Breast feeding support

Supporting breast feeding

1. Evidence-based interventions to support breastfeeding Journal club

2. A uthor: Lori Feldman- W inter,MD,MPH Journal: Pediatric clinics of North America: Breast feeding Updates for the Pediatrician . Morrow and Chantry February 2013,Volume 60,Number 1

3. Introduction Decision to breast feed is one of the most important decision a mother can make. 75% of US mothers started breastfeeding in early postpartum period according to CDC and NIS. Merely 14.8% women exclusively breast fed upto 6 months(NIS) in 2008. Therefore along with focusing on the decision to breastfeed there should be focus on protection and support of breastfeeding

4. Describes evidence based practices that have been established to support breastfeeding. Discusses barriers and challenges to breastfeeding support .

5. Support for pregnant women : Ample time with prenatal health care practioner providing ample opputunity for brestfeeding support. Peer counselling , formal lactational consultation and breast feeding education. Mothers who are at more risk of not breast feeding are more to gain from prenatal support.

6. Content of effective sessions- benefits,priciples of lactation,myths,common problems,solutions and skill training. Prenatal classes in workshop format increases self efficacy. Weight control strategies should be offered. More effective when combined with elimination of infant formula marketing Step 3 of BFHI

7. Support in preipartum setting : Importance of skin to skin conatct : improves physiologic transition,increases success of first breast feed and more effective breast feeding. The first breast feed : early first breastfeed leads to increased milk supply in first days, early passage of meconium and continuing of breast feeding. Newborn procedures :weighing,injectons,blood sampling.

8. BFHI: Has been shown to increase initiation, continuation and exclusivity. 10 steps have dose dependent effect.

9. Support for postpartum women in community Support by physician and advanced practice nurses.

10. Professional support by other health care professional :

11. Peer(lay) Support

12. Employment

13. Schools and preconception education :

14. Government and legistation :

15. Conclusion Considerable progress has been made in past decade in developing support systems to enable more women to reach breastfeeding goals. Each of this system is to rigorously tested and replicated if effective. Additional research is needed to determine best support during preconception period Along with outcome ,cost benefit analysis of breast feeding support program. evaluation of government activities and program.