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March 15, 2005  
New Breastfeeding Policy From the AAP  
The news:The American Academy of Pediatrics (AAP) has revised its policy statement about breastfeeding, based on recent scientific information. Here are some of the most important recommendations:

  Breastfeeding continues to be recommended for at least the first year or longer, and exclusive breastfeeding for the first six months.

  Routine procedures for a newborn—such as weighing, measuring, and receiving eye drops—should be delayed so that an infant can be placed in direct skin-to-skin contact with the mother immediately after birth and allowed to remain there during the recovery period. This promotes breastfeeding because infants can latch onto a breast better immediately after birth than in the sleepy few hours right afterwards.

  Breastfed infants should be given a vitamin D supplement, starting at 2 months of age and continuing until the child is on formula or taking 16 ounces of vitamin D-fortified milk per day. Breast milk does not contain enough Vitamin D.

  Infants should sleep in close proximity to a breastfeeding mother in the early weeks of nursing so that the mother can respond to the early signs of hunger. Once an infant is crying vigorously, it is more difficult to get her to latch on.

  Pacifiers should be avoided until breastfeeding is well established, as they can interfere with feeding in the early stages. (Pediatrics, vol. 115, no. 2 [Feb. 2005]: pp. 496-506)

Comment, by Loraine Stern, M.D.: The AAP's new statement contains several points that especially please me. One is that "a small, celebratory alcoholic drink is acceptable" for mothers who breastfeed. The drink is best taken right after a feed so that alcohol levels are lower by the time the baby nurses again. That is not to say that you should start drinking if you never have, but if you enjoy a glass of wine or a cocktail and have abstained throughout pregnancy, as you should, a glass of wine or a drink once in a while now that the baby is here might help you relax and feel a little more elegant.
Another new recommendation I applaud is that infants should be seen by their pediatrician in the office or clinic at 3 to 5 days after birth. Currently, babies go in for their first checkup at 2 weeks, which is too late to correct some feeding problems and can allow jaundice levels to reach dangerous highs.


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