Thank you, Star, for pointing us to the fabulous new
AAFP position paper on breastfeeding.  I ask only why
my local family practice informants have not kept me
informed!  (Ahhhhem!  Jenny?!)

Lovely moments include:

“If the child is younger than two years of age, the
child is at increased risk of illness if weaned.
Breastfeeding the nursing child after delivery of the
next child (tandem nursing) may help to provide a
smooth transition psychologically for the older
child.”

“The physician should offer the adoptive mother the
opportunity to breastfeed her child. A knowledgeable
physician or lactation consultant may help the mother
to develop a milk supply either before or after an
adoption.”

“Family physicians should advocate for improved access
to lactation services by encouraging increased
availability of lactation consultants.”

My one small quibble is that I’d like to see a direct
reference in the body of the statement to the
importance of mother (& family) support groups.  Since
this position paper makes similar suggestions re
community and family education, I’d love to see a nod
to LLL and/or the suggestion of additional support
groups through family practice clinics, WIC,
hospitals, and community centers which already offer
birth preparation and parenting classes to general and
at-risk populations.  Perhaps I have simply missed
this in my reading and someone will help me out.
Since the statement strongly recommends physician
education and community education regarding all
aspects of breastfeeding including nursing well past
infancy, I’d also love a nod to support for families
nursing longterm.  ILCA, LLLI, etc are listed as
resources at the end of the statement along with the
WHO Code & the 10 Steps.  All in all though, terrific.

“Women of lower socioeconomic status may have less
education and are often employed in positions where
work hours, transportation, and other constraints
interfere with the maintenance of a regular schedule
of breastfeeding and/or pumping. Provision of formula
through WIC may make bottle-feeding an attractive
alternative, despite concordant attempts to encourage
breastfeeding. Family responsibilities, the cost of
nursing paraphernalia, lack of a private space to
nurse, and issues of partner acceptance pose
additional obstacles to lactation.10,33,75 In
addition, these mothers often lack personal role
models as well as access to breastfeeding information
and to lactation specialists. Certain populations are
potentially more vulnerable to the effects of
aggressive infant formula marketing practices.25”

Hear, hear.

There are detailed comments on premature babies, the
special challenges of military mothers, and teens and
body image.  Great piece.  Must-read for HCPs and
mothers at all stages.

Suitable for publication in its entirety.  Is
permission necessary for publication (in part or in
whole)?  If so, how would an editor obtain permission?
 TIA!

Obviously I’m having a grand start to a new week.
Thanks, Star!


Susan Johnson MFA, IBCLC
Salt Lake City, USA


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