by Anne Eglash MD, IBCLC, FABM
What are the important components of a breastfeeding-friendly physician’s office? The Academy of Breastfeeding Medicine first published its recommendations for the Breastfeeding Friendly Physician’s Office almost 10 years ago.
In May, 2017, the American Academy of Pediatrics (AAP) published its version of a Breastfeeding Friendly Pediatric Office Practice with very similar recommendations.
The AAP’s recommendations are made up of 19 components, including having an office policy on breastfeeding, training office staff to provide breastfeeding support, encouraging breastfeeding education for families, aligning with one’s local birthing hospital on baby-friendly policies and practices, and evidence-based management of breastfeeding dyads, among other recommendations.
Which recommendations below are included in the AAP Breastfeeding-Friendly Pediatric Office Practice report: (choose 1 or more)
- Frenulum clipping of the tongue/upper lip may improve infant latch and the effectiveness of breastfeeding.
- The office staff should let families know that the pediatric provider may want to observe a feeding at the breast during the first newborn visit.
- Encourage families to use a comfort room or exam room to breastfeed, to prevent families from feeling uncomfortable when breastfeeding in the waiting room.
- The physician office should not accept gifts such as free formula, office supplies, bottles, etc, from companies that manufacture infant formula.
- Tear-off cards from magazines that offer free or discounted formula would be an acceptable means of providing free formula for needy families.
See the Answer
The answers are A, B and D
April 2017
From the American Academy of Pediatrics
Clinical Report
The Breastfeeding-Friendly Pediatric Office Practice
Joan Younger Meek, Amy J. Hatcher, SECTION ON BREASTFEEDING
Abstract
The landscape of breastfeeding has changed over the past several decades as more women initiate breastfeeding in the postpartum period and more hospitals are designated as Baby-Friendly Hospitals by following the evidence-based Ten Steps to Successful Breastfeeding. The number of births in such facilities has increased more than sixfold over the past decade. With more women breastfeeding and stays in the maternity facilities lasting only a few days, the vast majority of continued breastfeeding support occurs in the community. Pediatric care providers evaluate breastfeeding infants and their mothers in the office setting frequently during the first year of life. The office setting should be conducive to providing ongoing breastfeeding support. Likewise, the office practice should avoid creating barriers for breastfeeding mothers and families or unduly promoting infant formula. This clinical report aims to review practices shown to support breastfeeding that can be implemented in the outpatient setting, with the ultimate goal of increasing the duration of exclusive breastfeeding and the continuation of any breastfeeding.
Milk Mob Comment by Anne Eglash MD, IBCLC, FABM
The AAP report encourages offices to normalize breastfeeding in waiting rooms, as long as families are comfortable with this. They do not advocate for any formula giveaways, even if in the form of a redeemable postcard.
Approximately 80% of new mothers in the USA initiate breastfeeding after birth. A significant portion of this achievement comes from hospitals that have worked hard to incorporate breastfeeding supportive policies, and have trained their staff. However, once families step out of the hospital, they often need to find their own support somewhere in the community. Unlike hospital staff, outpatient physicians, nurses, nutritionists, pharmacists, and other allied health professionals are unlikely to have attained sufficient breastfeeding management skills to answer even the most common questions asked by the typical breastfeeding mother. This puts breastfeeding dyads at risk for medical complications such as mastitis, breast abscesses, massive breastmilk oversupply, hyperbilirubinemia, and insufficient infant weight gain. Further, not providing optimal breastfeeding medical care for a breastfeeding dyad may lead to premature weaning.
Until breastfeeding medicine education in professional schools and residencies is given equal time to the education of other physiologic systems, physicians and allied health professionals who care for breastfeeding dyads need to seek their own education.
The Milk Mob’s 8 hour on-line Breastfeeding Medicine Basics Course for Physicians and other Providers is a great option to learn how to manage the most commonly asked questions from breastfeeding families.
The Milk Mob’s 16-hour Outpatient Breastfeeding Champion Training has been adopted by many communities, medical groups, and WIC agencies as an appropriate training for allied health professionals who are counseling breastfeeding families on a regular basis.
A nice little secret that the AAP statement does not disclose is that physician offices with knowledgeable providers and nursing staff build their newborn populations, and patient satisfaction increases. Let’s face it, more than 80% of mothers breastfeed to provide optimal health for themselves and their infants, and they seek guidance to be successful. I urge you to talk to any primary care physician who is board certified in lactation. He/she will tell you that being knowledgeable and supportive of breastfeeding keeps their practices busy and young!