Initial Management of Breastfeeding
Keith Sinusas, M.D. and Amy Gagliardi, M.A., I.B.C.L.C.
Am Fam Physician 2001;64:981-8,991-2.
Breast milk is widely accepted as the ideal source of nutrition for infants. In order to ensure success in breastfeeding, it is important that it be initiated as early as possible during the neonatal period. This is facilitated by skin-to-skin contact between the mother and infant immediately following birth. When possible, the infant should be allowed to root and latch on spontaneously within the first hour of life. Many common nursery routines such as weighing the infant, administration of vitamin K and application of ocular antibiotics can be safely delayed until after the initial breastfeeding. Postpartum care practices that improve breastfeeding rates include rooming-in, anticipatory guidance about breastfeeding problems and the avoidance of formula supplementation and pacifiers.
One goal of the Healthy People 20101 initiative is to achieve a breastfeeding initiation rate of 75 percent. Breastfeeding is supported by the American Academy of Family Physicians2 and the American Academy of Pediatrics (AAP).3 The AAP recommends continuation of breastfeeding for at least the first full year of life. Clearly, an important goal of family physicians, whether or not they provide maternity care, is to ensure that all women receive support for breastfeeding and encouragement to provide this ideal form of nutrition to their infants (Table 1).3
This article describes ways in which family physicians can facilitate the early initiation and long-term success of breastfeeding in their patients.
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