• Resident & Student News •
BY LESLIE CHAMPLIN
Mother Nature designed humans to breastfeed, but for 50 years, many patients and physicians have ignored that fact. Now, however, medicine and the public have begun to revisit the health benefits of mother's milk for newborns.
Family physicians should be at the forefront of that trend, say David Meyers, M.D., assistant professor and director of the CAPRICORN Research Network in the Department of Family Medicine at Georgetown University in Washington, and Julie Wood, M.D., faculty member at the Baptist-Lutheran Family Practice Residency in Kansas City, Mo. Meyers and Wood spoke Aug. 7 to packed sessions of "Breastfeeding 101" and "Breastfeeding 201" during the National Conference.
The rate of breastfeeding began to slide in the 1950s and has never fully recovered, said Meyers. The environmental and women's movements in the 1970s prompted a small revival of breastfeeding, but interest dipped again in the 1980s.
New breastfeeding guidelines issuedThe U.S. Preventive Services Task force recently released its first-ever set of breastfeeding guidelines. Those recommendations, along with a research article on the effectiveness of primary care-based interventions to promote breastfeeding, were published in the July/August Annals of Family Medicine. To view the guidelines, go to http://www.annfammed.org/content/ vol1/issue2/index.shtml and scroll down to the link to the USPSTF item. |
Over the past decade, breastfeeding has regained some acceptance as research has consistently demonstrated health benefits to mothers and their children, said Meyers. Studies have shown dramatic reductions in incidences of common infantile illnesses -- diarrhea, lower respiratory infections, otitis media and urinary tract infections -- among breastfed infants. These babies also experience far fewer serious illnesses, including bacteremia and sepsis, bacterial meningitis, sudden infant death syndrome and necrotizing enterocolitis.
Equally important, breastfed babies develop fewer chronic conditions such as asthma or allergies, show better cognitive progress, and exhibit more stable psychological development, Meyers said. And their mothers are at lower risk for postmenopausal hip fractures and ovarian and breast cancers.
The data have prompted national medical organizations to adopt policies supporting goals set in the U.S. Public Health Service's "Healthy People 2010" initiative. Those goals -- that 75 percent of newborns, 50 percent of 6-month-olds and 25 percent of 1-year-olds be breastfed -- have not yet been met. Several obstacles stand in the way. Society discourages breastfeeding, and the medical community has little knowledge and less interest in promoting the practice, said Meyers.
Active support from family physicians can wear down those barriers, said Meyers and Wood. The first and most important step is eliminating physician ignorance and apathy.
"We don't really care, and we have misinformation and myths that we learned from the culture and that we pass on," said Meyers.
By educating expectant parents about the birthing process, health benefits of breastfeeding and techniques for successful nursing, family physicians can influence the short- and long-term health of their patients. The AAFP's position paper on breastfeeding, available at http://www.aafp.org/x6633.xml, calls on family physicians to become breastfeeding advocates by working through health care settings such as community clinics, supporting changes in public health policy, and implementing breastfeeding-friendly procedures in their offices and hospitals.
According to the World Health Organization, baby-friendly hospitals have:
To reach writer Leslie Champlin, e-mail lchampli@aafp.org.
FP Report is published by the AAFP
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Copyright © 2003 by American Academy of Family Physicians.