without a backing band, as the musicians on "The Man Who Sold the World" – including its producer and bassist Tony Visconti, guitarist Mick Ronson and drummer Mick Woodmansey – departed in August 1970 due to personal conflicts with the artist. After hearing a demo of Bowie's "Holy Holy", recorded in autumn 1970, Defries signed the singer to a contract with Chrysalis, but thereafter limited his work with Bowie to focus on other projects. Bowie, who was devoting himself to songwriting, turned to Chrysalis partner Bob Grace, who loved the demo of "Holy Holy" and subsequently booked time at Radio Luxembourg's studios in London for Bowie to record his demos. "Holy Holy", recorded in November 1970 and released as a single in January 1971, was a commercial flop.


title: Hunky Dory

text: "The Man Who Sold the World" was released in the United States through Mercury Records in November 1970. The album sold poorly but fared better both critically and commercially in the US than in the UK. It was played on American radio stations frequently and its "heavy rock content" increased interest in Bowie. The critical success of the album prompted Mercury to send Bowie on a promotional radio tour of the US in February 1971. The trip inspired him to write tribute songs for three American icons: artist Andy Warhol, singer-songwriter Bob Dylan and the rock band the Velvet Underground, more specifically their singer Lou Reed. After the tour, Bowie returned to his apartment in Haddon Hall, Beckenham, where he recorded many of his early 1970s demos, and began writing. According to his then-wife Angela, Bowie had spent time composing songs on piano rather than acoustic guitar, which would "infuse the flavour of the new album". In total, he composed over three-dozen songs there, many of which would appear on "Hunky Dory" and its follow-up album "The Rise and Fall of Ziggy Stardust and the Spiders from Mars". The first song Bowie wrote for "Hunky Dory" was "Oh! You Pretty Things" in January 1971. After recording its demo at Radio Luxembourg, Bowie gave the tape to Grace, who showed it to Peter Noone of Herman's Hermits. Noone decided to record his own version and release it as his debut single.


title: Hunky Dory

text: Released in April 1971, Noone's version of "Oh! You Pretty Things" was a commercial success, peaking at number 12 on the UK Singles Chart. It was the first time most listeners had heard of Bowie since "Space Oddity" (1969). Noone told "NME": "My view is that David Bowie is the best writer in Britain at the moment ... certainly the best since Lennon and McCartney." Following the success of the single, Defries sought to extricate Bowie from his contract with Mercury, which was set to expire in June 1971. Defries felt that Mercury had not done Bowie justice financially. Although Mercury had intended to renew it on improved terms, Defries forced the label to terminate the contract in May by threatening to deliver a low-quality album. Defries then paid off Bowie's debts to Mercury through Gem Productions, and the label surrendered its copyright on "David Bowie" (1969) and "The Man Who Sold the World".


title: Hunky Dory

text: After his short-lived band Arnold Corns folded in February, Bowie returned to the studio in May 1971 to record his next album. He concluded that he could not do the project without Ronson, who was enthusiastic when Bowie contacted him for the first time in nine months. Woodmansey returned with Ronson, who began looking for a bass player to replace Visconti. Ronson initially suggested Rick Kemp, with whom Bowie had recorded in the mid-1960s, but Bowie was unimpressed with Kemp's audition at Haddon Hall. According to some reports, per biographer Nicholas Pegg, it was Defries who rejected Kemp, because of his "receding hairline". Ronson then suggested his acquaintance Trevor Bolder, a former hairdresser and piano tuner who had previously seen Bowie in concert in 1970 and met Ronson at Haddon Hall. After Bolder was hired, the trio grouped at Haddon to rehearse some of Bowie's new material, such as the song "Andy Warhol". Bowie and his new backing trio, soon to be named the Spiders from Mars, played for the first time on 3June on BBC DJ John Peel's radio programme "In Concert". The set included debut performances of several songs Bowie had recently written such as "Queen Bitch", "Bombers", "Song for Bob Dylan" and "Andy Warhol". The title "Hunky Dory" was also announced at this session.


title: Hunky Dory

text: Bowie and the future Spiders officially started work on the new album at Trident Studios in London on 8June 1971. Ken Scott, who had engineered Bowie's two previous records, was hired to co-produce alongside him. Scott accepted the position as a way to gain experience, although at the time he didn't believe Bowie would become a huge star. His debut as a producer, Scott would borrow some of the acoustic sounds of George Harrison's "All Things Must Pass" (1970), an album he engineered. Scott would retain the role of co-producer for Bowie's next three records: "Ziggy Stardust", "Aladdin Sane" and "Pin Ups". Bowie played demos for Scott and the two picked which ones would be recorded for the album. On 8June, the band recorded "Song for Bob Dylan", although according to Pegg this version was scrapped and the released version was not recorded until 23June. Scott later recalled that recording went very quickly: "Almost everything was done in one take." He was surprised when he and the Spiders would think a vocal or guitar part needed re-recording but Bowie would say "No, wait, listen", and when everything was played simultaneously it would sound perfect. Regarding Bowie's talent as a vocalist, Scott stated: "He was unique. [He is] the only singer I ever worked with where virtually every take was a master." Bolder described recording with Bowie for the first time as a "nerve-wracking experience", saying: "When that red light came on in the studio it was, God, in at the deep end of what!" As a co-producer Bowie took an active interest in the album's sound and arrangements, an about-face from his generally hands-off attitude during the "Man Who Sold the World" sessions.


title: Hunky Dory

text: Keyboardist Rick Wakeman, noted session musician and member of the Strawbs, plays piano on the album; he previously played Mellotron on "David Bowie" (1969). In 1995 he recalled that he met with Bowie in late June 1971 at Haddon Hall, where he heard demos of "Changes" and "Life on Mars?" in "their raw brilliance ... the finest selection of songs I have ever heard in one sitting in my entire life ... I couldn't wait to get into the studio and record them." The piano Wakeman played was the same 1898 Bechstein used by Paul McCartney for "Hey Jude" and later by Queen for "Bohemian Rhapsody". According to Wakeman, the first few sessions started poorly as the band had not learned the songs. He recalled that Bowie had to halt the sessions, telling the musicians off and to come back when they knew the music. When they returned after a week, Wakeman thought "the band were hot! They were so good, and the tracks just flowed through." This story has been contested by other band members, including Bolder, who told biographer Kevin Cann: "[That's] rubbish. David would never have told the band off in the studio. Especially as Mick and Woody had already left him once, and everyone was now getting on. The band would not have survived that – it definitely didn't happen." Scott contended: "I definitely don't remember that, and it's not something I would forget. I would definitely dispute that one."


title: Hunky Dory

text: With Wakeman in the line-up, on 9July Bowie and his band recorded two takes of "Bombers" and "It Ain't Easy", the latter featuring backing vocals by Dana Gillespie. Five days later, the group recorded four takes of "Quicksand", the last of which appears on the finished album. On 18July, the group spent the day rehearsing and mixing. Further mixing sessions were carried out between 21 and 26July to compile a promotional album for Gem Productions. By this point, the songs "Oh! You Pretty Things", "Eight Line Poem", "Kooks", "Queen Bitch" and "Andy Warhol" had been recorded; the mixes of "Eight Line Poem" and "Kooks" on the promotional album differed from the final versions on "Hunky Dory". Two takes of "The Bewlay Brothers" were recorded on 30July, the second appearing on the final album; it was recorded on a tape that contained scrapped versions of "Song for Bob Dylan" and "Fill Your Heart". On 6August, the band recorded "Life on Mars?" and "Song for Bob Dylan", after which the recording process was considered finished. Before the sessions ended, Bowie asked Wakeman if he wanted to be a part of the Spiders from Mars. Wakeman declined and joined the progressive rock band Yes instead.


title: Hunky Dory

text: After the hard rock sound of "The Man Who Sold the World", "Hunky Dory" features a stylistic shift from Bowie towards art pop and melodic pop rock. The songs are mostly piano-led rather than guitar-led. Biographer Marc Spitz believes the piano incites a warmer feel on this record compared to its two predecessors. Biographer Christopher Sandford states that "the songs [are] characterised by the lush ambience established by Bowie's vocal and the piano" and, along with Elton John and Phil Collins, helped create music on the "easy-listening continuum". Lior Phillips of "Consequence of Sound" wrote that the songs are accessible, both musically and lyrically, allowing the listener to dissect them again and again. Music journalist Peter Doggett concurs, regarding "Hunky Dory" as "a collective of attractively accessible pop songs, through which Bowie tested out his feelings about the nature of stardom and power". Rick Quinn described the songs in "PopMatters" as a fusion of "British pop, orchestral works, art-rock, folk and ballads" that emerge to form glam rock.


title: Hunky Dory

text: Robert Dimery, in his book "1001 Albums You Must Hear Before You Die", calls it "a toybox of acoustic oddities, tributes to heroes and surrealism". Stephen Thomas Erlewine of AllMusic describes it as "a kaleidoscopic array of pop styles, tied together only by Bowie's sense of vision: a sweeping, cinematic mélange of high and low art, ambiguous sexuality, kitsch, and class". Michael Gallucci of "Ultimate Classic Rock" notes that it is Bowie's first record to include "a mix of pop, glam, art and folk wrapped in an ambisexual pose that would come to define the artist". James Perone similarly describes the album as "a unique blend of folk, pop, glam, and progressive rock" that distinguished Bowie from other musicians at the time. Peter Ormerod of "The Guardian" writes that the music of "Hunky Dory" celebrates "uncertainty, rootlessness, inner chaos, difference, otherness, doubt and impermanence" and did it with "beauty, style and charisma".


title: Hunky Dory

text: The opening track, "Changes", is built around a distinctive piano riff. The lyrics focus on the compulsive nature of artistic reinvention and distancing oneself from the rock mainstream. Biographer David Buckley writes that "strange fascination" is a phrase that "embodies a continued quest for the new and the bizarre". Pegg summarises the lyrics as Bowie "holding a mirror to his face" just as he is about to achieve stardom. The lyrics contributed to his being dubbed the "chameleon of rock" and one of rock's greatest innovators. Doggett notes that "Changes" is a "statement of purpose": as the opening track, the song provided a stark contrast to the hard rock sound found on its predecessor. The song was also unlike "Space Oddity" and its 1969 parent album, but rather "pure, unashamedly melodic, gleefully commercial, gorgeously mellifluous pop".


title: Hunky Dory

text: "Oh! You Pretty Things" was the first track written for the album. The piano style has been compared to the Beatles' "Martha My Dear". Biographer Chris O'Leary writes that Bowie played piano on the track alone. Wakeman contended in a BBC interview in 2017 that Bowie played piano in the beginning section before he took over for the rest of the track. The lyrics reference the teachings of the occultist Aleister Crowley and his Golden Dawn and the philosopher Friedrich Nietzsche, particularly with the lines "the homo superior", "the golden ones" and "homo sapiens have outgrown their use". "Homo Superior" refers to Nietzsche's theory of "Übermensch", or "Superman". The music itself provides a contrast to the darker themes. Doggett describes Bowie's vocal performance as "quite unadorned, presented so starkly ... that it [is] almost unsettling".


title: Hunky Dory

text: Designed to sound like a "continuation" of the previous track, "Eight Line Poem" is described by Pegg as the album's most "overlooked" song. It features Bowie on a gentle, sporadic piano while he sings and a country-influenced guitar line from Ronson. Exactly eight lines long, the lyrics describe a room where a cat just knocked over a spinning mobile and a cactus sits in a window. Doggett believes there is a metaphor between the cactus and a prairie. At the time of the album's release, Bowie described the song as the city that is "a kind of high-life wart on the backside of the prairie".


title: Hunky Dory

text: "Life on Mars?" is described by Buckley as a "soaring, cinematic ballad". Although Bowie was fixated on becoming Ziggy Stardust at the time of its recording, the song has no connection to Mars itself; the title was a reference to the recent media frenzy of the US and Soviet Union racing to get to the red planet. The song is a parody of singer Frank Sinatra's "My Way" and uses the same chord sequence for its opening bars. The handwritten notes on the back cover say "Inspired by Frankie". Like most songs on the album, "Life on Mars?" is mostly piano-led, but features a string arrangement from Ronson – his first – that is described by Doggett as "gargantuan". Bowie's vocals – recorded in one take – are delivered passionately during the chorus and almost nasally in the verses. He mentions "the girl with the mousy hair", whose identity commentators have debated, and who according to Greene "goes to the movies as an escape from life".


title: Hunky Dory

text: A few days after his son Duncan Zowie Haywood Jones was born on 30 May 1971, Bowie completed "Kooks" and dedicated it to him. Performed by Bowie as early as 3 June, the "Hunky Dory" version features a string arrangement from Ronson and trumpet played by Bolder. "Kooks" is noticeably lighter than the two tracks it is sequenced between but, according to Pegg, ultimately "carries a hint of [the album's] preoccupation with the compulsion to fictionalise life, as Bowie invites his son to 'stay in our lovers' story'". Doggett writes that its inclusion on "Hunky Dory" "ensured its enduring appeal among those who were less entranced by his explorations of politics, psychology and occult elsewhere on the album". In the handwritten liner notes on the LP sleeve, Bowie wrote "For Small Z".


title: Hunky Dory

text: According to Pegg, "Quicksand" was inspired by Bowie's trip to America in February 1971. Doggett states that the song "was written "about" a lack of inspiration and as a means of "accessing" it". Writer Colin Wilson wrote in "" (1971) that thought was a form of quicksand that allowed consciousness to keep the unconscious beyond reach, from which Doggett concluded that Quicksand' was Bowie's plea to search within himself to be shown the way". In the mid-1970s, Bowie described the song as "a mixture of narrative and surrealism" and a "precursor" to the music of his 1977 album "Low". Throughout the track, Bowie makes numerous references to Crowley and his Golden Dawn, Winston Churchill, Heinrich Himmler and the "supermen" of Friedrich Nietzsche. "Quicksand" also evokes spiritualism through the mention of Buddhist teachings such as bardo. The instrumental track features multiple layers of acoustic guitars atop one another, which was done at Scott's insistence.


title: Hunky Dory

text: "Fill Your Heart", written by Biff Rose and Paul Williams, is the only track on "Hunky Dory" not written by Bowie; it is his first recorded cover song in six years. It replaced "Bombers" as the side two opener late in the album's development. "Fill Your Heart" is one of the more up-tempo tracks on the album, and according to Doggett is "practically identical" to Rose's original version, albeit more "bouncy" and less "swung". The piano-driven arrangement differs from Bowie's live performances of the song in 1970 when acoustic guitar dominated. Pegg writes that the track provides a "cogent counterpoint" to the "angst" of "Quicksand" and the "cautionary warnings" of "Changes" and is best remembered for Bowie's saxophone break, Ronson's string arrangement, and Wakeman's piano solo.


title: Hunky Dory

text: The song "Andy Warhol" is a tribute to American artist, producer, and director Andy Warhol, who had inspired Bowie since the mid-1960s and was described by him as "one of the leaders" of "the media of the streets, street messages". Originally written for Bowie's friend Dana Gillespie, the song is based around a riff played on two acoustic guitars that heavily resembles the intro of Ron Davies' "Silent Song Across the Land". The lyrics emphasise Warhol's belief that life and art blur together. The song's opening features Ken Scott saying "This is 'Andy Warhol', and it's take one", only for Bowie to correct his pronunciation of "Warhol". When Bowie met Warhol in September 1971 and played the song for him, Warhol hated it and left the room; Bowie recalled in 1997 that he found the meeting "fascinating" because Warhol had "nothing to say at all, absolutely nothing".