Convincing new mothers that "breast is best"

A recent report from the Centers for Disease Control and Prevention found that despite evidence that birthing environments strongly influence new mothers' feeding practices, only 3.5 percent of surveyed U.S. hospitals met most quality indicators of the Baby-Friendly Hospital Initiative, an international program that seeks to reduce obstacles to successful breastfeeding. Hospitals received low marks on items such as restricting pacifier use and supplemental infant formula, and only a minority permitted 24-hour "rooming in," which makes it easier for infants to breastfeed on demand.

Although the American Academy of Family Physicians and the American Academy of Pediatrics recommend that mothers exclusively breastfeed infants for the first 6 months of life, and supports continuing breastfeeding to at least one year of age, data from the 2004-2008 National Immunization Survey document that only 73% of U.S. women attempt to breastfeed after birth, and only 42% and 21% are still breasfeeding at 6 and 12 months of life. The percentages are even lower for Black women: only 54% attempt breastfeeding, and just 27% and 11% are still doing so at 6 and 12 months.

Family physicians can help convince expectant and new mothers that "breast is best" by applying a number of evidence-based interventions recommended by the U.S. Preventive Services Task Force. Patients should be informed that the Department of Health and Human Services mandates first dollar coverage of comprehensive lactation support and breastfeeding equipment (e.g., breast pumps) for insurance plans starting in August 2012. Recognizing that primary care clinicians have many opportunities to support breastfeeding throughout pregnancy and the newborn period, we have included related content in each of the AFP By Topic collections on Prenatal Care, Labor and Delivery, and Newborn Care.