Michelle Winokur, DrPH
According to the American Academy of Pediatrics new guidelines, mothers are now encouraged to nurse for two years – up from one year. (1)
A mother’s willingness or ability to initiate breastfeeding is dependent on many factors, including support from family, close friends, and the hospital or birth center where the child is born. However, many other barriers can potentially keep moms from exclusively nursing for even six months, long considered the benchmark before introducing “nutritious complementary foods.”
Barriers to Breastfeeding
In recognition of the challenge of a lengthened breastfeeding period, the AAP concurrently released a technical report (2) identifying hurdles and approaches to support nursing moms. Among the challenges moms face are:
• Societal judgment: Upwards of 80% of women breast- feed initially, establishing the practice as a “cultural norm.” However, just one-third of infants are nursed beyond one year. (3) This sharp decline can lead to judgment and comments from well-intentioned yet misinformed relations – or strangers – who may not recognize the value of longer-term breastfeeding. Similarly, providers should support nursing beyond one year, though there is evidence that is not always the case. (4)
• Workplace barriers: The United States is one of only a handful of upper-income countries that does not guarantee paid maternity leave. Lack of income or loss of job protection forces some moms back to work sooner than they would like. Furthermore, few businesses provide on-site childcare, making it more convenient for moms to nurse during the workday. The country also lacks requirements for workplace breaks and the provision of a clean, private space to nurse or express milk.
• Insurance coverage: In most cases, insurance will provide or reimburse for select breast pumps, but coverage varies by plan and is not guaranteed. Similarly, only some insurers cover lactation support. While most hospitals and birth centers provide an initial consultation, many moms require additional guidance and support to continue nursing.
Benefits of Breastfeeding
The benefits (5) of breastfeeding for babies and moms are numerous.
Babies who nurse receive immunities from their moms, making them less likely to develop ear infections and less susceptible to stomach bugs. They also experience sudden infant death syndrome at lower rates. Moreover, breastfed babies have a lower risk of developing certain conditions, including asthma, obesity, and type 1 diabetes, as they grow.
Moms who nurse likewise reap long-term benefits, including reduced risk of breast and ovarian cancer, type 2 diabetes, and high blood pressure.
There is no better time than now, during National Breastfeeding Month, (6) to reflect on the AAP’s updated guidance and recommit to reducing barriers that discourage moms from breastfeeding. Providers, policymakers, employers, insurers, and communities all have opportunities to support nursing moms and their babies.
References:
2. https://publications.aap.org/pediatrics/article/150/1/e2022057989/188348/Technical-Report-Breastfeeding-and-the-Use-of?preview=true&utm_source=TrendMD&utm_medium=TrendMD&utm_campaign=Pediatrics_Trend-MD_0&_ga=2.60311022.2100616299.1660052238-843904336.1660052238 https://doi.org/10.1542/peds.2022-057989
3. https://www.cdc.gov/breastfeeding/data/nis_data/results.html
4. https://www.liebertpub.com/doi/abs/10.1089/bfm.2017.0184
5. https://www.cdc.gov/nccdphp/dnpao/features/breastfeeding-benefits/index.html#:~:text=Breastfeeding%20can%20help%20protect%20babies,ear%20infections%20and%20stomach%20bugs.
6. https://www.usbreastfeeding.org/national-breastfeeding-month.html.
Michelle Winokur, DrPH, is the Executive Director of the Institute for Patient Access. This article was also published at healthpolicytoday.org.
The Alliance for Patient Access (https://allianceforpatientaccess.org), founded in 2006, is a national network of physicians dedicated to ensuring patient access to approved therapies and appropriate clinical care. AfPA accomplishes this mission by recruiting, training and mobilizing policy-minded physicians to be effective advocates for patient access. AfPA is organized as a non-profit 501(c)(4) corporation and headed by an independent board of directors. Its physician leadership is supported by policy advocacy management and public afairs consultants. In 2012, AfPA established the Institute for Patient Access (IfPA), a related 501(c)(3) non-profit corporation. In keeping with its mission to promote a better understanding of the benefits of the physician-patient relationship in the provision of quality healthcrae, IfPA sponsors policy research and educational programing.
Corresponding Author
Michelle Winokur, DrPH
Policy Communications Director
Alliance for Patient Access (AfPA) Government Affairs Team
2020 K Street NW, Suite 505
Washington, DC 20006
(202) 964-2625
Email: info@allianceforpatientaccess.org