Role of the American College of Obstetricians and Gynecologists in Supporting and Encouraging Breastfeeding

Resources Provided by ACOG

ACOG periodically issues Committee Opinions (COs) on important matters. ¹ These are developed by committees of experts in various areas and are updated on a regular basis to provide guidance to our members. The current, relevant Opinions are CO 361 and CO 570.

CO 361, “Breastfeeding: Maternal and Infant Aspects,” recommends that ObGyns should advise and encourage patients to make the decision to breastfeed. According to the Opinion, these discussions should take place during preconception and prenatal and postpartum visits, as well as during the interconception period. Good hospital practices surrounding childbirth are also extremely important in enabling women to breastfeed. The Opinion recommends that providers should be aware of gift packs with formula that are often given to patients upon discharge, as they can be a significant deterrent to continuation of breastfeeding.

After discharge, the ObGyn's office should be a resource for 24/7 assistance or, at the very least, provide connections to community-based resources to support lactation issues. The Opinion also recommends that contraception should be discussed early, as well as in follow-up for breastfeeding women. Options that should be explained in detail should especially include methods compatible with breastfeeding. In short, women should be supported in integrating breastfeeding into their daily lives in the community and in the workplace. ACOG recommends exclusive breastfeeding for at least the first 6 months, longer if possible. ObGyns are asked to encourage and enable as many women as possible to breastfeed and to help them continue as long as possible.

CO 570, “Breastfeeding in Underserved Women: Increasing Initiation and Continuation of Breastfeeding,” points out the fact that underserved women are disproportionately likely to experience the very adverse health outcomes that may improve with breastfeeding. In particular, the Opinion points out the following improvements associated with breastfeeding:

• Decreased rate of common childhood infections, such as ear infections and infections that causes diarrhea, which result in decreased parental absenteeism from work

It is important that we remind our providers of these benefits. And, we need to remind our providers to remind their patients of these benefits. The underserved also face unique barriers and have low rates of initiation and continuation of breastfeeding, so it will take a multidisciplinary approach that involves practitioners, family members, care coordinators, and childcare providers to help them overcome obstacles and obtain the benefits of breastfeeding for themselves and their infants.

In addition to these COs, ACOG has published the Breastfeeding Handbook for Physicians, 2nd edition, ² which provides guidance for providers in all specialties. This is a joint project of the American Academy of Pediatrics and ACOG. It contains new information on the benefits of breastmilk to preterm infants and discusses breastfeeding issues during a disaster. ACOG has also published the Guidelines for Perinatal Care, 7th edition, ³ which is another joint project by ACOG and American Academy of Pediatrics. This edition provides updated information on breastfeeding.

ACOG provides information for patients about breastfeeding in the following publications: an “FAQ” called “Breastfeeding Your Baby” and “Your Pregnancy and Childbirth: Month to Month, 5th edition” which is not only sold online through Amazon.com and in other venues, but is also given free of charge by many of our members to their patients. There is also a patient booklet available to patients called “You and Your Baby: Prenatal Care, Labor and Delivery, and Postpartum Care.” All of these can be found on the ACOG Web site, ¹ and we encourage our ObGyns to make them available in their offices for patients.

Collaborative Partners

Other leaders in breastfeeding with which ACOG continues to partner include, among others, the Academy of Breastfeeding Medicine, the United States Breastfeeding Committee, the American Academy of Pediatrics, Section on Breastfeeding, the National Institute of Child Health and Human Development, and the 1,000 Days Initiative. We look forward to continuing to collaborate with all of our partners in this very important area.

In February 2014, ACOG formed the Breastfeeding Expert Work Group (BFEWG). This group serves as an advisory group to, and under the purview of, ACOG's Committee on Obstetric Practice. This work group also functions as a resource to other relevant ACOG committees as needed.

The BFEWG works to develop timely and accurate content in patient and provider resources and continues to demonstrate ACOG's commitment to help women achieve their goals for the best care possible for their newborns. The BFEWG members are generalist obstetricians, maternal–fetal medicine subspecialists, and ObGyn lactation consultants, all of whom were invited to join the Work Group based on their leadership, expertise, and interest in breastfeeding medicine and advocacy. The BFEWG is currently exploring new provider and patient breastfeeding education opportunities.

In April, at ACOG's national scientific meeting, we sponsored a course specifically about breastfeeding that was very well attended. Our members are increasingly interested in the topic, and we will continue to have breastfeeding education at the annual clinical and scientific meeting. We will also continue to collaborate with other organizations to help women achieve their breastfeeding goals, both in the community and in the workplace.

Summary

ACOG strongly supports breastfeeding and recognizes the value of breastfeeding for the mother and the baby. We have multiple resources for providers and patients and will continue to advocate on behalf of our patients and promote breastfeeding.