There are many barriers for mothers wishing to breastfeed their infants. While breastfeeding is widely accepted in the pediatric field to be excellent for mothers’ and infants’ health, stigma, workplace barriers, and other challenges can prevent families who wish to breastfeed their children. In 2022, the American Academy of Pediatrics updated guidelines for the support of breastfeeding mothers and parents. In this post, we’ll look at the guidelines pediatricians should follow and strategies for supporting breastfeeding parents, including whether hiring or becoming a lactation consultant could benefit your practice.
Updated Guidelines Support Breastfeeding, Identify Barriers
The American Academy of Pediatrics recommends breastfeeding for the first six months of life, and to continue as long as mother and child desire it. This update will not be surprising to many pediatricians and parents, as breastfeeding has long been recognized as an important nutritional and relationship-building factor for infants and parents.
“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 the reports, written by the AAP Section on Breastfeeding. “Families deserve nonjudgmental support, information and help to guide them in feeding their infant.”
The updated policy and technical report, both titled “Breastfeeding and the Use of Human Milk”, both introduce calls for additional support for breastfeeding mothers, supportive parents, and gender-diverse families who face societal, workplace, and other barriers in their efforts to breastfeed.
Pediatricians’ role as advocate and supporter for new parents and infants places them in an ideal position to be a voice in changing societal barriers that would prevent parents from breastfeeding, such as stigma, lack of childcare, lack of lactation support, gender-diverse biological and social constraints, guaranteed paid maternity leave, and more.
Populations That Need Breastfeeding Support
The updated AAP policy views breastfeeding not only as vital for individual patients’ health, but as a “public health imperative”. While average breastfeeding rates in the U.S. are deceptively high, populations such as non-Hispanic Black families show a 75.5% breastfeeding initiation rate, compared to 85.3% for non-Hispanic White families and 85% for Hispanic/Latino families, a 10% disparity that results in greater health risks for children and their mothers.
Some mothers cannot produce breast milk due to biological or other constraints. Families who adopt or become parents through surrogacy can breastfeed with advanced planning through hormonal stimulation and/or pasteurized donor human milk. Gender-diverse families have varying biological and emotional capabilities for breastfeeding, and may prefer the term “chest-feeding” as more accurate or gender-inclusive.
To support these families, it is important for pediatric practices to ascertain the demographics of their patient populations and communities in order to understand the unique needs of families arriving at the practice. For example, cultural norms, language barriers, and socioeconomic factors may make it difficult for parents to discuss breastfeeding, introducing the parent to fears of embarrassment, failure, or lack of resources. Open conversations and supportive questions can help pediatricians offer the right support for each family.
Possible solutions that could help expand breastfeeding support in your community include:
- Free or low cost lactation consultation and classes
- Breastfeeding mother or parent groups hosted by the practice
- Resources for transportation, both to the pediatrician and to nearby milk banks
- Cultural and language integration through interpreters or local advocates
Tying all support systems together is the pediatricians’ role in advocating for mothers’ right to breastfeed their infants, which extends to breaking down societal and workplace barriers. Ask families about barriers that could prevent breastfeeding to or past the age of 6 months, such as fears of breastfeeding in public or to breastfeed or hand pump breast milk at the workplace. In some cases, advocacy on behalf of the family can help introduce opportunities that ultimately place mother and infant on a course for better health outcomes.
Breastfeeding Support at the Office and Beyond
Pediatricians will be familiar with the initial visit 24 to 48 hours after birth, where breastfeeding is discussed. This important visit and conversation shouldn’t be discounted for the value of imparting important breastfeeding information, support resources, and advice. Pediatricians can ask about the parents’ plans for breastfeeding, offer suggestions, as the child’s primary care physician, and provide the many benefits of breastfeeding for infants and mothers.
However, as Dr. Todd Wolynn, MD FAAP and CEO of Kids Plus Pediatrics in Pittsburgh, PA points out in his regular courses and talks, the time to engage new parents on the importance of breastfeeding, safe sleep, vaccines, and many more items is perhaps not best left to the first visits of an infant’s life, where both the surfeit of information and emotions for parents and child are overwhelming.
Instead, Dr. Wolynn suggests creating systems at your practice that support these conversations early and often, and not always in the office. Social media, email newsletters, and prenatal classes and events are excellent opportunities to offer parents the opportunity to receive breastfeeding advice and resources. Dr. Wolynn also suggests the importance of allowing families to access trusted, professional medical resources (pediatricians) rather than relying on the internet and social media for perhaps well-intentioned but misinformed influencers.
So, if further education for lactation medicine is off the table for you, have you considered becoming a breastfeeding influencer? Yes, really! Social media and online engagement can open the door to opportunities for families to learn more about breastfeeding, donor milk, diversity-inclusive breastfeeding, and much more. Whether you choose to write an editorial for the local newspaper, share Instagram posts with advice, or videos on Facebook explaining common breastfeeding problems, connecting to families online relies on and reinforces the trust and relationships so important to engage families.
Does Your Practice Need a Lactation Consultant?
Lactation consultation is a great additional service for parents and infants, especially in the first days of parenthood where breastfeeding can be overwhelming and perhaps difficult. A board certified lactation consultant can be hired to practice as an additional member of your staff, or you could choose to begin a collaborative relationship with a local consultant who would act as an “on call” professional for new parents.
Hiring or working with a lactation consultant will be unique to your practice and will likely depend on how often your families request or could benefit from this service. In the meantime, there is plenty that pediatricians, office managers, and staff can do to support breastfeeding parents. Pediatricians or other health professionals at the practice might attend courses to become certified lactation consultants, or choose relevant continuing medical education credits on the subject.
Interested in hearing more about connecting to families online and out of the exam room? We recommend Dr. Todd Wolynn’s 2022 PCC Users’ Conference course, Practice Connectedness, Communication, and Care available for a limited time online until summer 2023. Check out this course and all of the UC 2022 courses on the PCC Youtube channel!