Breastfeeding and human milk are the normative standards for infant feeding and nutrition. Given the documented short- and long-term medical and neurodevelopmental advantages of breastfeeding, infant nutrition should be considered a public health issue and not only a lifestyle choice. The American Academy of Pediatrics reaffirms its recommendation of exclusive breastfeeding for about 6 months, followed by continued breastfeeding as complementary foods are introduced, with continuation of breastfeeding for 1 year or longer as mutually desired by mother and infant. Medical contraindications to breastfeeding are rare. Infant growth should be monitored with the World Health Organization (WHO) Growth Curve Standards to avoid mislabeling infants as underweight or failing to thrive. Hospital routines to encourage and support the initiation and sustaining of exclusive breastfeeding should be based on the American Academy of Pediatrics-endorsed WHO/UNICEF “Ten Steps to Successful Breastfeeding.” National strategies supported by the US Surgeon General’s Call to Action, the Centers for Disease Control and Prevention, and The Joint Commission are involved to facilitate breastfeeding practices in US hospitals and communities. Pediatricians play a critical role in their practices and communities as advocates of breastfeeding and thus should be knowledgeable about the health risks of not breastfeeding, the economic benefits to society of breastfeeding, and the techniques for managing and supporting the breastfeeding dyad. The “Business Case for Breastfeeding” details how mothers can maintain lactation in the workplace and the benefits to employers who facilitate this practice.

Objective-To determine whether a web-based, interactive, breastfeeding monitoring system increased breastfeeding duration, exclusivity, and intensity as primary outcomes and decreased symptoms of postpartum depression as a secondary outcome.Methods-A two arm randomized controlled trial took place in three Midwestern hospitals. Postpartum women were randomly assigned to the control or intervention group. Women in the control group (n=57) followed the standard hospital protocol, while women in the intervention group (n= 49) were given access to an online, interactive, breastfeeding monitoring system and prompted to record breastfeeding and infant output data for 30 days. A follow-up online survey was sent to both groups at 1, 2, and 3 months to assess breastfeeding outcomes and postpartum depression.Results-For mothers and infants, there were no significant differences in demographics between groups. No significant differences in breastfeeding outcomes were found between groups at discharge (p = 0.707). A significant difference in breastfeeding outcomes was found between groups at 1, 2, and 3 months (p = 0.027, p = 0.000 and p = 0.002). Members of the intervention Corresponding Information Azza H Ahmed, DNSc, RN, IBCLC, CPNP, School of Nursing, Purdue University, 502 N. University St, West Lafayette, IN, 47907, ahmedah@purdue.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.Disclosure The authors report no conflict of interest or relevant financial relationships. HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript group had higher exclusive breastfeeding rates at 1, 2, and 3 months. By the end of the third month, 84% of the intervention group was breastfeeding compared to 66% in the control group. Postpartum depression symptom scores decreased for both groups at 1, 2, and 3 months (4.9±3.9, 4.3±4.9, and 3.2±3.9 for control and 4.7±4.5, 3.0±3.4, and 2.8±3.6 for intervention). However, there was no significant difference between groups at 1, 2, and 3 months (p= 0.389, 0.170, and 0.920) for depression. Conclusion-The web-based interactive breastfeeding monitoring system may be a promising intervention to improve breastfeeding duration, exclusivity, and intensity. KeywordsWeb-based interactive monitoring; Breastfeeding; e-health; Breastfeeding supportThe benefits of breastfeeding and the risks associated with formula feeding are well known. Infants who are not breastfed are at increased risk for infections that include otitis media and diarrhea, elevated risks of childhood obesity, type 1 and type 2 diabetes, leukemia, and sudden ...

The authors report the first published case of premature twins whose adoptive mother induced lactation. Both infants are receiving exclusively human milk (adoptive mother's milk) at 2 months of age. This remarkable achievement reflects careful planning by the adoptive mother beginning in the prenatal period, her active role during the infants' hospital stay, and support from health care personnel and family members. Health care professionals are encouraged to support any adoptive mother who expresses interest in breastfeeding her infant(s).

This study illuminated key disconnectedness challenges (and, hence, opportunities) for a model medical home in fostering continuous, comprehensive, coordinated, culturally effective, and evidence-based breastfeeding promotion and support.