new American Academy of Pediatrics policy
The differences between the 1998 AAP policy and the one which was released yesterday are subtle, but important. The new policy includes two new sections, "Contraindications to Breastfeeding" and "Conditions that are Not Contraindications to Breastfeeding and many new references documenting the reductions in health risks that are associated with breastfeeding. This increased clarity about who should and should not breastfeed will certainly be helpful in communicating with the public. From the list, it is clear that most mothers are capable of breastfeeding their infants.
Another new section, "the challenge", refers to the Healthy People 2010 goals and points out that current breastfeeding rates are well below those goals.
A new table is provided with 2001 statistics on breastfeeding rates, exclusive breastfeeding rates, and the Healthy People 2010 goals so that the contrast between reality and the desired future is readily apparent. The new AAP statement also states that "although breastfeeding initiation rates have increased steadily since 1990, exclusive breastfeeding initiation rates have shown little or no increase over that same period of time." The importance of breastfeeding without supplementation of nonhuman milks or foods is bolstered with several references that show a connection between supplementation and decreased likelihood of contributed breastfeeding and decreased protection against diseases.
The treatment recommendations for healthy term infants are much more detailed than in the 1998 policy, emphasizing the importance of skin-to-skin contact after birth until the first feeding occurs. Frequent support and assessment of the breastfeeding relationship is recommended: at least twice daily while mother and baby are in the hospital, and during office visits to a pediatrician or other knowledgeable professional at 3-5 days after childbirth, and again at 2-3 weeks after childbirth. Recommendations also include this sentence: "mother and infant should sleep in proximity to each other to facilitate breastfeeding."
The final section of the new statement is reorganized an expanded, addressing the role of pediatricians and other healthcare professionals in protecting, promoting, and supporting breastfeeding. It includes the statement that pediatricians should "use every opportunity to provide age-appropriate breastfeeding education to children and adults in the medical setting and in outreach programs for student and parent groups" and "work actively toward eliminating hospital policies and practices that discourage breastfeeding (e.g., promotion of infant formula in hospitals including infant formula discharge packs and formula discount coupons, separation of mother and infant, inappropriate infant feeding images, and lack of adequate encouragement and support of breastfeeding by all health care staff)".
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