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Optimizing Post-Delivery Care with Breastfeeding

Blog_BreastFeedingPostDeliveryCare_BreastFeedMotherNewbornHospital_260x200pxWorld Breastfeeding Month gives us an opportunity to highlight the benefits of breastfeeding as a life-saving infant feeding practice. In support of the importance of breastfeeding exclusivity and skin-to-skin (STS) for the reduction of infant morbidity and mortality, Bill Gates recently wrote, “Some of the best breakthrough ideas don’t involve technology at all. There is a solution that is readily available, requires no special equipment, and is so cheap any government can support it.”

Breastfeeding is recognized worldwide as the “gold standard” of infant feeding with lasting maternal and infant benefit. The CDC, ACOG, AWHONN, AAP, CDC, WHO, U.S. Surgeon General, ADA, U.S. Task Force for Promotion of Health and Disease Prevention, and The Joint Commission all endorse and support it as “optimal infant nutrition.” AWHONN, ACOG, and AAP Position Statements on breastfeeding all speak to the importance of hospitals and healthcare professionals promoting breastfeeding and exclusive human milk feedings. Hospitals now track breastfeeding metrics while recognizing the risks of formula.

Immediate uninterrupted STS and mother-infant contact has become the gold standard of post-delivery care for all stable infants 37 weeks or greater born vaginally or by C-section, while high-risk scenarios require early initiation of maternal pumping to ensure early onset of milk production. In addition, there are recent AAP recommendations for pasteurized human donor milk to be given to vulnerable and preterm infants in cases where maternal milk is not available.

The numerous benefits associated with breastfeeding are documented throughout the literature, and AWHONN has cited both short- and long-term benefits for mother and baby.

  • Skin-to-skin benefits include infant thermoregulation, cardiopulmonary stabilization, blood glucose stabilization, and improved breastfeeding exclusivity and duration rates.
  • Short-term infant benefits include reduction of gastroenteritis, necrotizing enterocolitis, ear infections, pain following minor procedures, hospital readmissions, respiratory infections, Sudden Infant Death Syndrome (SIDS), and urinary tract infections.
  • Long-term infant benefits include reduction of incidence of asthma, atopic dermatitis, cardiovascular disease, celiac disease, diabetes, childhood inflammatory bowel disease, obesity, and sleep disordered breathing.
  • Breastfeeding is associated with increased cognition and neurodevelopment, initiation of life-long gut microbiota and initiation of a strong immune system.
  • Maternal health benefits include decreased postpartum blood loss, lower risk of postpartum infection and anemia, and greater weight loss. Later in life there is reduced incidence of breast cancer, diabetes (type II), hypertension, cardiovascular disease, metabolic syndrome, ovarian cancer, osteoporosis, and rheumatoid arthritis.

Protection of breastfeeding includes:

  • Immediate STS contact
  • Rooming-in practices in which mom and baby are not separated
  • Teaching mothers how to hand express milk and how to maintain milk supply
  • Decreasing the use of formula supplementation
  • Consistent support from the healthcare team

website_author_hillAll women have the right to make an informed feeding choice for their child. As healthcare professionals, we should provide them with information about the proven science of human lactation, thereby empowering them to make an educated decision.

I share this poem in tribute to World Breastfeeding Week.

World Breastfeeding Week Poem

By Lynn Hill

This is the perfect time to take a peak
and honor World Breastfeeding Week.
Break through the barriers of history past
To a science becoming increasingly vast.
Human milk research is gaining intensity
While the act of breastfeeding offers steady propensity.
Known as “optimal infant feeding” and nutrition extraordinaire
Human lactation deserves recognition beyond compare.
So many impressive qualities to repeat,
that it is no easy feat.
Affordability and accessibility are benefits to name a few
But physiologic benefits are always abundant too.

Milk precursor colostrum is superiorly effective
At building intestinal microbiota guaranteed protective.
Oligosaccharides are ample and have prebiotic dominance
Thereby reducing infections by preponderance.
Pathogenic viruses and bacteria are just plain finished
While incidence of NEC is sharply diminished.
Lactose, Lysozyme, and Lactoferrin promote infant growth
While limiting pathogens more than you can boast.
Vitamins and minerals in perfect proportion and amount
With anti-inflammatories higher than one can count.
Childhood allergies and asthma will be so much less
and ear infections are almost zeroless!

OB professionals on the front line
Can lend their voices to a story old as time.
Healthcare systems should prioritize breastfeeding as first rate
And put an end to the formula debate.
Artificial milk will never match
The benefits of human milk with infant latch.
The desired goal is breastfeeding exclusivity and duration rates to soar
With the idea of reaching the poorest of the poor.
Healthy People 2020 recognizes a 6-month minimum
With an “ideal” of mutual respect for the mom & baby feeding continuum.
Achieving the 2020 goals are seemingly urgent
While epigenetic research is quickly becoming emergent.

Best-practice initiation of quality infant feeding care
Comes with RN and MD support that is not rare.
Fundamental platforms of success include professional buy-in
While mom and baby need numerous opportunities of tryin’.
Far superior to any medication
Breastfeeding should not require supplementation.
Addition of formula supplementation
Does not support maternal milk regeneration.
Stay clear of such practices that will clearly derail
And cause establishment of breastfeeding to fail.

Don’t let the opportunity to support the mother/baby dyad go by
Every healthcare professional should try
To implement and support breastfeeding success
So that outcomes will be stellar and nothing less.
Promote bonding and skin-to-skin for first feed
Because colostrum and human milk is all that infant’s truly need.
While technology advances our society in so many ways,
Some things are best left without improved solution,
It’s breastfeeding “au natural” that has been around since evolution.
Let’s embrace this evidenced-based quality measure
That is truly a life-sustaining treasure.

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Categories: Obstetrics, Labor & Delivery

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