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 Updated recommendations issued today by the U.S. Preventive Services
Task Force (USPSTF) recognize the many health benefits of
breastfeeding for both mothers and babies while also accepting that
women need to make a personal choice about how to feed their
infants, said task force member Ann Kurth, dean of the Yale School
of Nursing in Orange, Connecticut.
“Evidence suggests that any breastfeeding appears to be more
beneficial than no breastfeeding, and health benefits continue to
increase the longer a woman continues to breastfeed,” Kurth said by
email.
Pediatricians recommend that mothers exclusively breastfeed infants
until at least six months of age because it can reduce babies’ risk
of ear and respiratory infections, sudden infant death syndrome,
allergies, childhood obesity and diabetes.
Mothers can benefit too, with longer periods of breastfeeding linked
to lower risks of depression, bone deterioration and certain
cancers.
Programs such as one-on-one counseling from lactation experts,
education about the health benefits of nursing, provision of
supplies like nursing bras and breast pumps, and peer support groups
for nursing mothers may all help encourage breastfeeding, the USPSTF
concludes in guidelines published in JAMA.
The task force analyzed 43 previously published studies and found
that support efforts can help increase how many women breastfeed and
how long they continue to do it.
These studies didn’t offer clear evidence that one type of support
is better than another, but they did suggest timing matters, said
Carrie Patnode, lead author of the USPSTF research review.
“Interventions that included prenatal education, support at or
around the time of delivery, and postpartum support were more
beneficial than those that only provided prenatal support, for
instance,” Patnode added by email.
The USPSTF, a government-backed independent organization that
reviews medical evidence, last updated its breastfeeding guidelines
in 2008. Then, as now, the task force urged support of breastfeeding
during pregnancy and after delivery. These guidelines are widely
used to determine whether insurance will pay for screenings and
treatments and are widely followed by primary care physicians.
This time around, though, the recommendations also take extra care
to avoid putting unnecessary pressure on mothers who don’t
breastfeed their babies, said Dr. Valerie Flaherman, a researcher at
the University of California, San Francisco, and author of an
accompanying editorial.
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“Doctors and nurses should provide mothers with information and
education regarding the benefits of breastfeeding, but we should not
pressure mothers to breastfeed, and mothers should not be made to
feel guilty if they are unable to breastfeed or decide that it is
not the best decision for their family,” Flaherman said by email.
Beyond just making mothers feel guilty for giving babies formula,
there’s a potential to ratchet up feelings of anxiety or increase
the odds of postpartum depression, Kurth noted.
Still, some women may need more support than they get, Dr. Dimitri
Christakis of Seattle Children’s Research Institute notes in a
separate editorial in JAMA Pediatrics.
Roughly four in five U.S. mothers start breastfeeding, Christakis
writes. This suggests that most new mothers are motivated to
breastfeed.
But within three months, only 43 percent of mothers exclusively
nurse their babies. By six months, just 22 percent of women
exclusively breastfeed their infants.
This suggests a missed opportunity to offer help, and an opportunity
for doctors to prioritize conversations about breastfeeding.
“Of the myriad topics one might discuss, why not start with the ones
that caregivers are most interested in,” Christakis writes.
“Breastfeeding is surely one of those.”
“We might very well add breastfeeding support right after
vaccinations,” Christakis adds.
SOURCE: http://bit.ly/2eC0BsB, http://bit.ly/2ermB7D and http://bit.ly/2dFv3AP
JAMA; http://bit.ly/2eI4hWj JAMA Pediatrics, online October 25,
2016.
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