ACOG Committee Opinion No. 756 Summary: Optimizing Support for Breastfeeding as Part of Obstetric Practice

Abstract

As reproductive health experts and advocates for women’s health who work in conjunction with other obstetric and pediatric health care providers, obstetrician–gynecologists are uniquely positioned to enable women to achieve their infant feeding goals. Maternity care policies and practices that support breastfeeding are improving nationally; however, more work is needed to ensure all women receive optimal breastfeeding support during prenatal care, during their maternity stay, and after the birth occurs. Enabling women to breastfeed is a public health priority because, on a population level, interruption of lactation is associated with adverse health outcomes for the woman and her child, including higher maternal risks of breast cancer, ovarian cancer, diabetes, hypertension, and heart disease, and greater infant risks of infectious disease, sudden infant death syndrome, and metabolic disease. Contraindications to breastfeeding are few. Most medications and vaccinations are safe for use during breastfeeding, with few exceptions. Breastfeeding confers medical, economic, societal, and environmental advantages; however, each woman is uniquely qualified to make an informed decision surrounding infant feeding. Obstetrician–gynecologists and other obstetric care providers should discuss the medical and nonmedical benefits of breastfeeding with women and families. Because lactation is an integral part of reproductive physiology, all obstetrician–gynecologists and other obstetric care providers should develop and maintain skills in anticipatory guidance, support for normal breastfeeding physiology, and management of common complications of lactation. Obstetrician–gynecologists and other obstetric care providers should support women and encourage policies that enable women to integrate breastfeeding into their daily lives and in the workplace. This Committee Opinion has been revised to include additional guidance for obstetrician–gynecologists and other obstetric care providers to better enable women in unique circumstances to achieve their breastfeeding goals.

Knowledge and attitude of spouses of puerperas towards breastfeeding

“…The Investigation Report on Influencing Factors of Breastfeeding in China published by the China Development Research Foundation found that there are significant regional differences in exclusive breastfeeding rates among big cities, small and medium-sized cities, and rural areas in China, which are 35.6%, 23.3%, and 28.3% respectively, far less than the world average of 44% [ 10 ]. The American Academy of Pediatrics [ 11 ] (AAP), the American College of Obstetricians and Gynecolo gists (ACOG), Professional organizations such as and the [ 12 ] consider breast milk to be the nutritional standard for infant feeding.The World Health Organization (WHO) recommends that exclusive breastfeeding (EBF) should continue until 6 months, followed by gradual addition of complementary foods until 24 months [ 13 ]. Infant feeding attitude is an important predictor of infant feeding decisions, which plays a decisive role in compliance with infant feeding guidelines [ 14 , 15 ], and is also a predictor of breastfeeding duration and exclusivity [ 16 ].…”

Breastfeeding as a Quality Measure

“…Despite the social and professional debates, breastfeeding is commonly understood to be the ideal form of infant feeding for the life course health of the mother and the infant. 8,[24][25][26][27][28] Large variations in access to effective breastfeeding care across the United States at the community and hospital levels continue to be well documented, despite every perinatal professional organization supporting breastfeeding as a pathway to improved population health. 29,30 Variations relate to evidence-based care practices not being followed at the facility level.…”

Development of SARS-CoV-2 specific IgG and IgA antibodies in serum and milk with different SARS-COV-2 vaccines in lactating women

“…Exclusive breastfeeding is recommended for the first 6 months of life, continuing with complementary foods for at least the first year of life and beyond. These recommendations are strongly supported by multiple medical and professional childcare organizations, including the American Academy of Pediatrics (AAP) [1], the American Academy of Family Physicians (AAFP) [2], the American College of Obstetricians and Gynecologists (ACOG) [3], the World Health Organization (WHO) [4] and the Canadian Pediatric Society (CPS) [5], the American Academy of Breastfeeding (ABM) [6] and the Spanish Association of Pediatrics [7] based on short-and longterm benefits for mother and child. Suboptimal breastfeeding is associated with an increased risk of infant and child morbidity and mortality, and an increased risk of certain chronic conditions [8][9][10][11][12].…”