In a recently released issue of Pediatrics, the updated and revised 2022 AAP Policy Statement on Breastfeeding and Human Milk (10.1542/peds.2022-057988), and the accompanying AAP Technical Report, are now available so you can become familiar with them (10.1542/peds.2022-057989). Drs. Joan Meek and Lawrence Noble and the Section on Breastfeeding have authored a focused, evidence-based and easy-to-read AAP Policy Statement that covers an impressive breadth of topics related to breastfeeding and human milk. The Technical Report provides supporting evidence for the AAP Policy Statement and is organized similarly to the AAP Policy Statement. Don’t be daunted by the length of either report – the topic headings provide helpful “signposts,” and figures and tables summarize important points. Ten “Key Recommendations” at the end of the AAP Policy Statement provide a succinct concluding synthesis.
There is a specific emphasis both on breastfeeding and human milk as a public health imperative, and on the role of the pediatrician in supporting parents’ breastfeeding efforts and goals. The policy describes breastfeeding and human milk as “normative” for infant feeding and nutrition and continues to recommend exclusive breastfeeding through 6 months of age, with appropriate complementary foods introduced at this time, and now in full alignment with the World Health Organization recommendations, for “as long as mutually desired by mother and child for 2 years and beyond.” The phrasing “normative” goes beyond “optimal” as a descriptor of human milk feeding, and the explicit support for a longer duration of continued breastfeeding is another leap forward. Pediatrician support is critical for breastfeeding families: the AAP Technical Report notes that, “…women who are supported in breastfeeding are 2.5 times more likely to exclusively breastfeed for 6 months…” The 3-5 day postpartum well infant visit (usually 48-72 hours after hospital discharge) is especially important, since early help for good latch, as well as appropriate lactation referrals, are time critical for comfortable and continued breastfeeding and adequate milk supply. Physician support for breastfeeding beyond one year of age is also needed, and the AAP Policy Statement notes that this is an area in which we can do better in supporting mothers and validating their dedication and commitment to continued breastfeeding.
Multiple other areas are covered and concisely discussed. The topic of equity is addressed, since rates of breastfeeding initiation, exclusivity and duration are lower among non-Hispanic Black and African American mothers as compared to Hispanic, non-Hispanic white and Asian mothers across the US. Suboptimal breastfeeding among the non-Hispanic Black population is estimated to be associated with a 2.2 times excess number of child deaths compared with a non-Hispanic White population. This unsettling and shocking statistic brings home why breastfeeding and human milk feeding are truly public health issues that we all need to own. Learn what more you can do to support and promote breastfeeding individually, in your office, and in legislative advocacy – we all can contribute and move the needle!
