Nutrition

Breastfeeding Recommendations

Breastfeeding is acknowledged as the preferred method of infant feeding by:

• American Academy of Pediatrics

• Georgia Chapter of the American Academy of Pediatrics
• American College of Obstetrics and Gynecology
• American Dietetic Association
• American College of Nurse-Midwives
• Association of Women's Health, Obstetric and Neonatal Nurses
• National Association of Pediatric Nurse Practitioners
• Healthy Mothers, Healthy Babies Coalition
• American Public Health Association
  
   

Professional Organization Support for Breastfeeding

• Breastmilk is the ideal nutrition for infants and breastmilk alone is the only food infants need for growth and development for the first six months of life. Gradual introduction of iron rich solid foods in the second half of the first year should complement the breastmilk. In 2005, the American Academy of Pediatrics (AAP) made the following recommendations:
   

• Human milk is the preferred feeding for all infants, including premature and sick newborns, with rare exceptions. The ultimate decision on feeding of the infant is the mother's. Pediatricians should provide parents with complete, current information on the benefits and methods of breastfeeding to ensure that the feeding decision is a fully informed one. When direct breastfeeding is not possible, expressed human milk, fortified when necessary for the premature infant, should be provided. Before advising against breastfeeding or recommending premature weaning, the practitioner should weigh thoughtfully the benefits of breastfeeding against the risks of not receiving human milk.
   

• Breastfeeding should begin as soon as possible after birth, usually within the first hour. Except under special circumstances, the newborn infant should remain with the mother throughout the recovery period. Procedures that may interfere with breastfeeding or traumatize the infant should be avoided or minimized.

• Newborns should be nursed whenever they show signs of hunger, such as increased alertness or activity, mouthing, or rooting.

• No supplements (water, glucose water, formula, and so forth) should be given to breastfeeding newborns unless a medical indication exists.

• When discharged <48 hours after delivery, all breastfeeding mothers and their newborns should be seen by a pediatrician or other knowledgeable health care practitioner when the newborn is 2 to 4 days of age. In addition to determination of infant weight and general health assessment, breastfeeding should be observed and evaluated for evidence of successful breastfeeding behavior. The infant should be assessed for jaundice, adequate hydration, and age-appropriate elimination patterns (at least six urinations per day and three to four stools per day) by 5 to 7 days of age.

• Exclusive breastfeeding is ideal nutrition and sufficient to support optimal growth and development for approximately the first 6 months after birth. It is recommended that breastfeeding continue for at least 12 months, and thereafter for as long as mutually desired.

• In the first 6 months, water, juice, and other foods are generally unnecessary for breastfed infants.
   

Should hospitalization of the breastfeeding mother or infant be necessary, every effort should be made to maintain breastfeeding, preferably directly, or by pumping the breasts and feeding expressed breast milk, if necessary.

 

Federal Government Support for Breastfeeding
 

In 1984, the Office of the Surgeon General held the first workshop on breastfeeding and human lactation. Out of this workshop came the Report on the Surgeon General's Workshop on Breastfeeding & Human Lactation and two follow-up reports in 1985 and 1991. All three reports included the following recommendations:
 

• strengthen the support of breastfeeding in the health care system;

• improve professional education in human lactation and breastfeeding;

• develop public education and promotional efforts;

• develop a broad range of support services in the community;

• initiate a national breastfeeding promotion effort directed to women in the work force; and

• expand research on human lactation and breastfeeding.

The HHS Blueprint for Action on Breastfeeding was developed as a national plan for breastfeeding based on education, training, awareness, support, and research. This document provides evidence-based information on breastfeeding benefits from health to economics, addresses disparities in breastfeeding rates and can be used as a guide for State and local planning.

 

International Support for Breastfeeding

The Innocenti Declaration was produced and adopted by participants at a World Health Organization (WHO)/UNICEF policymakers' meeting on, co-sponsored by the United States Agency for International Development (A.I.D.) and the Swedish International Development Authority (SIDA), held at the Spedale degli Innocenti, Florence, Italy, in 1990. The Innocenti Declaration is used, worldwide, to guide efforts in promoting and setting policy for breastfeeding.