Breastfeeding promotion

Nature designed human milk for human babies; it provides infants with the best source of nourishment for healthy growth and development. Yet, some aspects of health care, industry, and society, in general, have evolved in ways that are not conducive to breastfeeding support and success.

Breastfeeding is associated with decreased risk for infant morbidity and mortality as well as maternal morbidity. The benefits do not end when breastfeeding does but can extend into and after toddlerhood.

Exclusive breastfeeding is recommended for the first six months of life. Continue breastfeeding for a year or as long as mother and baby desire.

The decision to breastfeed is an important one. New mothers and new parents should feel comfortable seeking help and finding sources of peer and professional support. The free Arkansas Breastfeeding Help Line is available 24 hours a day, seven days a week. Call to speak to a certified lactation consultant at 800-445-6175. The lactation consultant can help new moms, pregnant women, and health care providers with information about common breastfeeding concerns. The Arkansas Breastfeeding Help Line is sponsored by the Arkansas Department of Health and Baptist Health.

Increasing breastfeeding rates is a national priority, and improvement is needed to protect, promote, and support breastfeeding. AFMC is working with the Arkansas Department of Human Services to promote best practices for increasing breastfeeding success as part of our larger effort to improve maternal and child health statewide.

Breastfeeding promotion: physicians’ office strategies for success

Improve office systems create a breastfeeding-friendly office

  • Establish a written breastfeeding-friendly office policy
  • Collaborate with colleagues and office staff during development
  • Provide staff education and training
  • Provide copies of your practice’s policy to hospitals and covering physicians
  • Develop and follow telephone triage protocols to address breastfeeding concerns and problems
  • Integrate breastfeeding promotion, education, and support throughout prenatal care
  • Take a detailed breastfeeding history as part of the prenatal history
  • Consider the culture of women, families, and communities
  • Incorporate breastfeeding as an important component of the initial prenatal breast exam
  • Discuss breastfeeding at each prenatal visit
  • Enable women and their families to have the birth experience most conducive to breastfeeding
 

Provide an office environment that demonstrates breastfeeding promotion and support

  • Provide a lactation room for employees who breastfeed or express breast milk at work
  • Eliminate the distribution of free formula and baby items from formula companies to parents
  • Store formula supplies out of view of parents
  • Display posters, pamphlets, pictures, and photographs of breastfeeding mothers
  • Do not display images of infants bottle-feeding
  • Target display image material to populations with low breastfeeding rates
  • Do not accept gifts or samples from companies manufacturing infant formula, feeding bottles, or pacifiers
  • Employ a lactation consultant or nurse trained in lactation

Improve patient experience

  • Do not interrupt or discourage breastfeeding in the office
  • Allow and encourage breastfeeding in the waiting room
  • Display signs in the waiting area encouraging mothers to breastfeed
  • Provide a comfortable private area to breastfeeding mothers who prefer privacy
  • Conduct follow-up phone calls to assist breastfeeding mothers
  • Encourage breastfeeding mothers to feed newborns only breast milk
  • Avoid offering supplemental formula or glucose water unless medically indicated
  • Commend breastfeeding mothers during each visit for choosing and continuing breastfeeding
  • Provide breastfeeding anticipatory guidance in routine periodic health maintenance visits
  • Encourage fathers of infants to accompany mother and baby to office visits
  • Encourage mothers to exclusively breastfeed for six months and continue breastfeeding for a year, or as long as mother and baby desire

Education

  • Provide access to a multilingual staff, translators, and ethnically diverse educational material
  • Instruct mother not to offer bottles or a pacifier until breastfeeding is well established
  • Breastfed babies should receive 400 IU of vitamin D each day starting in the first few days of life and continuing until babies are weaned to at least one liter or one quart of vitamin D-fortified formula or milk a day (American Academy of Pediatrics)
  • Early in the pregnancy, it is important to promote the Women, Infants, and Children (WIC) program’s many benefits: healthy foods for pregnant women, nutrition education, and referrals to other services
  • Breastfeeding questions answered 24/7 by the Arkansas Breastfeeding Helpline 800-445-6175 (sponsored by the Arkansas Department of Health and Baptist Health)

Breastfeeding promotion: inpatient strategies for success

Labor and delivery care

  • Babies should be placed skin-to-skin with their mothers immediately after birth for at least one hour
  • Educate mothers to recognize when baby is ready to breastfeed and offer assistance as needed
  • Routine procedures are performed skin-to-skin

Feeding of breastfed infants

  • Initial feeding is breast milk (vaginal and cesarean births)
  • Give infants no food or drink other than breast milk unless medically indicated

Breastfeeding assistance

  • Infant feeding decision is documented in the patient chart
  • Provide breastfeeding advice, instructions, and assistance
  • Provide instruction on how to maintain lactation even when separated from infant
  • Teach and encourage to feed on demand
  • Directly observe and assess breastfeeding
  • Use a standard feeding assessment tool
  • Do not provide pacifiers or artificial nipples to breastfeeding infants

Contact between mother and infant

  • Mother-infant pairs are not separated for postpartum transition
  • Mother-infant pairs room-in at night
  • Mother-infant pairs are not separated during the hospital stay
  • Infant procedures, assessment, and care are in the patient room

Facility discharge care

  • Provide appropriate discharge planning (referrals and other multi-modal support)
  • Discharge packs containing infant formula samples and marketing products are not given to breastfeeding patients

Staff training

  • All staff receive annual breastfeeding education
  • Annual assessment of staff competency in breastfeeding management and support

Structural and organizational aspects of care delivery

  • Breastfeeding policy is effectively communicated
  • Facility documents infant feeding rates inpatient population
  • The facility provides breastfeeding support to employees
  • The facility does not receive infant formula free of charge
  • Breastfeeding is included in prenatal patient education
  • The facility has a designated staff member responsible for the coordination of lactation care

Web resources

Breastfeeding policy

Academy of Breastfeeding Medicine (ABM)

Baby-Friendly USA

American Academy of Pediatrics

Centers for Disease Control and Prevention (CDC), 2020 Breastfeeding Report Card, United States

U.S. Department of Health and Human Services. The surgeon general’s call to action. (2020)

U.S. Department of Health and Human Services

Breastfeeding programs

Breastmilk: Every Ounce Counts

Breastfeeding laws

National Conference of State Legislatures (NCSL) State Breastfeeding Laws

Breastfeeding training for health professionals

Health e-learning online education

UAMS Learn On Demand

Breastfeeding supportive services

Arkansas Breastfeeding Helpline – Breastfeeding Questions Answered 24/7
800-445-6175

Arkansas Department of Health B.E.S.T. Breastfeeding Education and Support Together (virtual workplace support group facilitated by lactation consultants)

Arkansas Department of Health Peer Counselor Program

Arkansas WIC Program

Kellymom provides evidence-based information on breastfeeding, sleep and parenting

La Leche League (LLL) mothering through breastfeeding

The United States Breastfeeding Committee (USBC) works to improve the Nation’s health by working collaboratively to protect, promote, and support breastfeeding

The Arkansas Breastfeeding Coalition is dedicated to protecting and promoting breastfeeding in Arkansas

Breastfeeding support

Breastfeeding Resources and Tools

Reviewed and Revised April, 2021