02 March 2012

Paediatricians reaffirm breastfeeding guidelines

Women should breastfeed their newborns for about the first six months of life, after which some foods can be added along, according to the American Academy of Paediatrics (AAP).


Women should breastfeed their newborns exclusively for about the first six months of life, after which some foods can be added along with continued breastfeeding, according to updated guidelines from the American Academy of Paediatrics (AAP).

The recommendations, which call for additional breastfeeding until a baby's first birthday or longer, are similar to those from the World Health Organization.

"It's a healthy choice and not just a lifestyle choice, and it's going to protect her baby as well as her," said Dr Richard Schanler, a neonatologist from North Shore-Long Island Jewish Health System and one of the guideline's co-authors.

"Our problem as paediatricians is we're not getting that message across enough to mothers," he said.

Breastfeeding recommendation is not new

Although the six-month exclusive breastfeeding recommendation is not new, AAP members said it's a firmer guideline, with more evidence behind it, than in the organisation's last breastfeeding statement published in 2005.

Recent studies suggest that only about 13% of moms in the US still haven't used any formula or added solid foods at six months.

And many women, especially young, poor mothers, don't ever start breastfeeding, according to the report, published online in Paediatrics.

"It's clear that in order to realise all of the benefits of breastfeeding, to ward off... adverse health outcomes, you need exclusive breastfeeding," said Dr Lori Feldman-Winter, a paediatrician at Cooper University Hospital in Camden, New Jersey, and chairperson of the policy committee for the AAP's Section on Breastfeeding.

Formula is not superior to breastfeeding

"Combination feeding, or using infant formula, will undermine that," she said. "Our recommendation for mothers is not to do any formula feeding."

"Formula has never been shown to be superior to breastfeeding for anything for the mother or the baby," agreed Dr Michael Kramer, who studies pregnancy and breastfeeding at The Montreal Children's Hospital and wasn't part of the AAP committee.

Still, he pointed out that the health benefit of breastfeeding is "not a guarantee – it's a relative protection."

The new guidelines also urge hospitals to promote breastfeeding as early as possible. The AAP recommends that moms first breastfeed their newborns within an hour of giving birth, that moms and babies be kept together in the hospital and that free samples of infant formula not be distributed, as has been common practise.

Other ways to be a good mom

After that, workplaces should make breastfeeding as convenient as possible for women – which will save companies money in the long run, when mothers have to spend fewer days at home.

Dr Schanler said that although breastfeeding shouldn't be stopped at six months, that's the time when babies would benefit from the extra micronutrients in foods like fortified cereal, meat and fruits and vegetables.

Dr Kramer told Reuters Health that breastfeeding isn't the end-all-be-all for children's health and development, and that reading to a baby and making sure young kids are physically active is also important.

"There are lots of other ways that women can be good mothers if they can't or don't want to breastfeed," he said.

Still, Dr Schanler concluded, "It's going to protect their babies' health, so why not try it?"

(Genevra Pittman, Reuters Health, March 2012)

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