Milk production in women after childbirth is a physiological function that is part of the reproductive process and, as in other mammals, its purpose is to provide adequate nutrition to the offspring. Unlike other animals, in humans, breastfeeding is also a social construct and, therefore, is determined by learning, beliefs, values, norms, and socio-cultural conditions that evolve or regress to the beat of the times and the individuals who live and shape them (Rodríguez, 2015; Rodríguez and Acosta, 2008).

Although all societies have considered breastfeeding as a natural and necessary event for the life of the newborn, the practices regarding it have been very different according to the socio-cultural and temporal contexts. Like any practice, it depends on the meaning and interpretation that the individual gives to said practice in a specific time and circumstance, or, in other words, it depends on the social representations that exist in each group, time, and place (Rodríguez, 2015).

There are different reasons why a woman may decide not to breastfeed her newborn child m. Therefore, to establish breastfeeding, the socio-cultural factors of the mothers must be taken into account (Schmied, Beake, Sheehan, McCourt and Dykes, 2011), as well as the emotional or partner aspect, the mother's attitude to maternity, and, of course, the mother's culture, which has a marked influence (Victora et al.. 2016). It is worth mentioning that the concept of culture refers to the ways of living that are passed from generation to generation. In this sense, culture is learned, shared, symbolic, natural, encompasses everything, and is integrated into the life of each individual (Kottak, 1994; Lee. 2019).

The analysis of the variables for the establishment of breastfeeding should include socioeconomic characteristics and circumstances (Ministry of Health and Welfare, 2016). meaning the economic conditions and capacities of the mother (Afulani, 2016). The variable is conceptualized in the assistance and emotional support of the mother; thus, a single woman, without help, who must meet the needs of her home, is not the same as a woman who has the help of her partner and family (Pérez-Bravo, 2015; Meedya, 2010; Mekhail, 2019).

To understand breastfeeding and everything that is directly and indirectly associated with it, it is relevant to go beyond the individual and include the social and cultural community contexts where the lack of training and specific skills of breastfeeding professionals are addressed and strengthened. Also, hospital practices that favor bottle feeding, health policies that limit resources for the promotion, protection, and support of programs, cultural loss, and the network monitoring of neighboring environments (Oliver, 2012).

The predominant quantitative positivist paradigm in the health sciences has almost always studied breastfeeding from a physiological perspective. However, at the beginning of the 1980s, with the development and scientific acceptance of the Bronfenbrenner Ecological Model, a new approach emerged to address human interactions based on a set of structures to support the different concepts and factors that influence human behavior. The purpose: to achieve a greater understanding of reality.

The concept of ecology is based on the understanding that a formal test does not always reflect performance in real life since an adequate anamnesis is required to determine daily capacities, which is why it is necessary to use scales that quantify the activities of daily living (Smith and Kroeger, 2009). However, there are reports of various ecological orientation tests that try to infer the ability of subjects to carry out their activities of daily living (Bronfenbrenner, 1991). In research, the difference between the designs and approaches lies in the levels of organization, specifically, at one level where individual units are integrated into groups and these groups become the units of analysis at the next level. Each level acquires collective properties that are more than the sum of the properties of its individual members (Susser, 1994).

With this in mind, the process of breastfeeding is one of the most complex processes in the life cycle of women and cannot be understood from a single perspective. Therefore, to study its meaning, prevalence, establishment, and duration, it is essential to understand the attitudinal and experiential aspects of the mother as a woman and mother, the environment and family support, and the social, cultural, emotional, and economic expectations, addressing breastfeeding within an Ecological Model with multiple interactions (Aguayo, Arena and Blásquez, 2008).

It is not by chance that the main motivation for conducting research with an ecological approach is centered on the ability to study health in an environmental context and not in a group since this is more than the sum of the health of individuals. Moreover, the perspective provided by the reflections whose unit of analysis is the group rather than the individual should be understood as a way of approaching epidemiology and public health, whose object of interest is the groups (Alpizar, 2019; Borja, 2000; Brown. 2011;Victora et al.. 2016).

Finally, it is correct to affirm that using the Ecological Model, different dimensions can be approached comprehensively since, from the perspective of psychology, ecological validity is the functional and predictive relationship between the individual's performance in a set of neuropsychological tests, and individual behavior in a variety of real-world settings, including the vital concept of understanding and interpreting the subject's moods. For example, the observation of post-partum psychological alterations leads to tests that allow suggestions to be made to improve education, therapies, and/or treatments. With this approach, internal and external actions are considered within a system that includes the immediate environment, family, neighborhood, and community, as well as local and national governments (Ortíz, Lauro, Jiménez and Silva, 2000). Additionally, with this model, new fields of research can be conceived that provide answers and conclusions regarding the abilities of individuals, especially about the competent performance of the activities of daily living, independent living, and occupational tasks, and the relationship with environments (Sbordone, 1998).

There are barriers in the lactation process that occur at various levels, the microsystem, mesosystem, exosystem, and macrosystem. In the first level, a relevant role is played by the mother and the child and their interactions with the other levels. Idealized concepts of beliefs, attitudes, and knowledge about breastfeeding do not work with real-world experiences (McLachlan, 2010). The component of the mother's attitude to and experience with the breastfeeding process determines a very important factor for developing successful breastfeeding, which complies with the parameters for its prolongation, independent of the cultural or social environment in which the mother develops the process (Hall and Hauck, 2007; Grummer. 2017).

Studies have shown the relevance of prenatal education and an attitude towards exclusive breastfeeding at six months after delivery when mothers, fathers, or the immediate environment, health services, and modifying territorial regulations are engaged, involving in that sense the second and third levels of the ecological model. And indeed, the support of the actors in each of the settings, the education of caregivers and maternal companions, improves the physical and psychological state of the mother, which translates into greater willingness to breastfeed (Kaunonen, 2012).

Finally, encompassing the fourth level of the ecological model is the training of state entities, the application of legislation and the formulation of government policies within the institutions, and physical and information access within the entities that provide health services around the protection of breastfeeding (Che'Muda et al.. 2019; Zhao, Lin, Wang and Bao, 2020; Gleason et al.. 2018).

Studies with ecological approaches have the advantage of viewing comparisons between different areas, which allows an evaluation of multiple levels of exposure, something that is almost impossible in a single geographical area when there are perhaps homogeneous exposures (Borja, 2000; Mateus. 2012; Susser, 1994). With this new paradigm, human interactions are conceived in a multifactorial environment within a complex, changing society, and, therefore, breastfeeding education must be approached using the Ecological Model, where there are interactions at different levels that modify the attitude towards the act of breastfeeding, influencing the duration of breastfeeding and its exclusivity (Lutter and Morrow, 2013).

In recent years, a greater number of qualitative studies have been carried out on breastfeeding, understanding it as a human practice that is historically constructed, transmitted by culture, and related to specific contexts. Although it is supported by physiological processes, it is not an irrepressible impulse of human nature. In this sense, it has very ancient roots and is the product of certain ecological, economic, and demographic conditions that prioritize certain cultural contents that give meaning to what "must be done" or to the pattern of what "must be" (Echazú, 2004). Under this scenario, the Ecological Model allows a broader understanding and a comprehensive approach to the factors influencing the prevalence and establishment of breastfeeding in society (Muñoz, 2019; Valderrama, 2019).

It is necessary to emphasize that the initiation and duration of breastfeeding must involve the four levels of the ecological model where there are meeting points between the psychological and demographic attributes of the health care environment and its policies, both local and governmental (Ojeda, Ordoñez and Ochoa, 2010). Despite the growing number of studies on breastfeeding with an ecological approach, where psychological, social, and cultural aspects are analyzed, the inclusion or reference of this new proposal is not observed in the field of public policies.

In this context,from an ecological perspective of breastfeeding, it is necessary to clarify the influence of the variables that affect the practice in the different cultural regions within a territory, in order to develop prospective research and identify determining factors of the practice and duration of breastfeeding. Also, to design and implement policies and plans based on comprehensive planning methodologies for health interventions, develop appropriate and cost-effective extra-institutional interventions to prolong the duration of breastfeeding, and implement more reliable surveillance systems (Mateus. 2012).

The reason for this is that the Ecological Model allows a detailed and in-depth analysis of the object of study. However, in the field of breastfeeding, there are very few studies carried out with an ecological approach in the international sphere, hence the need to promote and awaken interest in the use of this proposal for the development of public health research.