(2020) 150:184188. WHO actively promotes breastfeeding as the best source of nourishment for infants and young children, and is working to increase the rate of exclusive breastfeeding for the first 6 months up to at least 50% by 2025. WHO and UNICEF created the Global Breastfeeding Collective to rally political, legal, financial, and public support for breastfeeding. (2020) 323:24689. Bartick MC, Valds V, Giusti A, Chapin EM, Bhana NB, Hernndez-Aguilar M-T, et al. WHO and UNICEF recommend that children initiate breastfeeding within the first hour of birth and be exclusively breastfed for the first 6 months of life meaning no other foods or liquids are provided, including water. 30. These measures will allow for a new, adapted framework of practice that acknowledges the current COVID-19 paradigm and maintains the emphasis on the need to protect and support breastfeeding and the use of human milk. Only 41% of infants under 6 months of age are exclusively breastfed. Gozzi N, Bajardi P, Perra N. The importance of non-pharmaceutical interventions during the COVID-19 vaccine rollout. Breastfeed Med. This type of scaremongering can stimulate fear, apprehension, and confusion particularly to new parents surrounding breastfeeding. doi: 10.1089/bfm.2021.0012, 49. Lancet. (2013) 8:46973. Breastfeed Med. Changing the prenatal care paradigm to improve breastfeeding outcomes. However, nearly 2 out of 3 infants are not exclusively breastfed for the recommended 6 monthsa rate that has not improved in 2 decades. Exclusive breastfeeding for the first 6 months. (2003) 112:60719. Along with the improvements to antenatal education and facility preparedness, it is important that both the mother and the healthcare professional acknowledge that the initiation of lactation requires active management in the postnatal period. doi: 10.1111/mcn.13088, 44. Telehealth can promote breastfeeding during the COVID-19 pandemic. NEJM Catalyst. The first report details marketing techniques used by the formula milk industry, many of which are unethical, misleading, and not grounded in scientific evidence. Interventions for promoting the initiation of breastfeeding. In this narrative medicine essay, a pediatrician who learned the hard secrets of breastfeeding after the birth of her twins shares how her experience transformed her approach to new parents by acknowledging the difficulty and helping them find support. (2020) 16:e13010. Birth and breastfeeding in the hospital setting during the COVID-19 pandemic. Copyright 2022 American Academy of Pediatrics. Separation of the infant from the mother at birth was also shown to negatively correlate with breastfeeding at discharge (32, 33) and Bartick et al. WCRF International welcomes plans for WHO to introduce new guidance on digital marketing restrictions for breastmilk substitutes. Pediatr Res. Stockman LJ, Lowther SA, Coy K, Saw J, Parashar UD. 1. Good progress has been made at an international level on Baby-Friendly Hospitals and the Baby-Friendly Community Initiative. (2021) 175:11718. Schmied V, Beake S, Sheehan A, McCourt C, Dykes F. Women's perceptions and experiences of breastfeeding support: a metasynthesis. doi: 10.1038/jp.2016.14, 64. Pediatrics. The second report covers the digital space and persuasive techniques used to promote infant formula through websites, social media, and email communication to name a few. Explore the latest in breastfeeding, including advances in understanding ways to encourage it and its long-term effects on child health. Not everyone can breastfeed or continue breastfeeding for as long as desired for various reasons, including workplace barriers. Pace RM, Williams JE, Jrvinen KM, Belfort MB, Pace CDW, Lackey KA, et al. Some of these techniques include promotions, sponsored and targeted advertisements when thinking about breastfeeding or not. J Med Internet Res. These factors, when managed with practices known to be positive for the initiation of lactation, i.e., informed decision making, initiation and maintenance of milk supply, skin-to-skin care, and direct breastfeeding (22), will allow for an increase in the rates of human milk usage at discharge (5860). While some countries do have legislation in place, implementation and enforcement can often be weak and exploited. This randomized clinical trial investigates whether fortification of expressed breast milk by preterm formula powder is noninferior to fortification by human milk fortifier, in terms of short-term weight gain, in very low-birth-weight neonates. (2022) 107:21621. (2004) 10:168990. A positive outcome from the optimization of antenatal care is the development of a comprehensive breastfeeding plan. doi: 10.3238/arztebl.2017.0412, 53. (2016) 387:47590. The impact of caesarean section on breastfeeding initiation, duration and difficulties in the first four months postpartum. This study assesses the immunogenicity of the current COVID-19 mRNA vaccines in pregnant and lactating women against both the original SARS-CoV-2 USA-WA1/2020 strain as well as against the B.1.1.7 and B.1.351 variants of concern. White, Hispanic or Latino and Asian families initiate breastfeeding at higher rates than the Black population in the United States, according to the 2018 National Immunization Survey (NIS) of the Centers for Disease Control and Prevention. Riddle SW, Nommsen-Rivers LA. Get the latest news from the AAP including press statements, the AAP Voices Blog, the Pediatrics OnCall Podcast and more! J Matern Fetal Neonatal Med. doi: 10.1001/jamapediatrics.2020.5086, 69. Am J Obstet Gynecol. Dtsch Arztebl Int. A double-edged sword-telemedicine for maternal care during COVID-19: Findings from a global mixed-methods study of healthcare providers. Breastfeed Med. doi: 10.1001/jamapediatrics.2022.0084, 22. Research has shown that breastfeeding is linked to decreased rates of lower respiratory tract infections, severe diarrhea, ear infections and obesity. MCN Am J Matern Child Nurs. The early identification of lactation risk factors together with the development of person-centered methods to deliver breastfeeding information and education to parents-to-be will be critical. The introduction of extensive anti-breastfeeding practices early in the course of the pandemic was a consequence of the lack of information and preparedness in developing recommendations for pregnant and breastfeeding women and their infants (10). Unfortunately, the rapid introduction of these sweeping public health measures in response to the pandemic has severely jeopardized hospital and community based breastfeeding promotion programs and continues to do so in North America (4) as well as in Europe (5). Characterization of SARS-CoV-2 RNA, antibodies, and neutralizing capacity in milk produced by women with COVID-19. In this regard, it is important that hospital practices and protocols take into account maternal lactation risk factors known to impact the initiation of lactation, e.g., preterm birth, gestational diabetes, maternal obesity, cesarean section and primiparity, mother-infant separation, and that these are included in the breastfeeding plan (4957). It appears you are using Internet Explorer as your web browser. doi: 10.1002/ijgo.13249. doi: 10.1136/bmj.n730, 4. In addition, the establishment of a hospital culture that values breastfeeding and prioritizes the use of human milk will be integral for the motivation of health care professionals. Furthermore, in a systematic review of interventions for promoting the initiation of breastfeeding, informal one-to-one, needs-based education delivered by a healthcare professional in the antenatal period was found to be an effective means of increasing breastfeeding initiation (40). (2020). Accordingly, global health organizations such as the WHO, UNICEF and other non-governmental entities were already engaged in programs to improve breastfeeding initiation and duration rates worldwide. The AAP views breastfeeding as a public health imperative and also as an equity issue, said Lawrence Noble, MD, FAAP, FABM, IBCLC, co-author of the policy statement and technical report, which details the evidence that supports human milk feeding. Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss. (2020) 16:5860. (2020) 26:83746. doi: 10.1891/1058-1243.24.3.160, 71. (2021) 12:e03192-20. These protocols should be rescued and developed from the pre-pandemic era and appropriately integrated with the new science of coping with the risk of SARS-CoV-2 transmission (35). As part of World Breastfeeding Week 2022, our Policy and Public Affairs Officer Jennifer OMara looks into the levels of lactation around the world, in particular her home country of Ireland, and explores how rates can be increased where possible, given the health benefits for both mother and child. Available online at: http://hopkinshumanitarianhealth.org/empower/advocacy/covid19/covid-19-children-and-nutrition/. Of particular importance is the immediate post discharge period, especially considering the Academy of Breastfeeding current recommendation that all breastfed infants be seen by a healthcare provider at 35 days of life or within 4872 h of discharge (71). Nommsen-Rivers LA, Chantry CJ, Peerson JM, Cohen RJ, Dewey KG. Although the International Code of Marketing of Breast-milk Viet Nam breastfeeding campaign normalizes practice, improves rates. (2021) 372:n730. Up to what age can a baby stay well nourished by just being breastfed? Acta Obstet Gynecol Scand. Of particular concern was the issue of vertical transmission between mother and infant. (2021) 17:e13088. As such, it will be the adaptation of those known protocols to fit within post COVID-19 institutional restrictions that will be most critical. Joint statement by UNICEF Executive Director Catherine Russell and WHO Director-General Dr Tedros Adhanom Ghebreyesus on the occasion of World Breastfeeding Week, Launch of the COVID-19 impact on nutrition Analytical Framework, WHO reveals shocking extent of exploitative formula milk marketing, More than half of parents and pregnant women exposed to aggressive formula milk marketing WHO, UNICEF, Webinar series: the problem with the formula milk industry, Launch of new WHO report on the scope and impact of digital marketing for the promotion of breast-milk substitutes, Call for proposals Support for the development of WHO guidelines on donor human milk banking, Call for proposals BFHI Internal Monitoring Manual, Call for consultant on Infant and Young Child Feeding. (2007) 52:58894. doi: 10.1038/s41390-021-01902-y, 16. Improving human milk and breastfeeding practices in the NICU. doi: 10.1111/j.1523-536X.2010.00446.x, 43. Shek CC, Ng PC, Fung GPG, Cheng FWT, Chan PKS, Peiris MJS, et al. (2020) 15:698702. Terms of Use| This was further confirmed in relation to mothers' direct perceptions of an antenatal program, where new mothers suggested that an individualized approach could improve the delivery of information (41). Effect of novel breastfeeding smartphone applications on breastfeeding rates. doi: 10.1089/bfm.2020.0155. Despite this acknowledgment, it is important to note that prior to the COVID-19 pandemic, global breastfeeding rates still averaged only 41% (8). World Breastfeeding Week is an opportunity to showcase the positive benefits of breastfeeding (where possible) and drive the noise away from the harmful marketing tactics used by the formula industry. (COVID-19) pandemic. The updates include a recommendation to support parents who choose to breastfeed their infant to age 2 and beyond. Telehealth and breastfeeding: an integrative review. Evidence-based protocols and programs dedicated to the initiation and maintenance of lactation are well-established and have been shown to improve breastfeeding outcomes (58, 67). As the pandemic continues, there is the concern that this disruption to recognized quality standards of care will continue over the long term, as a sort of system inertia in hospitals (5), at the expense of practices known to promote and protect breastfeeding (22). This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). However, as a consequence of COVID-19 restrictions, many mothers lack face-to-face support in the post-discharge phase (43). When working with gender-diverse families, AAP suggests asking families what terms they use and that the term chestfeeding, may be more accurate and inclusive as it concerns lactation and physiology in gender-diverse families., Breastfeeding can be challenging for new parents, and support from their families, doctors and work places is essential, Dr. Meek said. JAMA Pediatr. Despite the evidence on the importance of breastfeeding on breast cancer risk for the mother and on childhood obesity particularly within the first 1000 days (2.7 years) of a babys life rates both globally and in Europe are still astonishingly low. It is therefore important to also address breast pump usage requirements within a COVID-19 framework (69), particularly the establishment of dedicated protocols to facilitate pump set up as well as cleaning. MMWR Morb Mortal Wkly Rep. (2020) 69:176770. (2021) 175:26066. (2020) 15:85. doi: 10.1186/s13006-020-00328-2, 42. (2010) 92:57484. The American Academy of Pediatrics recommends exclusive breastfeeding of infants for the first six months of life before introducing nutritious complementary foods, while encouraging social and systemic changes to support mothers who choose to breastfeed. Protecting breastfeeding during the COVID-19 pandemic. (2020) 226:6470. In 2016, breastfeeding rates upon discharge from a maternity hospital stood at 46.3% and by2019, this figure had dropped to 37.3%. Krogstad P, Contreras D, Ng H, Tobin N, Chambers CD, Bertrand K, et al. This survey study uses data from the National Immunization SurveyChild to examine trends in early formula supplementation by race/ethnicity among US children born during the period from 2009 to 2015. Latorre G, Martinelli D, Guida P, Masi E, Benedictis R de, Maggio L. Impact of COVID-19 pandemic lockdown on exclusive breastfeeding in non-infected mothers. (2016) 11:8085. Perhaps now, more than previously, it is important for healthcare professionals to acknowledge the value of such antenatal planning as well as staff education related to policy and protocol development. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. Lancet Diabetes Endocrinol. Cochrane Database Syst Rev. Mothers who choose to breastfeed beyond the first year need support from their medical care providers, as well as protections against workplace barriers. Families deserve nonjudgmental support, information and help to guide them in feeding their infant.. Some of these include monitoring and enforcing laws on the prevention and promotion of formula milk, creating policies and programmes in support of breastfeeding, and prohibiting health workers from engaging in sponsorship with formula milk companies. Holmes AV, McLeod AY, Bunik M. ABM clinical protocol #5: peripartum breastfeeding management for the healthy mother and infant at term, Revision (2013). Breastmilk provides all the energy and nutrients that the infant needs for the first months of life, and it continues to provide up to half or more of a childs nutritional needs during the second half of the first year, and up to one third during the second year of life. You can find the latest versions of these browsers at https://browsehappy.com, Lisa Black Hobbs AJ, Mannion CA, McDonald SW, Brockway M, Tough SC. Content on this website is for information only. doi: 10.1016/j.ajog.2020.05.029, 38. Snyder K, Worlton G. Social support during COVID-19: perspectives of breastfeeding mothers. The development of standardized programs relating to antenatal breastfeeding education have been shown to improve breastfeeding intention (38, 39). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Breastfed children perform better on intelligence tests, are less likely to be overweight or obese and less prone to diabetes later in life. (2020) 3:33950. doi: 10.1089/bfm.2013.9979. Have any problems using the site? The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. Birth. Virtual Lactation Support for Breastfeeding Mothers During the Early Postpartum Period [DNP Scholarly Project]. Global Breastfeeding Scorecard, 2018: Enabling Women to Breastfeed Through Better Policies and Programmes. In this connection, ~18% of hospitals in a CDC-conducted survey of 1,344 hospitals in the USA reported a reduction in direct lactation support for mothers delivering in their hospitals. A case control study of diabetes during pregnancy and low milk supply. Beyond 6 months, breastfeeding should be maintained along with nutritious complementary foods. 10:867540. doi: 10.3389/fped.2022.867540. In Ireland, my home country, breastfeeding rates have continued to decline. The AAP outlines its recommendations and evidence of significant health benefits to infant and mother within an updated policy statement and technical report, both titled, Breastfeeding and the Use of Human Milk Published in the July 2022 issue of Pediatrics and available online June 27. Notably, the impact of a reduction in lactation support in this manner affects both mothers with and without COVID-19 (31). (2021) 17:e1009346. These measures provide a new, adapted framework of practice that acknowledges the current COVID-19 paradigm and maintains the emphasis on the need to protect and support breastfeeding and the use of human milk. Matern Child Nutr. All Rights Reserved. Watson R. Covid-19: EU looks to speed up vaccine rollout. (2017) 114:41218. doi: 10.1097/JPN.0000000000000339, 59. However, it should be recognized that despite these encouraging outcomes, some mothers still have mixed feelings in relation to telehealth services and desire the emotional care that comes from in-person support from family, friends and lactation healthcare professionals (43, 77). Management of neonates after postpartum discharge and all children in the ambulatory setting during the coronavirus disease (2019). doi: 10.3945/an.115.011007, 52. (2020) 16:25863. There is no need to introduce infant formula or other sources of nutrition for most infants. doi: 10.1101/2021.01.09.21249480, PubMed Abstract | CrossRef Full Text | Google Scholar, 2. (2021) 16:3945. (2019) 46:11320. Spatz DL. SARS and pregnancy: a case report. Promoting breastfeeding and the marketing of formula milk substitutes is something we have spoken about at the highest level of public health at WHO. (2017) 44:122. Breastfeed Med. Kotlyar AM, Grechukhina O, Chen A, Popkhadze S, Grimshaw A, Tal O, et al. Views expressed here do not necessarily reflect those of ScienceDaily, its staff, its contributors, or its partners. (2020) 23:101735. doi: 10.1016/j.isci.2020.101735, 20. Markwei M, Goje O. Optimizing mother-baby wellness during the 2019 coronavirus disease pandemic: a case for telemedicine. Therefore, the recent COVID-19-led recommendations that superseded and deprioritized practices known to promote and protect breastfeeding, such as skin-to-skin care, early initiation and rooming in, were particularly damaging to the support of lactation (9). doi: 10.1001/jamapediatrics.2020.4298, 28. Policies that protect breastfeeding, including universal paid maternity leave; the right of a woman to breastfeed in public; insurance coverage for lactation support and breast pumps; on-site child care; universal workplace break time with a clean, private location for expressing milk; the right to feed expressed milk; and the right to breastfeed in child care centers and lactation rooms in schools are all essential to supporting families in sustaining breastfeeding. Popofsky S, Noor A, Leavens-Maurer J, Quintos-Alagheband ML, Mock A, Vinci A, et al. Front Pediatr. This consensus guidance summarizes best practice for the design, conduct, analysis, and reporting of trials of breast milk substitutes. Archives of Neurology & Psychiatry (1919-1959), Comparing Human Milk Antibody Response After 4 Different Vaccines for COVID-19, Association of Human Milk Antibody Induction, Persistence, and Neutralizing Capacity With SARS-CoV-2 Infection vs mRNA Vaccination, Evaluation of Messenger RNA From COVID-19 BTN162b2 and mRNA-1273 Vaccines in Human Milk, American Board of Medical Specialties Board Examination Lactation Accommodation Policies, Cardiac Performance in the First Year of Age Among Preterm Infants Fed Maternal Breast Milk, Quantification of Specific Antibodies Against SARS-CoV-2 in Breast Milk of Lactating Women Vaccinated With an mRNA Vaccine, Human Milk Fortification for Preterm Infants: The Right Kind at the Right Time for the Right Baby, Fortification of Breast Milk With Preterm Formula Powder vs Human Milk Fortifier in Preterm Neonates: A Randomized Noninferiority Trial, Immunogenicity of COVID-19 mRNA Vaccines in Pregnant and Lactating Women, Persistence of -9-Tetrahydrocannabinol in Human Breast Milk, SARS-CoV-2Specific Antibodies in Breast Milk After COVID-19 Vaccination of Breastfeeding Women, Effect of Community-Initiated Kangaroo Mother Care on Postpartum Depressive Symptoms and Stress Among Mothers of Low-Birth-Weight Infants: A Randomized Clinical Trial, Effect of a Home-Visiting Intervention to Reduce Early Childhood Obesity Among Native American Children: A Randomized Clinical Trial, Early Formula Supplementation Trends by Race/Ethnicity Among US Children Born From 2009 to 2015, COVID-19 Precautions Hamper Breastfeeding Support, Best Practices for COVID-19Positive or Exposed MothersBreastfeeding and Pumping Milk, Evaluation for SARS-CoV-2 in Breast Milk From 18 Infected Women, Guidance for the Conduct and Reporting of Clinical Trials of Breast Milk Substitutes, CONSERVE 2021 Guidelines for Reporting Trials Modified for the COVID-19 Pandemic, FDA Approval and Regulation of Pharmaceuticals, 1983-2018, Global Burden of Skin Diseases, 1990-2017, Managing Asthma in Adolescents and Adults: 2020 NAEPP Asthma Guideline Update, Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter, US Burden of Neurological Disease, 1990-2017, USPSTF Recommendation on Screening for Colorectal Cancer, USPSTF Recommendation on Screening for Hypertension, USPSTF Recommendation on Screening for Lung Cancer, USPSTF Recommendation on Screening for Prediabetes and Type 2 Diabetes, Statement on Potentially Offensive Content, Register for email alerts with links to free full-text articles. doi: 10.1136/archdischild-2021-322463, 21. Home - Public Policy - Breastfeeding across the world in 2022. Arora KS, Mauch JT, Gibson KS. Using quality improvement to increase human milk use for preterm infants. Insufficient maternal milk volume can have its origins in the first week postpartum, the decisive period during which the mammary gland undergoes programming processes that regulate long-term milk synthesis (6163). New Breath-Driven Concept Set to Transform Access to Hand Prosthetics, Organoid Production Breakthrough to Help Accelerate Disease and Drug Development Research, Songbird Can Keep Time With the Best of Them, Wireless Activation of Targeted Brain Circuits in Less Than One Second, Stress Transmitter Wakes Your Brain More Than 100 Times a Night -- And It Is Perfectly Normal, Exploring Factors That May Underlie How Domestic Cats Can Live in Groups, Scent of a Friend: Similarities in Body Odor May Contribute to Social Bonding, Turn Up the Beat! Prenatal care redesign: Creating flexible maternity care models through virtual care. A control framework to optimize public health policies in the course of the COVID-19 pandemic. In addition to the development of a new mother's breastfeeding plan, it is important that the role of the healthcare professional is adapted to ensure that not only a motivation to actively support breastfeeding initiation exists, but that suitable 'back-up' plans and protocols are developed as well, including the use of a breast pump to support initiation for those mothers with selected lactation difficulties/risk factors or who meet with lactation challenges.

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