Some breastfeeding advice worth ditching: US task force

A review of scientific evidence on breastfeeding out today found that some long-held advice is worth ditching, including that babies should avoid pacifiers and moms should breastfeed exclusively in the first days after birth.
Individual interventions to help expectant and new moms breastfeed are still recommended, but systematic or hospital-wide policies tend to show little benefit, said the report by the US Preventive Services Task Force (USPSTF), an independent panel of experts.
The benefits of breastfeeding include providing optimal nutrition and an immune system boost for babies, while helping mothers bond with infants and speeding maternal weight loss after birth.

"There is convincing evidence that breastfeeding provides substantial health benefits for children and adequate evidence that breastfeeding provides moderate health benefits for women," said the report in the Journal of the American Medical Association (JAMA).
"However, nearly half of all mothers in the United States who initially breastfeed stop doing so by six months."
The American Academy of Pediatrics urges women to breastfeed for at least the first year if possible, while the World Health Organization recommends up to two years of age or beyond.

Just 22 percent of US babies are breastfed exclusively for six months, even though 80 percent were breastfed at some point in their young lives, suggesting that women face challenges in continuing to breastfeed.

Although the process is natural, getting started can be complicated, and babies often need help learning how to latch on and feed.
For some mothers, the demands of returning to work can make breastfeeding impossible. Others may be physically unable, or may prefer the convenience of formula.
To update its 2008 recommendations, which also urged breastfeeding support for women, the task force reviewed evidence from dozens of studies, both new and old, on the effectiveness of various kinds of interventions on whether women took up breastfeeding, and how long they continued.
They found that the most effective interventions were one-on-one assistance provided by trained personnel, particularly when delivered at multiple points in time.

Hospital policies designed to encourage breastfeeding by implementing a series of pre-determined steps did not show any significant effect on improving breastfeeding.
Some of the policies in place even have the potential to be harmful, an accompanying editorial in JAMA by doctors Valerie Flaherman and Isabelle Von Kohorn warned.