On Oct. 25, the U.S. Preventive Services Task Force (USPSTF) released its final recommendation statement(www.uspreventiveservicestaskforce.org) and evidence summary(www.uspreventiveservicestaskforce.org) supporting breastfeeding interventions during pregnancy and after birth, which it found effectively increased the initiation and duration of breastfeeding -- a "B" recommendation.(www.uspreventiveservicestaskforce.org)
This final recommendation is largely consistent with the task force's 2016 draft recommendation and its 2008 final recommendation.
The AAFP also released a final "B" recommendation that mirrors the USPSTF's guidance.
Benefits of Breastfeeding
"Breastfeeding has real health benefits for babies and their mothers. Primary care clinicians can help new moms who breastfeed be successful," said USPSTF member Ann Kurth, Ph.D., R.N., in a news release.(www.uspreventiveservicestaskforce.org) "Primary care interventions to support breastfeeding are effective in increasing both the number of mothers who breastfeed and how long they breastfeed their babies."
Breastfeeding benefits mothers and their infants, because infants who are breastfed are at reduced risk for certain infections, as well as for chronic conditions such as asthma, obesity and diabetes. For new moms, breastfeeding is associated with lower risks of breast and ovarian cancers and type 2 diabetes.
The task force said effective primary care interventions include educating pregnant women and their families about breastfeeding and directing these patients to resources for assistance with breastfeeding and mother support groups.
The USPSTF also noted in its release that it recognizes breastfeeding is not the right choice for every mother and suggested physicians should be mindful of this when implementing interventions to support breastfeeding.
Response to Public Comment
The draft version of this recommendation statement was posted for public comment on the USPSTF website from April 26 to May 23.
The task force said it received many comments that expressed concern the recommendation didn't explicitly include the term "promotion" of breastfeeding. In response, the USPSTF said it interprets "support" as including promotion. The task force also revised its recommendation statement to clarify that its confidence in the benefits of breastfeeding hadn't changed and that it continues to recommend interventions to encourage breastfeeding.
Furthermore, the USPSTF clarified the type of interventions being recommended haven't changed from the previous recommendation.
Additional comments expressed concern that the recommendation would lead to undue pressure on women who decide not to breastfeed, so the USPSTF reviewed the recommendation's language to ensure the autonomy of women is respected.
Finally, some comments requested the USPSTF address policy- and society-level barriers to breastfeeding. Although the task force recognized these as important issues, it noted they are beyond its scope.
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