Breastfeeding in the Headlines

Breastmilk is easier to digest than formula, and contains antibodies that protect against infections, allergies, inflammatory bowel disease and sudden infant death syndrome. The benefits of breastfeeding extend into adulthood, with lower rates of obesity, cardiovascular disease risk factors, diabetes and some types of cancers. Nursing mothers also enjoy benefits such as reduced risk for breast cancer, ovarian cancer, diabetes, hypertension, and heart disease.

There is no shortage of evidence showing the value of breastfeeding for both women and their infants.  And yet, studies show that while most women in the United States initiate breastfeeding, more than half wean earlier than they desire. Barriers to breastfeeding can have a dramatic impact on the likelihood a mother will continue to nurse her child.  Common barriers include a women’s socioeconomic status, education, misconceptions, and social norms. For example, barriers such as the need to return to work sooner after giving birth and employment in positions that make breastfeeding at work more difficult contribute to lower rates of breast feeding among low-income women than women with higher incomes.

While the Affordable Care Act includes provisions to support breastfeeding mothers, there is more to be done. Supporting a woman’s decision to breast-feed takes a multifaceted approach, including advancing public policies like paid family leave, access to quality child care, break time, and a location other than a bathroom for expressing milk.

As ob-gyns and advocates for women’s health, we can also support women to achieve their infant feeding goals directly through patient care. According to  ACOG Committee Opinion NO. 658, Ob-gyns and other obstetric care providers should:

  • Develop and maintain knowledge and skills in anticipatory guidance, physical assessment and support for normal breastfeeding physiology, and management of common complications of lactation.
  • Support each woman’s informed decision about whether to initiate or continue breastfeeding, recognizing that she is uniquely qualified to decide whether exclusive breastfeeding, mixed feeding, or formula feeding is optimal for her and her infant.
  • Support women in integrating breastfeeding into their daily lives in the community and in the workplace.
  • Be a resource for breastfeeding women through the infant’s first year of life, and for those who continue beyond the first year.

ACOG strongly supports breastfeeding and provides resources for both you and your patients. I encourage you to visit to learn more.

Ob-Gyns Can Empower Women to Choose Breastfeeding

Only 22 percent of mothers in the United States are exclusively breastfeeding their babies at six months. Although most U.S. women initiate breastfeeding, more than half wean earlier than they desire and fall short of their personal goals. These are startling statistics given all the research and evidence we have that shows how beneficial it can be for both women and babies. That says to me that we, as providers, can do more to empower women with the knowledge to make this critical decision. As National Breastfeeding Month comes to a close, it seems like an appropriate time to remind us how important our guidance really is and the potential impact it could make on health outcomes.

There are many barriers to successful breastfeeding but I believe the key to overcoming them starts with education—the one factor that physicians have the most control over. Misinformation can often be the culprit when it comes to a mother making the decision not to breastfeed. Discussions about breastfeeding should be integrated into maternity care. Providers should obtain a thorough history and find out early what expectant mothers know or have heard about breastfeeding. Often times, it’s as simple as mitigating fears regarding pain associated with breastfeeding and letting mothers know that it might not come naturally at first and that, with the right support, techniques are learned and will improve over time. Providers should respect and support a woman’s informed decision whether to initiate or continue breastfeeding, as each woman is uniquely qualified to decide which feeding option is best for herself and her infant.  However, pregnant mothers take their doctors’ advice seriously, so we shouldn’t underestimate our influence. By saying nothing, we imply that it doesn’t matter—and it does.

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It Takes a Village to Increase Breastfeeding Rates

It’s disappointing that in 2013 we still regularly read stories about mothers being shamed for breastfeeding in public. Despite the fact that breastfeeding is a natural, age-old practice that has nourished babies for millennia, it remains a source of much debate. As an ob-gyn, I don’t see breastfeeding as controversial. In fact, I think it’s as close as we get to a “win-win.” The key point is to support women in their choice, whether their decision is to breastfeed or not, and to recognize that for some women breastfeeding can be very difficult. This is why as ob-gyns, we can partner with others to support women’s needs and desires and advocate for workplace accommodations that help promote breastfeeding on the job.

The benefits to mother and baby are clear. Breast milk is truly nature’s perfect baby food—it provides infants with complete nutrition, helps build strong digestive and immune systems, and protects against childhood illness such as respiratory infection and cancer. Breastfeeding also helps women bond with their newborns, contributes to faster postpartum weight loss, and decreases a mother’s risk of developing breast or ovarian cancers in the future.

Fortunately, the majority of women will be able to successfully breastfeed. ACOG recommends exclusive breastfeeding—without supplementing with formula—until infants are 6 months old. National efforts to increase breastfeeding rates are helping. Today, 75% of women initiate breastfeeding. However, research has shown that many women stop breastfeeding earlier than intended. Only 14% of women exclusively breastfeed at 6 months, well short of the 60% goal set by the US Public Health Service for Healthy People 2020.

To increase the duration of breastfeeding, it will take a village. Ob-gyns, pediatricians, family members, child care providers, workplaces, and communities all play a role. As ob-gyns, we have many opportunities to support our patients’ desire to breastfeed. We can counsel women during pregnancy about the benefits of breastfeeding, and we can put plans in place to ensure immediate and smooth initiation after delivery. We should be available to help our patients who experience physical problems by quickly evaluating and treating breast issues (such as mastitis) and referring them to lactation specialists or breastfeeding experts who can assess logistical problems. We must also remember that the challenges don’t end at the hospital and serve as vocal advocates of creating breastfeeding-friendly hospitals, communities, and workplaces—our own offices included.

The bottom line: Breastfeeding is healthy for mom and baby. While we should always be compassionate and nonjudgmental to our patients that can’t or choose not to do it, we should continue to support and encourage the practice in any way we can.

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The Original Organic Baby Food

Breastfeeding—it’s a woman’s built-in system for nourishing her baby. It provides complete nutrition, and it’s an inexpensive and convenient feeding option. ACOG recommends that infants be breastfed for the first six months. Unfortunately, people in the US have not whole-heartedly embraced breastfeeding, making it a constant source of debate, controversy, and awkward pauses. But I say enough already. It’s time to move beyond thinking that breastfeeding is odd, taboo, or indecent.

Breastfeeding helps babies build strong digestive and immune systems and may protect against respiratory infections, some childhood cancers, and obesity. Breastfed babies often have less gas, constipation, and diarrhea, fewer feeding problems, and less illness than do formula-fed babies. Women who breastfeed may lose weight faster, experience less stress during the postpartum period, build stronger bonds with their babies, and have a decreased risk of breast and ovarian cancer in the future. Exclusive breastfeeding can also temporarily stop ovulation, lowering the risk of pregnancy. However, it is not a foolproof method of contraception. Women who want to avoid pregnancy should discuss birth control options with their ob-gyn to be on the safe side.

Overall, the benefits of breastfeeding are great, and the vast majority of women are able to breastfeed. But even though breastfeeding is a natural process, it’s not always intuitive. That’s why it’s a good idea to let your doctor and health care team know your breastfeeding plans before you deliver. They will help you start and support your breastfeeding once the baby is born. For some, learning how to nurse takes time, patience, and practice.

Women may also face logistical or workplace-based obstacles to breastfeeding. ACOG continues to advocate for employers to provide designated spaces to facilitate breastfeeding moms. In the meantime, it’s a good idea to talk to your coworkers and other moms who have breastfed and share strategies for how you can make breastfeeding work at work.

If you’re pregnant, consider giving breastfeeding a try. If it’s not the best choice for you and your baby, that’s OK. But who knows? You may be surprised to find that it comes…naturally.