AHN Pediatricians respond to new AAP guidelines during National Breastfeeding Awareness Month
PITTSBURGH – Pediatricians across Allegheny Health Network (AHN) will recognize August as National Breastfeeding Awareness month by applauding updated guidelines from the American Academy of Pediatrics (AAP) and offering guidance and support for new mothers on their nursing journey.
In late June, the AAP updated its recommendations urging exclusive breastfeeding until six months of age followed by the introduction of complementary foods. However, the guidelines now recommend the continuation of breastfeeding until at least two years old, instead of one year as previously advised.
“Breastfeeding and the Use of Human Milk,” published last month in Pediatrics (doi.org/10.1542/ peds.2022-057988), reported out preliminary data showing breastfeeding through the second year of life continues to be a significant source of macronutrients and immunologic factors for growing toddlers. Studies and meta-analyses also have confirmed that breastfeeding longer than 12 months continues to have a positive impact on overall maternal health and bonding.
“The benefits of breastfeeding for mother and baby are numerous and in the United States, nearly 85% of infants receive breastmilk as newborns but unfortunately, only 25% are exclusively breastfed by the 6-month mark,” said Joseph Aracri, DO, pediatrician and chair of AHN Pediatric Institute. “The reasons for the decline following the first few weeks of birth vary greatly but convey that the nursing journey for many new mothers can be a challenge. At AHN, we recognize the importance of nursing and in line with AAP recommendations, want to offer as much support as we can through our clinical teams, pediatricians, and award-winning lactation consultants.”
Board certified lactation consultants across the AHN Pediatric Institute place phone calls to families of babies born at AHN facilities within 48 hours of discharge when many common concerns and barriers to nursing typically arise for new mothers.
“Breastfeeding provides babies protection from infection and longterm health concerns including allergies, diabetes and certain types of cancer. However, it’s a common misconception that breastfeeding comes naturally to all new mothers, and many experience significant challenges throughout their journey of new parenthood, especially in the early days,” said Jennifer Yoon, RN, LDN and Board Certified Lactation Consultant at AHN. “Therefore, our team works extensively with new families to help meet those needs head on and help ensure their desired outcomes for baby are met.”
Yoon and the AHN team cite the most common breastfeeding challenges and some preliminary management techniques:
• Sleepy feeder: Newborns are often sleepy and will choose sleep over feeding so they may need to be woken every 2-3 hours to feed. AHN clinicians recommend appropriate stimulation of cheek, chin, hands, feet or ribs as well as clothing removal to help baby stay alert enough for a productive feeding session.
• Difficult, painful latching: Latching baby to the breast within the hour after delivery lays a great foundation for the days ahead. For those in the hospital, enlist the help of AHN clinicians and caregivers to help achieve the proper form and identify baby’s hunger cues.
• Nipple soreness: Although the proper form will alleviate some pain, nipple soreness in the first few days is inevitable. For soreness, apply warm compresses, breast milk, or nipple cream after each feed, allowing the breast to be exposed to air a few times a day or using nipple shields, shells or gel pads to minimize irritation.
• Uncertainty over amounts: Uncertainty about how much milk baby is drinking at the breast or fear about whether baby is getting enough is a common concern and often leads moms to reconsider breastfeeding. For reassurance, watch for long sucks and listen for swallows which sound like small ‘clicks,” look for signs that baby is relaxed and content and monitor dirty diapers.
• Cluster Feeding: Common in newborns especially within the first three nights of birth, cluster feeding is a block of time when baby is extremely fussy and demanding to be fed very frequently. It’s emotionally and physically exhausting and can be hard to manage for new families. Yoon recommends getting through this time by leaning on other caregivers for support, fueling up with food and water and creating as calming of an environment as possible.
• Engorgement: After birth, colostrum (often referred to as “liquid gold”) comes in to provide unmatched protection for baby. Mother’s milk typically comes in on the third or fourth day following birth and more gradually over the next two weeks. However, milk coming in can often cause extreme fullness and pain in the breasts, also creating difficulty with latching. Use warm compresses, massages and warm showers prior to feeding to relieve pressure/pain and allow for an easier nursing session. “The benefits of breastfeeding continue to be evident with clinical research, however not all mothers may be able to nurse for a variety of reasons and at the AHN Pediatric Institute, we support our patients in all circumstances,” continued Dr.