In the United States, the American Academy of Pediatrics (AAP) provides guidelines and recommendations for board certified pediatricians to follow. They also provide recommendations for parents as well as other professionals who work with children. This includes the AAP breastfeeding recommendations.

The AAP breastfeeding recommendations have long included exclusively breastfeeding for six months, then continuing alongside solids for at least one year. However, this has varied from guidelines made by the World Health Organization.

For many parents, exclusively breastfeeding for six months and then continuing to one year becomes a breastfeeding goal. There are also many parents who do not meet their breastfeeding goals, or struggle to meet them. This is often where breastfeeding counselors come in.

As a certified breastfeeding counselor, it is important to be aware of up-to-date guidelines in your area.

New AAP Breastfeeding Recommendations

We have long been aware of the benefits of breastfeeding. We know on a population level, not breastfeeding can increase several risks.

However, despite guidelines recommending and encouraging breastfeeding, the AAP is aware many families are not receiving evidenced-based support.

The new guidelines are designed to hopefully improve that. The new guidelines include:

“The AAP recommends:

• Exclusive breastfeeding for the first 6 months. There is no need to introduce infant formula or other sources of nutrition for most infants. Beyond 6 months, breastfeeding should be maintained along with nutritious complementary foods.
• AAP recommends that birth hospitals or centers implement maternity care practices that improve breastfeeding initiation, duration, and exclusivity.
• There are continued benefits from breastfeeding beyond 1 year, and up to 2 years especially in the mother. Long-term breastfeeding is associated with protections against diabetes, high blood pressure, and cancers of the breast and ovaries.
• Mothers who choose to breastfeed beyond the first year need support from their medical care providers, as well as protections against workplace barriers.
• Policies that protect breastfeeding, including universal paid maternity leave; the right of a woman to breastfeed in public; insurance coverage for lactation support and breast pumps; on-site child care; universal workplace break time with a clean, private location for expressing milk; the right to feed expressed milk; and the right to breastfeed in child care centers and lactation rooms in schools are all essential to supporting families in sustaining breastfeeding.”

You can visit the American Academy of Pediatrics website to read the entire release.

What Do These New Recommendations Mean For CBCs?

As a breastfeeding counselor, you will notice that these recommendations are in-line with current WHO guidelines. They are also like guidelines in some other countries.

For many parents with personal breastfeeding goals, where and how they give birth, their pediatricians advice, and their back to work timeline can all influence whether they meet their goals.

These new guidelines should not be used to make parents feel like they must meet specific goals. They are designed to encourage professionals to follow evidenced-based support and practice and encourage better public health and family policies.

As a CBC, you can help educate your clients on the current recommendations. This can aid in them choosing providers who are supporting them in an evidenced-based way. While the AAP is meant to educate pediatricians, not all pediatricians follow up-to-date guidelines.

You can also use this information to help normalize breastfeeding beyond a year. Many CBCs are active on social media, in local parenting communities, etc.

Will These Guidelines Add More Pressure For Parents?

We already know many new parents feel intense pressure to breastfeed. As a CBC, you should know that no parent can ever “fail” at breastfeeding. Parents may not reach their personal breastfeeding goals. However, that is typically the result of lack of support, misinformation, or circumstances beyond their control.

No parent should ever be pressured or made to feel guilty about how they feed their baby.

The overall purpose of these new guidelines, as mentioned above, is to highlight the benefits and need of lactation support. It also encourages improved policies to make reaching evidenced-based breastfeeding goals possible.

“The AAP views breastfeeding as a public health imperative and also as an equity issue,” said Lawrence Noble, MD, FAAP, FABM, IBCLC, co-author of the policy statement and technical report, which details the evidence that supports human milk feeding. “Pediatricians and other medical professionals can help mothers meet their intended goals for breastfeeding and provide care that is inclusive, equitable, and culturally sensitive.”

We know breastmilk is the biological norm for human infants and toddlers. It is a living substance with the ability to protect against frequency and severity of many common childhood illnesses.

Finally, the AAP said:

“Breastfeeding can be challenging for new parents, and support from their families, doctors and work places is essential,” Dr. Meek said. “The health benefits are vast and can be viewed as a long-term investment not only in a child’s development, but to public health as a whole.”