Just ahead of National Breastfeeding Month, the American Academy of Pediatrics (AAP) released an updated policy statement, which includes a recommendation to support parents who choose to breastfeed their infant to age 2. While the AAP has long recommended exclusive breastfeeding for the first six months of life, further support is needed for those who wish to continue up to a year and beyond.
We sat down with Jenelle Ferry, M.D., neonatologist and director of feeding, nutrition and infant development at Pediatrix® Neonatology of Florida – Tampa, to review the key takeaways from the AAP’s statement.
The health benefits of human milk are undeniable. “We’ve known for a long time that the benefits of breastfeeding exist and that the longer a baby receives breast milk, the more those benefits can extend,” said Dr. Ferry.
Exclusive breastfeeding during the first 6 to 12 months offers the greatest health benefits, and those extend for both mom and baby as breastfeeding continues during the first and second years.
“For the child, they can have less atopy — allergic diseases like asthma and eczema,” she said. “There is also shown to be a reduction in upper respiratory and ear infections. Later in life, there is a decrease in obesity, metabolic disorders and high blood pressure. For the mom, breastfeeding can reduce the risk of breast and ovarian cancer, type 2 diabetes and high blood pressure.”
Adequate support for breastfeeding moms in the infant stage is still lacking, which creates an added strain for those who wish to continue up to age 2. To start, maternity leave policies in the United States are inadequate. While many companies have made great strides to change that, it is one of the first obstacles new moms encounter.
Once moms are back to work, they often don’t have the ability to pump to sustain their supply.
“One of the biggest barriers is protected time and space in the workplace,” said Dr. Ferry. “That kind of legislature is hard because you have to try and protect breastfeeding moms and at the same time recognize that different sized companies and employers may have different space and financial constraints. It’s sad that I still hear stories of moms sitting on a toilet to pump — that breaks my heart all the time.”
This is especially true for low-wage jobs, most of which are not able to provide this kind of support.
Access to breast pumps is no longer a barrier thanks to policy change that requires all health insurance plans to cover the cost of a breast pump.
“In the state of Florida, for example, for Medicaid, it used to be difficult to get a breast pump if your child was also getting formula — it was one or the other,” said Dr. Ferry. “Now, there is more of a recognition that both things may need to be supported. There are certainly moms who need a breast pump who may also need to give their baby some formula and those things both need to be provided.”
Lactation support coverage still varies by insurer, but Dr. Ferry encourages moms to speak with their doctor, who can help point them to available resources.
Cultural norms also greatly impact the level of support parents have.
“Raising a child takes a village, that still remains true, and if your village isn’t supportive of breastfeeding, that can make it a lot more difficult for moms,” said Dr. Ferry. “If you rely on other people to help take care of your children and their feelings about breastfeeding are different, you may or may not get as much support as you need there.”
For moms who have made it to a year and are worried about trying to make it two years, kudos to you!
“You’ve already overcome a big feat — probably one of the biggest feats,” said Dr. Ferry.
Babies start to naturally wean at different times, at which point moms can struggle with maintaining their supply, and pumping may need to be factored in. However, Dr. Ferry notes that pumping at this stage won’t be as much of a time commitment given that breast milk isn’t the main source of nutrition once solid foods are introduced at 6 months.
“It’s not going to be every three hours like when they’re a newborn, so you can extend that breastfeeding with those morning and evening feeding times, which makes that a little bit easier when you look at factoring in work constraints,” she said.
Ultimately, Dr. Ferry says that moms instinctively know what’s best for them and their child.
“I think with anything when it comes to your children, listen to the recommendations, talk to your physician and then make the decision that you feel in your heart is right for you, your child and your family and tune out the others,” she said. “We are in a society that doesn’t always fully support breastfeeding. Again, I think that has changed a bit in recent years as these benefits continue to be expounded and we educate moms and try to change the way that we support them. But any time you’re looking at something that is out of the norm, not what we used to do or a bit of a change, there can be resistance. Well-meaning people in your lives are going to have their opinions about that, so I think it’s important to really educate yourself so you can educate others and make sure that you find those places that you can get supported.”
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