Nature designed human milk for human babies; it provides infants with the best source of nourishment for healthy growth and development and is associated with a decreased risk of infant morbidity, infant mortality, and maternal morbidity. More than 80% of women in the US initiate breastfeeding, but only 25% are breastfeeding at six months. State and federal laws are in place to protect a woman's right to breastfeed, to breastfeed in public, and to express breastmilk in the workplace.
The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for the first six months of life. Complimentary appropriate foods should be introduced around six months of age. The AAP adopted a new policy in support of continued breastfeeding until two years of age or longer if desired by mother and child.
The decision to breastfeed is an important one, and new moms and parents should feel comfortable seeking peer and professional support. The Arkansas Breastfeeding Help Line, sponsored by the Arkansas Department of Health and Baptist Health, is a free service available 24 hours a day, seven days a week. Call 800-445-6175 to speak to a certified lactation consultant.
Increasing breastfeeding rates is a national priority, and improvement to protect, promote, and support breastfeeding continues to be a need in Arkansas. AFMC is working with the Arkansas Department of Human Services to promote best practices for increasing breastfeeding success as part of our larger effort to improve maternal and child health statewide.
Breastfeeding Promotion: Physicians’ Office Strategies for Success
Improve office systems to create a breastfeeding-friendly office.
- Establish a written breastfeeding-friendly office policy.
- Collaborate with colleagues and office staff during development.
- Provide staff education and training.
- Provide copies of your practice’s policy to hospitals and covering physicians.
- Develop and follow telephone triage protocols to address breastfeeding concerns and problems.
- Integrate breastfeeding promotion, education, and support throughout prenatal care.
- Take a detailed breastfeeding history as part of the prenatal history.
- Consider the culture of women, families, and communities.
- Incorporate breastfeeding as an important component of the initial prenatal breast exam.
- Discuss breastfeeding at each prenatal visit.
- Enable women and their families to have the birth experience most conducive to breastfeeding.
Provide an office environment that demonstrates breastfeeding promotion and support.
- Provide a lactation room for employees who breastfeed or express breast milk at work.
- Eliminate the distribution of free formula and baby items from formula companies to parents.
- Store formula supplies out of view of parents.
- Display posters, pamphlets, and pictures of breastfeeding mothers.
- Do not display images of infants bottle-feeding.
- Target display image material to populations with low breastfeeding rates.
- Do not accept gifts or samples from companies manufacturing infant formula, feeding bottles or pacifiers.
- Employ a lactation consultant or nurse trained in lactation.
Improve the patient experience.
- Do not interrupt or discourage breastfeeding in the office.
- Allow and encourage breastfeeding in the waiting room.
- Display signs in the waiting area encouraging mothers to breastfeed.
- Provide a comfortable private area to breastfeeding mothers who prefer privacy.
- Conduct follow-up phone calls to assist breastfeeding mothers.
- Encourage breastfeeding mothers to feed newborns only breast milk.
- Avoid offering supplemental formula or glucose water unless medically indicated.
- Commend breastfeeding mothers during each visit for choosing and continuing breastfeeding.
- Provide breastfeeding anticipatory guidance in routine periodic health maintenance visits.
- Encourage fathers of infants to accompany mother and baby to office visits.
- Encourage mothers to exclusively breastfeed for six months and continue breastfeeding for two years of age or longer as desired by mother and child.
Education
- Provide access to a multilingual staff and/or translators
- Provide culturally diverse educational material
- Instruct mother not to offer bottles or a pacifier until breastfeeding is well established.
- Breastfed babies should receive 400 IU of vitamin D per day starting in the first few days of life and continuing until one year of age. Babies over one year of age should receive 600 IU (15mcg) per day. (American Academy of Pediatrics)
- Early in the pregnancy, it is important to promote the Women, Infants and Children (WIC) program’s many benefits: healthy foods for pregnant women, nutrition education and referrals to other services.
- Breastfeeding questions answered 24/7 by the Arkansas Breastfeeding Helpline 800-445-6175 (sponsored by the Arkansas Department of Health and Baptist Health).
Breastfeeding Promotion: Inpatient Strategies for Success
Labor and delivery care
- Babies should be placed skin-to-skin with their mothers immediately after birth for at least one hour.
- Breastfeeding initiated within first hour after birth.
- Educate mothers to recognize when baby is ready to breastfeed and offer assistance as needed.
- Routine procedures are performed skin-to-skin.
Feeding of breastfed infants
- Initial feeding is breast milk (vaginal and cesarean births).
- Give infants no food or drink other than breast milk unless medically indicated.
Breastfeeding assistance
- Infant feeding decision is documented in the patient chart.
- Provide breastfeeding advice, instructions, and assistance.
- Provide instruction on how to maintain lactation even when separated from infant.
- Teach and encourage to feed on demand.
- Directly observe and assess breastfeeding.
- Use a standard feeding assessment tool.
- Do not provide pacifiers or artificial nipples to breastfeeding infants.
Contact between mother and infant
- Mother-infant pairs are not separated for postpartum transition.
- Mother-infant pairs room-in at night.
- Mother-infant pairs are not separated during the hospital stay.
- Infant procedures, assessment, and care occur in the patient room.
Facility discharge care
- Provide appropriate discharge planning (referrals and other multi-modal support).
- Discharge packs containing infant formula samples and marketing products are not given to breastfeeding patients.
Staff training
- All staff receive annual breastfeeding education.
- Annual assessment of staff competency in breastfeeding management and support.
Structural and organizational aspects of care delivery
- Breastfeeding policy is effectively communicated.
- Facility documents infant feeding rates inpatient population.
- The facility provides breastfeeding support to employees.
- The facility does not receive infant formula free of charge.
- Breastfeeding is included in prenatal patient education.
- The facility has a designated staff member responsible for the coordination of lactation care.
Web Resources
Breastfeeding policy
American Academy of Pediatrics Breastfeeding: AAP Policy Explained
American Academy of Pediatrics Policy Statement: Breastfeeding and the Use of Human Milk
American Academy of Pediatrics Where We Stand: Vitamin D & Iron Supplements for Babies
Centers for Disease Control and Prevention (CDC), 2022 Breastfeeding Report Card, United States
U.S. Department of Health and Human Services, The surgeon general’s call to action (2020).
U.S. Department of Health and Human Services, How Public Health Professionals Can Help
Breastfeeding programs
Breastfeeding laws
Breastfeeding training for health professionals
Breastfeeding supportive services
Arkansas Breastfeeding Helpline – Breastfeeding Questions Answered 24/7
800-445-6175
Arkansas Department of Health Peer Counselor Program
Kellymom provides evidence-based information on breastfeeding, sleep and parenting.
La Leche League (LLL) mothering through breastfeeding
The United States Breastfeeding Committee (USBC) works to improve the Nation’s health by working collaboratively to protect, promote, and support breastfeeding
The Arkansas Breastfeeding Coalition is dedicated to protecting and promoting breastfeeding in Arkansas
Breastfeeding support
Reviewed and Revised March 2024
