U.S. Breastfeeding Actions Undermine Policy and Clinical Guidelines

Breastfeeding is and always has been the most basic practice of feeding newborn babies. An overwhelming body of evidence shows the positive benefits to infant and maternal health, but it was just rejected by the United States.

Specifically, the United States rejected a proposed resolution by the World Health Organization that aimed to encourage and support women in breastfeeding across the globe. This decision undermines years of evidence-based policy and clinical guidelines that institutions such as the American Academy of Pediatrics have fought so hard to protect.

And while the Trump administration is denying that it called into question the importance of breastfeeding for infants in a recent op-ed, it has been heavily reported that American officials at the World Health Assembly made every effort to remove language that called on governments to “protect, promote and support breastfeeding.”

Whether you ask health care professionals, researchers or policy experts, you will generally reach unanimous consensus that breastfeeding provides enormous benefits to the health and well-being of both new mothers and their babies. Breastfeeding can protect against common childhood infections and improve a baby’s survival during the first year. It lowers the risks of sudden infant death syndrome, certain allergic diseases, asthma, obesity and type 2 diabetes, and may help with cognitive development. At a minimum, the pre-eminent experts in pediatric health, the AAP, recommend that infants be fed breast milk exclusively until they are at least 6 months old.

Research has also shown the potential benefits of breastfeeding for new mothers. Breastfeeding may reduce maternal bleeding after delivery, facilitate postpartum weight loss and reduce stress. In the long term, breastfeeding has also been linked to decreasing a woman’s risk for chronic disease and reproductive cancers.

In 2010, the mounting evidence was so vast in supporting breastfeeding that Congress acted by including provisions in the Affordable Care Act to guarantee most health insurance provides coverage for certain recommended preventive services without cost sharing, including breastfeeding counseling, supplies and support services. This means that the majority of insurance plans today must cover breastfeeding counseling and supplies at no out-of-pocket cost for mothers. Congress also included a provision that requires many employers to provide their employees with dedicated time for breastfeeding breaks and a private space to nurse or pump in order to support mothers who choose to continue breastfeeding after returning to work.

Building on that momentum, in 2011, the U.S. surgeon general issued a call to action to support mothers who choose to breastfeed. The call to action outlines steps that the United States can take as a society to support mothers and babies who are breastfeeding.

The first, and most crucial step in the call to action, is to “give the mothers the support they need to breastfeed their babies,” including education, open communication with professionals and the time and support mothers may need. We, as a country, may have taken the first steps of this call to action, but we need to make sure we continue to move forward and not backward.       

As a practicing registered nurse in maternal/fetal medicine, and as a mother, I understand how deeply personal the decision to breastfeed can be. This message is not intended to argue that everyone should breastfeed, but instead, to motivate us to create a world that supports women who make the choice to do so.

In the United States, we have adopted policies and clinical guidelines because research has demonstrated the benefits of breastfeeding. We should be promoting and encouraging other countries to adopt evidence-based policies that increase utilization and access to preventive services.

Instead of undermining our medical community and failing to lead the world in creating a supportive and healthy environment, we should continue to protect and expand the care women and babies deserve. We as a nation, and a global society, should lead in supporting the health of all mothers and babies.


Beth Battaglino, RN, is CEO of HealthyWomen.

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