The American Academy of Pediatrics released a policy statement Monday extending the recommended period of breastfeeding to two years or more, but also recognizing the obstacles that stand in the way of parents.
“We need societal changes that will help support this, such as paid time off work, increased breastfeeding support in public and childcare facilities, and workplace support,” said Dr. Joan Meek, professor emeritus in the Florida State University College Department of Clinical Sciences. of Medicine and lead author of the new recommendations.
Much of the policy — the group’s first updated breastfeeding guidelines in a decade — is identical to what the AAP has said in the past. The organization continues to recommend that babies be exclusively breastfed for about six months, after which supplemental foods can be introduced. The statement cites research linking breastfeeding to a range of benefits in infants, including reduced rates of lower respiratory tract infections, severe diarrhea and ear infections.
But the group is now calling on pediatricians to support breastfeeding for two years or more — rather than a year or more — if mothers and their babies have “mutually wished.” dr. Meek said the shift was rooted in research suggesting there are particular health benefits of long-term breastfeeding for mothers, such as a reduced risk of type 2 diabetes in the mother. But it also reflects the AAP’s desire to normalize breastfeeding for longer for parents who choose to do it.
“In the medical field, there is often a tendency to support breastfeeding until a child’s first birthday,” said Dr. meek. “After that it’s like, ‘Well, there’s no reason to continue breastfeeding.'”
Read more about the shortage of baby food
- Understand the deficiency: With only a handful of companies making infant formulas for the US market, the closure of an Abbott Laboratories plant had an excessive effect.
- Premature Babies: Many newborns who spend time in the NICU rely on a specialized formula to thrive once they get home. While the shortage continues, their parents can’t find it anywhere.
- Pumps for the cause: In New York City, the shortage has prompted a massive volunteer effort, with some moms donating their excess breast milk to help other parents.
- An emotional toll: The shortage is forcing many new moms to breastfeed more, and some are even looking for ways to start over after they stop.
However, the reality is that a majority of American babies are not breastfed for as long as the AAP recommends. The new policy statement is in line with the guidelines of the World Health Organization, which has long approved breastfeeding until a child’s second birthday or beyond.
The most recent data available from the Centers for Disease Control and Prevention says that 84 percent of babies are breastfed, but only 58 percent are breastfed at 6 months — and only 25 percent are exclusively breastfed. Thirty-five percent of babies are still breastfed after 1 year, and there are no reliable national estimates after that time frame.
The gap between public health guidelines and what happens in most American families can leave new parents vulnerable to guilt or disappointment.
“This is the recommendation, but in reality — in practice — we don’t want parents to feel bad if they can’t get there,” said Dr. Dale Lee, a pediatric gastroenterology and nutrition specialist at Seattle Children’s Hospital.
The AAP’s new breastfeeding policy statement recognizes that many of the barriers parents face in meeting public health recommendations and their own goals are beyond their control. It encourages pediatricians to advocate for changes that would help parents, including guaranteed paid time off work, flexible work schedules, and workplace resources such as lactation rooms, universal breaks for expressing breast milk, and on-site childcare.
The recommendations also suggest that pediatricians have “non-judgmental conversations” with families about their breastfeeding goals and recognize that exclusive breastfeeding isn’t always possible. The AAP notes that children of parents of different genders may have less access to human breast milk, and clinicians should consider using more inclusive language, such as “breastfeeding,” when working with those families.
“I love breastfeeding and I really want to highlight its benefits,” said Dr. Lee. “But I also want to tell parents that it’s not like you’re obligated to give breast milk, and you’re a failure if you don’t.” He added that babies can thrive on breast milk, baby food, or a combination of both, and most importantly, parents can “feed their children with love.”
Yet policy comes at a challenging time for many American families, amid a months-long baby food shortage that has made it more difficult for parents to meet their children’s basic needs.
Navigating the US Baby Food Shortage
A growing problem. A nationwide baby food shortage – caused in part by supply chain problems and exacerbated by a recall from baby food manufacturer Abbott Nutrition – has left parents confused and concerned. Here are some ways to deal with this uncertainty:
dr. Meek noted that the AAP had been working on its new policy statement for years. She said the timing of the publication should not be interpreted as if the AAP in any way suggests that women can breastfeed to get out of the current formula crisis.
Pediatricians should support families in finding a nutrition plan that works for them, experts said.
“It’s not a one-size-fits-all,” said Dr. Natasha Sriraman, an associate professor of pediatrics at Eastern Virginia Medical School/Children’s Hospital of the King’s Daughters, on the new recommendations. “What may work for the mother in the X situation, won’t work for the mother in the Y situation, and I think unfortunately we still have a sense of guilt and judgment from the mother.”
In her practice, she tends to emphasize that the amount of breast milk that parents can give their babies is beneficial, rather than bluntly applying public health recommendations about duration or exclusivity.
dr. Sriraman called the idea of breastfeeding for two years “great” – if that is the goal of a family. But, she added, it’s “really a stretch in this country.”