The American Academy of Pediatrics (AAP) has published a guide with new recommendations for breastfeeding, which come to update its recommendations made a decade ago.
The organization continues to recommend exclusive breastfeeding until six months of age (as it did in 2012), but under the new policy it now supports continuing to breastfeed for two years or more , “according to the mutual desire of mother and child.” “. Previously it only suggested continuing for a year or more.
These recommendations align with those of the World Health Organization (WHO), which speaks of breastfeeding for at least two years, as well as with the recommendations of the American Academy of Family Physicians and the Canadian Society of Pediatrics.
In addition, the AAP also recognizes that more social and occupational support is needed for that to happen, and that pediatricians can play a key role in advocating for better policies for breastfeeding mothers.
Benefits of prolonged breastfeeding
The new position is part of the Breastfeeding and Use of Breastmilk report, to be published in the July issue of Pediatrics.
“Human milk is all a baby needs for the first six months of life,” said Joan Younger Meek, MD, MS, RD, FAAP, FABM, IBCLC, lead author of reports written by the Breastfeeding Section of The AAP: “Breast milk is unique in its nurturing and protective effects, and truly remarkable when you look at what it does for a child’s developing immune system.”
The results of the report show that children who were breastfed presented less frequently acute and chronic pediatric disorders such as: otitis media, severe diarrhea, lower respiratory tract infections, sudden infant death syndrome, inflammatory bowel disease, childhood leukemia, diabetes mellitus , obesity, asthma and atopic dermatitis.
In addition, the data show that breast milk during the second year of life continues to be an important source of macronutrients and immunological factors, which helps the proper development of young children.
It also highlights the positive impact that prolonged breastfeeding has on maternal health, such as lowering maternal rates of type 2 diabetes, hypertension, breast cancer, and ovarian cancer.
New AAP Recommendations on Breastfeeding
The AAP recommends:
- Exclusive breastfeeding for the first 6 months. There is no need to introduce infant formula or other sources of nutrition for most babies. Beyond 6 months, breastfeeding should be continued along with nutritious complementary foods.
- The AAP recommends that hospitals or birthing centers implement maternity care practices that improve the initiation, duration, and exclusivity of breastfeeding.
- There are continuing benefits of breastfeeding beyond 1 year and up to 2 years, especially in the mother. Long-term breastfeeding is associated with protections against diabetes, high blood pressure, and breast and ovarian cancer.
- Mothers who choose to breastfeed beyond the first year need support from their health care providers, as well as protection from workplace barriers.
- Policies that protect breastfeeding, including universal paid maternity leave; the right of a woman to breastfeed in public; insurance coverage for lactation support and breast pumps; etc.
Only one in four breastfeed until six months
More than 80% of women in the United States initiate breastfeeding, but only 25.8% breastfeed exclusively at six months . Additionally, 19% of breastfed infants receive infant formula supplementation in the first 48 hours after birth.
The main concern is to increase breastfeeding rates in a country where there are large sociodemographic and cultural disparities, with the lowest rates of initiation among African-American populations.
Nor should we forget that the consequences of the shortage of formula milk that put the country in crisis are still with us, showing that better policies are needed to support breastfeeding.
More social and work support: maternity leave
Mothers returning to work after giving birth face many obstacles in being able to continue to breastfeed their babies in most developed countries. But in addition, the United States is the only developed country in the world where there is no national law that guarantees maternity leave , it only contemplates four weeks of leave after birth.
“Not everyone is able to breastfeed or continue to breastfeed for as long as they want for a number of reasons, including workplace barriers. Families deserve non-judgmental support, information and help to guide them in feeding their baby,” says Meek . .
And adds:
“We need societal changes to help support this, such as paid leave, more support for breastfeeding in public and childcare facilities, and support in the workplace”
What things should change?
Breastfeeding is a public health issue, and the AAP highlights that pediatricians are key figures in helping parents make decisions about breastfeeding and begin to make a difference.
But in addition, there are many other support measures that should be implemented so that women can breastfeed their babies longer, starting with the basics: paid maternity leave.
The AAP also advocates for insurance coverage for breastfeeding support, the right to breastfeed in public, remote work and flexible work opportunities, workplace childcare, break time, and a clean environment. and privacy to express milk are some essential measures to help families maintain breastfeeding.
