Breastfeeding is a public health imperative, according to a newly updated American Academy of Pediatrics (AAP) policy statement.

 The AAP released its updated policy statement and accompanying technical report on breastfeeding and the use of human milk in the July 2022 issue of the journal Pediatrics.

Recommendations and underlying evidence

The policy statement serves as an update to the group’s recommendations regarding breastfeeding, while the technical report provides the evidence and basis for the recommendations.

The policy statement notes that breastfeeding initiation rates among non-Hispanic White and Hispanic populations are much higher than in the non-Hispanic Black or African-American population.  Therefore, the document’s authors assert that efforts to increase rates of breastfeeding (or “the provision of human milk”) must acknowledge existing disparities and the effect of racism while promoting equity in education, support, and services.

Duration

The AAP recommends exclusive breastfeeding for approximately 6 months and continued—along with appropriate complementary foods introduced at about 6 months—as long as mutually desired for 2 years or beyond. The policy statement notes that “…mothers who decide to breastfeed beyond the first year need support.  They often report feeling ridiculed or alienated in their choice and conceal their breastfeeding behavior to minimize unsolicited judgment and comments.”

According to the technical report, “human milk has a unique composition, with antimicrobial, anti-inflammatory, and immunoregulatory agents and living cells, all of which contribute to the developing immune system of the child.  Studies and meta-analyses have confirmed that 6 months of exclusive breastfeeding was associated with decreased lower respiratory tract infections, severe diarrhea, otitis media, and obesity.”

The documents address infant outcomes and maternal outcomes of breastfeeding and also consider breastfeeding in special medical circumstances such as metabolic and infectious diseases, maternal substance use, hyperbilirubinemia, and preterm birth.

Special concerns

Also addressed are special societal circumstances such as adoption, surrogacy, and “gender diverse” parents, as well as breastfeeding in the workplace and during emergencies such as natural disasters.

Joan Younger Meek, MD, lead author of the reports, stated in an accompanying AAP news release:

“Human milk is all a baby needs for the first six months of life.

“Breast milk is unique in its nutrients and protective effects, and really quite remarkable when you look at what it does for a child’s developing immune system.

However, she counsels, “Not everyone can breastfeed or continue breastfeeding for as long as desired for various reasons, including workplace barriers.  Families deserve nonjudgmental support, information and help to guide them in feeding their infant.”

Find the full AAP Policy Statement, “Breastfeeding and the Use of Human Milk,” here.

The complete technical report is accessible here.

Be sure to read about a recent study which found shorter hospital stays and milder respiratory illness for breastfed babies here.

The contents of this feature are not provided or reviewed by NPWH.