When her infant daughter, Isabelle, started fussing in a restaurant one day, Erin Simons knew what she had to do to mollify her: Breastfeed.

After discreetly positioning the child, Simons was shocked when a waiter asked her to leave the dining room because some of the Ohio eatery’s other patrons had expressed discomfort.

Only after she finished breastfeeding Isabelle, now 13 months, in the car, did Simons feel a flush of anger replace her first blush of embarrassment.

"There’s no reason why you should feel embarrassed about feeding your child in the most healthy way there is," she says. "The breasts are so sexualized. It’s just funny because when you get to nurse for a while, it’s the most natural thing in the world and you never think about that anymore."

State and federal health officials are actively pushing to have more women — and their spouses and society as a whole — accept that breastfeeding is an acceptable activity, no matter where it takes place.

Two years ago, Indiana passed a law allowing women to breastfeed in public with no fears of being cited for indecency, a protection that more than a dozen other states do not offer.

The Indiana State Department of Health doles out wallet-sized cards that affirm the right of a nursing mom to feed her infant wherever, however and whenever she wants. And national efforts are afoot to wean new mothers away from formula and into breastfeeding.

In its Healthy People 2010 blueprint, the government calls for at least 75 percent of mothers to start breastfeeding immediately after giving birth, 50 percent to continue it for at least six months and 25 percent to continue until the baby is a year old.

Behind the movement lies an increasing body of scientific evidence that breastfeeding has a host of health benefits. Breastfed babies experience lower rates of meningitis, diarrhea and respiratory and ear infections.

The practice also decreases the rates of SIDS, diabetes, leukemia and asthma, says Dr. Kinga A. Szucs, associate professor of clinical pediatrics at the Indiana University School of Medicine. Achieving the government’s goals could save $3.6 billion annually in health-care costs.

A 2002 study found that 70 percent of mothers breastfed after birth, 33.2 percent were breastfeeding at six months and just under 20 percent were breastfeeding at a year.

In Indiana, about 68 percent of new mothers start breastfeeding, a 2005 Centers for Disease Study found. That was an increase from the previous year, when a study found only 64 percent breastfed.

"We’re in this culture of bottle-feeding, and it became the norm. What we’re trying to do is turn the norm around," says Sharon Farrell, development manager for the community nutrition /obesity prevention program of the state health department.

"Lactivists," those who advocate for breastfeeding, fear that social disapproval of women breastfeeding in public combined with a lack of private spaces for them to pump milk dissuades many from starting or continuing to breastfeed.

For the first time, the Indiana State Fair this year featured a lactation station.

Coordinated by the Indiana Mother’s Milk Bank, it was intended to do more than provide a safe, comfortable haven for breastfeeding, says Mary Alexander, milk bank executive director, who came up with the idea.

"It promotes breastfeeding by having it in front of the public," she says. "We’re trying to send the message that breastfeeding is best for infants and for mothers in the community."

The group is considering sponsoring a similar booth at next year’s Indiana Black Expo.

Fairgoer Misty Areal settled into one of the station’s five white rockers one afternoon with her 8-month-old daughter, Sara. Earlier in the day, before happening upon the booth, she had ducked behind some shrubs to feed her little girl.

Some days, she says, the need to feed keeps her at home.

"I feel like I’m trapped in my house a lot of times because I don’t feel people are open to it," says Areal, 31, who lives on the Westside.

Jason Guthrie of Columbus has no problem with his wife, Carolyn, breastfeeding their 8-month-old, Brianna. But it does give him pause when they’re out in public and he sees a stranger watching.

"It’s not her doing something; it’s more just other people trying to stare that bothers me," he says. "I just like to try to find someplace in the corner and be out of the way."

As for Simons, she recalled visiting the fair last year with her 2-month-old, looking for a calm, secluded place to sit and nurse. She wound up walking around the fairgrounds with a fleece blanket thrown over her child as she suckled.

"It was definitely not what I would call the most positive experience for a nursing mom," she says.

Experiences like these can persuade would-be breastfeeding mothers to discontinue the practice. Other mothers return to work and find that there’s no comfortable place to pump milk for later use.

On the flip side lies the ease of formula. Most hospitals hand new mothers diaper bags filled with free formula samples and coupons to purchase more. Last year, the Massachusetts Public Health Council banned hospitals in that state from distributing such bags, but the governor soon overturned their ruling.

About 50 hospitals around the nation, including Methodist in Indianapolis and Community Hospital Anderson, however, have adopted a similar policy, earning them the designation "baby-friendly" from a joint UNICEF/World Health Organization program.

"As a baby-friendly hospital, you have as much as possible in line for the promotion and support of breastfeeding for your patients, and one component is not giving out coupons and free hospital bags," says Tina Babbitt, coordinator of the breastfeeding center at Methodist and education coordinator for the Indiana Perinatal Network.

Instead of bags laden with formula-promoting products, new moms at Methodist, the nation’s largest baby-friendly hospital, get a Clarian Health backpack with items like a bath thermometer and a medicine spoon, she says.

Last month, a group of Massachusetts advocates started a national campaign to remove diaper bags filled with formula samples from all hospitals.

The Indiana Department of Health has no initiatives under way targeting formula samples, but it does have some other efforts to support breastfeeding women, such as improving laws surrounding the worksite, Farrell says.

"We’ve just really got to start over to educate people that we’re not moving backwards, and that bottle feeding is not the ideal way to feed babies."