Letters to the editor

Reducing Barriers to Breastfeeding


Am Fam Physician. 2002 Apr 15;65(8):1522.

to the editor: I appreciate the emphasis made on the importance of initiating breastfeeding as early as possible during the neonatal period. The article “Initial Management of Breastfeeding”1 by Dr. Sinusas and Ms. Gagliardi addressed important issues regarding this topic. However, I think more emphasis should be made on various methods of prenatal interventions to increase breastfeeding rates and issues surrounding possible social and cultural barriers to initiating breastfeeding.

Results of studies2 show that women in the United States encounter a variety of barriers to breastfeeding, including lack of social support, inadequate prenatal education, and the media's portrayal of formula feeding as the norm. It is important to address these common barriers as early as possible in the prenatal period because this might positively affect a woman's decision to breastfeed.

The long-term success of breastfeeding is based on active initial postnatal interventions and active, multifaceted prenatal interventions that are started early in the prenatal period. This intervention should include ongoing one-on-one counseling by health care providers, written materials, videos on breastfeeding techniques, and support groups. These early prenatal and postnatal interventions are essential to the success of long-term breastfeeding.


1. Sinusas K, Gagliardi A. Management of breastfeeding. Am Fam Physician. 2001;64:981–8.

2. Breastfeeding and the use of human milk. American Academy of Pediatrics. Work Group on Breastfeeding. Pediatrics. 1997;100:1035–9.

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Letters submitted for publication in AFP must not be submitted to any other publication. Possible conflicts of interest must be disclosed at time of submission. Submission of a letter will be construed as granting the AAFP permission to publish the letter in any of its publications in any form. The editors may edit letters to meet style and space requirements.

This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.



Copyright © 2002 by the American Academy of Family Physicians.
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