Breastfeeding
"Breast IS Best"
Breastmilk is the perfect food for babies; it is a complex living nutritional fluid that additionally contains enzymes, antibodies and hormones, all of which have health benefits.
The following World Health Organization (WHO) recommendations are also supported by American Academy of Family Physicians (AAFP) and American academy of Pediatrics (AAP):
Exclusive Breastfeeding for six months
Supplemental Breastfeeding continuing for two years or more
We CAN make a difference!
Most women decide by the beginning of the third trimester whether or not they will breastfeed (Ertem, et al., Pediatrics, 2001). Family physicians are uniquely positioned to influence breastfeeding outcomes because they care for women and children from preconception counseling through well child care and beyond (Meyers, AFP, July 2008).
You can make a big difference on breastfeeding rates if you introduce this topic early in prenatal care (or ideally, pre-conception).
Educate your patients on the health benefits of breastfeeding.
Help patients make an informed decision.
The United States Preventive Services Task force (USPSTF) recommends structured breastfeeding education and behaviorally oriented counseling programs to increase breastfeeding initiation and maintenance.
Characteristics of women most likely to initiate breastfeeding:
Older
Better educated
Non-smokers
Higher socioeconomic status
Previous breastfeeding experience
Were breast fed themselves
Characteristics of women least likely to initiate breastfeeding:
Non-Hispanic black
Socio-economically disadvantaged groups
The biggest decline in breastfeeding rates occurs in first 4 days (12% stop), 22% stop by 2 wks, 37% by 6 weeks. Reasons women give for discontinuing breastfeeding include:
Maternal lack of confidence, early breast feeding problems, lower maternal education (Taveras 2003).
Postnatal depression, returning to work/school, maternal, anxiety, being born on hospital night shift (Gagnon, 2005).
Hospital supplementation, concern about breastfeeding in public.
Benefits of Breastfeeding:
Disease prevention: Decreased risk of asthma, Hodgkin's disease, hypercholesterolemia, leukemia, obesity, types 1 and 2 diabetes. Decreased hospitalizations for lower respiratory illnesses and sudden infant death syndrome.
Immunologic: Decrease in bacterial meningitis, bacteremia, diarrhea, late-onset sepsis, necrotizing enterocolitis, otitis media, respiratory tract infections, UTIs.
Developmental: Improved developmental outcomes in premature infants.
Psychological: Analgesic effects during painful procedures.
Maternal Health: Decrease in risk of breast and ovarian cancers, decreased postpartum bleeding, earlier return to pre-pregnancy weight, lactation amenorrhea. Studies also suggest women that breastfeed their babies are lowering their own risk of the following: myocardial infarction, coronary artery disease, stroke, diabetes, hypertension, hyperlipidemia, osteoporosis.
Economic: A decrease of $3.6 billion in annual health care costs, decreased cost for public supplementation programs (e.g., Women, Infants, and Children [WIC] program), and decreased patient costs.
Environmental: Decreased disposal of formula cans and bottles.
(Andrea Janda, 080308VanSickler073, flickr. CC: BY-NC-ND 2.0.
Downloaded on August 3, 2009.)