Pediatricians should establish a written “breastfeeding-friendly” office practice and train staff on how to support breastfeeding mothers, said the American Academy of Pediatrics in a clinical report.
Such a practice should include extensive discussion of breastfeeding during each well-child visit, reported Joan Younger Meek, MD, and colleagues from the AAP Section on Breastfeeding.
This includes support for clinicians and office staff who are breastfeeding, by providing a lactation room for the use of employees or breastfeeding mothers of patients, the authors wrote in Pediatrics.
The American Academy of Pediatrics recommends exclusive breastfeeding for the first 6 months of life, followed by continued breastfeeding for 1 year or longer, as desired by both mother and infant.
But the authors noted that many clinicians have gaps in their knowledge about breastfeeding and lack experience in clinical breastfeeding management. They cited a 2004 survey were pediatricians were “less likely to believe that the benefits of breastfeeding outweighed the difficulties or inconvenience, and fewer believed that almost all mothers were able to succeed.” Data from a 2014 unpublished survey found many of the same attitudes still persist among pediatricians, they said.
In a recent recommendation statement, the U.S. Preventive Services Task Force said that primary care physicians should provide education and resources to mothers who wish to breastfeed (B statement). Meek and colleagues cited the USPSTF’s conclusions, which found that specific breastfeeding interventions were more effective than usual care at increasing the rates of breastfeeding. They also noted that increasing breastfeeding rates is part of the Healthy People 2020 goals.
As part of these initiatives, clinicians should have at least one breastfeeding resource person on staff, said the authors, such as an International Board Certified Lactation Consultant, nurse, or another staff member trained in lactation support. This staff member should provide support under the guidance of a pediatrician.
The authors stated that clinician education about breastfeeding includes being aware of the contraindications, such as infants with the classic form of galactosemia (a genetic disorder affecting how the body processes food), maternal HIV, or antiretroviral therapy or untreated active tuberculosis.
They also encouraged clinicians to work within their communities — such as with the local hospital or birthing center to help educate them on breastfeeding-friendly care, and providing such education to community members as well. The authors emphasized that clinicians should push hospitals to pursue “Baby-Friendly USA” designations, which encourage maternal and newborn care that includes early initiation of breastfeeding and immediate postpartum skin-to-skin contact.
Other initiatives to encourage breastfeeding initiatives include:
- Scheduling the…