Hello Netters,
Dec. Pediatric Journal- Vol. 100, #6 finally arrived with the AAP
Guidellines--"Breastfeeding and the Use of Human Milk". It begins with the
benefits of BF to the infant, mother, and nation. Following is "The AAP
emphasizes the essential role of the pediatrician in promoting, protecting,
and supporting breastfeeding and recommends the following breastfeeding
policies."
1. Human milk is the preferred feeding for all infants, including premature
and sick newborns, with rare exceptions........
2. Breastfeeding should begin as soon as possible after birth, usually
within the first hour. Except under special circumstances, the newborn
infant should remain with the mother throughout the recovery perid.
Prodedures that may interfere with breastfeeding or traumatize the infant
should be avoided or minimized.
3. Newborns should be nursed whenever they show signs of hunger, such as
increased alertness or activity, mouthing, or rooting. Crying is a LATE
indicator of hunger. Newborns should be nursed approximately 8 to 12 times
every 24 hours until satiety, usually 10 to 15 minutes on each breast. In
the early weeks after birth, nondemanding babies should be aroused to feed if
4 hours have elapsed since the last nursing. Appropriate initiation of
breastfeeding is facilitated by continuous rooming-in........
4. No supplements (water, glucose water, formula, and so forth) should be
given to breastfeeding newborns unless a medical indication
exists.......Supplements and pacifiers should be avoided whenever possible,
if used at all, only after breastfeeding is well established.
5. When discharged <48hrs after delivery, all breastfeeding mothers and
their newborns should be seen by a pediatrician or other knowledgeable health
care practitioner when the newborn is 2-4 days of age............
6. Exclusive breastfeeding is ideal nutrition and sufficient to support
optimal growth and development for approximately the first 6 months after
birth. Infants weaned before 12 months of age should not receive cow's milk
feedings but should receive iron-fortified infant formula. Gradual
introduction of iron-enriched solid foods in the second half of the first
year should complement the breast milk diet. It is recommended that
breastfeeding continue for at least 12 months, and thereafter for as long as
mutually desired.
7. In the first 6 months, water, juice, and other foods are generally
unnecessary for breastfed infants. Vitamin D and iron may need to be given
before 6 months of age in selected groups of infants. (vitamin D for infants
whose mothers are vitamin D-deficient or those infants not exposed to
sunlight: iron for those who have low iron stores or anemia). Fluoride
should not be administered to infants during the first 6 months after birth,
whether they are breast or formula-fed. During 6 months to 3 years of age,
breastfed infants (formula-fed) require fluoride supplementation only if the
water supply is severely deficient in fluoride (<0.3ppm).
8. Should hospitalization of the breastfeeding mother or infant be
necessary, every effort should be made to maintain breastfeeding, preferably
directly, or by pumping the breasts and feeding expressed breast milk, if
necessary.
ROLE OF PEDIATRICIANS IN PROMOTING AND PROTECTING BF
1. Promote and support BF enthusiastically. .......
2. Become knowledgeable and skilled in both the physiology and the clinical
management of BF.
3. Work collaboratively with the obstetric community to ensure that women
receive adequate information throughout the perinatal period to make a fully
informed decision about infant feeding. ........
4. Promote hospital policies and procedures that facilitate BF. Electric
breast pumps and private lactation areas should be available to all BF mother
in the hospital, both on ambulatory and inpatient services..........
5. Become familiar with local BF resources............
6. Encourage routine insurance coverage for necessary BF services and
supplies, including breast pump rental and the time required by pediatricians
and other licensed health care professionals to assess and manage BF.
7. Promote BF as a normal part of daily life, and encourage family and
societal support for BF.
8. Develop and maintain effective communications and collaboration with
other health care providers to ensure optimal BF education, support, and
counsel for mother and infant.
9. Advise mothers to return to their physician for a thorough breast
examination when BF is terminated.
10. Promote BF education as routine component of medical school and
residency education.
11. Encourage the nedia to portray BF as positive and the norm.
12. Encourage employers to provide appropriate facilities and adequate time
in the workplace for breast-pumping.
Now we all have something to help back us up in the hospitals, WIC and
elsewhere.
Thanks to all the Work Group on Bf and Chairperson---Larry Gartner. I think
they did a good job.
Pat Bull, RN, IBCLC
The Breastfeeding Connection/Medela
Naperville, IL
|
