October 22, 2008

Task Force Recommends Prenatal and Postnatal Breastfeeding Support

The U.S. Preventive Services Task Force has updated its statement on breastfeeding promotion following a review of the evidence, and recommends that “health care settings use strategies that work with women and families both before and after delivery to encourage and support breastfeeding.” The previous review, published in 2003, did not address prenatal support and had found insufficient evidence for interventions such as counseling by primary care providers.

The Task Force is part of a government agency and focuses on better informing healthcare providers by reviewing evidence of effectiveness and developing recommendations for clinical services. Its recommendation in this case is Grade B, meaning that “There is high certainty that the net benefit is moderate or there is moderate certainty that the net benefit is moderate to substantial.”

In the recommendation, the reviewers note that there is evidence that breastfeeding may have health benefits for women and children, and that interventions to support breastfeeding have been found to increase the rates of initiation, duration, and exclusivity of breastfeeding, while the harms of such interventions are thought to be minimal.

The commentary on these potential harms specifically addresses the empowerment of women to make informed choices. The reviewers explain (emphasis added):

“No studies identified for the USPSTF reported harms from interventions to promote and support breastfeeding. Nonetheless, there are potential harms, such as making women feel guilty. Breastfeeding interventions, like all other health care interventions designed to encourage healthy behaviors, should aim to empower individuals to make informed choices supported by the best available evidence. As with interventions to achieve a healthy weight or to quit smoking, breastfeeding interventions should be designed and implemented in ways that do not make women feel guilty when they make an informed choice not to breastfeed.”

The reviewers also note that additional research is needed on issues such as exclusive vs. partial breastfeeding, costs and cost benefits of interventions to promote breastfeeding, the effectiveness of compliance with the World Health Organization’s Baby-Friendly Hospital Initiative in the United States, the effects of individual components of breastfeeding support, and “to allow the tailoring of interventions to the needs of individual women and families.”

The agency’s Recommendation Statement is freely available online, and links to supporting documents are provided here.


5 Responses to “Task Force Recommends Prenatal and Postnatal Breastfeeding Support”

  1. erica Says:

    Great info, thanks! But what about at the workplace?

  2. Rachel Says:

    Erica, that’s a great question, and one they didn’t address. The Task Force is geared more toward health care providers, so it’s not altogether surprising, although there certainly are workplace barriers to breastfeeding for many women.

  3. pixie Says:

    This is good! This is very good. But there’s still room for improvement, if you’ll allow me to be a wee bit picky. The first thing that jumped out at me was language to suggest that breastfeeding is still viewed, even by the greater medical community as the alternative, rather than the default setting: breastfeeding may have benefits. We say “smoking has helth risks,” not “being smoke-free has health benefits.” But that’s me being petty, and I’ll own up to it :)

    Second, and of bigger concern, was that I couldn’t find (although I didn’t dig as deep as I might have, since I took allergy meds a bit ago to counteract the horrible Oklahoma dust-filled wind) reccommendations for training medical staff that deals with these pregnant or recently delivered moms. And one thing I have found for myself is how hard it is to get accurate information from much of the “core” medical community. I was once told to quit nursing my then two-month-old son to use an eyedrop. I told him “no,” since my son is allergic to dairy and sensitive to soy, and he threw the script at me and stomped out of the room. When I called a friend that is a certified breastfeeding educator, I found out the medicine was approved for nursing by the AAP. And don’t get me started on what AAP policies my daughter’s first pediatrician didn’t know! Thankfully, I’m stubborn and uppity and always do my own research ;)

    I think that, unless we teach family doctors, pediatricians and ob-gyns enough of the basics to stop them from giving really, really BAD advice, no amount of research or reccommending will change a blessed thing.

  4. Margie Says:

    I only skimmed this article, so perhaps it was mentioned and I just missed it. The other thing that needs to be talked about is better nutrition for the breastfeeding women. You cannot produce healthy breast milk if you are eating a crappy diet…junk in = junk out. Vitamin D supplements need to be given to the babies. Babies are now suffering from Rickets. Not enough adults are getting enough Vitamin D, so it is impossible to have Vitamin D rich breast milk if the women are deficient.

  5. Wendy Luvic Says:

    I agree with the above comment that nutrition should also be talked about in prevention. I work with California drug treatment centers where prevention is the key to avoid any potential problem. Nutrition is key though, I couldn’t agree more!

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