Breastfeeding Medicine

Physicians blogging about breastfeeding

ABM Releases Revised Supplementation Protocol

with 3 comments

During a time of abundant research surrounding the long term implications of feeding practices in the neonatal period on maternal and child health, it is of utmost importance that healthcare professionals are guided by the best available evidence regarding infant feeding while caring for breastfeeding dyads. We know that despite the recommendations against routine formula supplementation, this practice is commonplace in hospitals worldwide for a myriad of reasons. In developing ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate (Read the protocol here) newborn physiology and management of breastfeeding mothers were highlighted to impress upon healthcare professionals the delicate balance involved in helping mothers establish exclusive breastfeeding in the early postpartum days. Many mothers set out with the goal of exclusive breastfeeding, but still in many countries, few reach their feeding goals. Studies clearly demonstrate that when healthcare teams have a clear understanding of these topics, provide antenatal education, and implement supportive hospital practices, the need for supplementary feedings in term neonates is rare.

Preventing the need for supplementation altogether should be a common goal for all members of the healthcare team. It has been well established in the literature that exclusive breastfeeding protects mothers and infants from various poor health outcomes, is cost effective, and is the physiologic norm. Thus, the authors of this protocol dedicated substantial time and focus on practices that have been shown to reduce this need, which include many of the ten steps required by the Baby Friendly Hospital Initiative. The revised protocol contains an algorithm for caring for the breastfeeding dyad before and during the birth hospital stay and responding to common concerns.

It is important to recognize true medical indications of supplementary feedings as well as the preferred choice and volumes of supplement, which are appropriately outlined in this protocol, re-emphasizing that, while there is a time and place for formula use, a mother’s own expressed milk or donated human milk in volumes that mimic normal breastfeeding physiology are preferable to breast milk substitutes. The preference for donor human milk over formula use has been suggested by the Academy of Breastfeeding Medicine for years, and is further supported by emerging research on the long term health consequences of the infant microbiome and the role that breast milk substitutes may have on individual health outcomes years down the road.

Educating ourselves as healthcare providers about how best to support mothers in their breastfeeding journey is crucial to their success in meeting their personal feeding goals. This revised clinical protocol highlights supporting evidence and contains information and strategies needed to provide state-of-the-art care and support.

Written by drharrel

April 4, 2017 at 12:22 pm

3 Responses

Subscribe to comments with RSS.

  1. Reblogged this on Sam Foster IBCLC RM and commented:
    “Educating ourselves as healthcare providers about how best to support mothers in their breastfeeding journey is crucial to their success in meeting their personal feeding goals. This revised clinical protocol highlights supporting evidence and contains information and strategies needed to provide state-of-the-art care and support.”

    Bubs&Milk

    April 10, 2017 at 7:05 pm

    • Dear Cadey Harrel, MD and Breastfeeding Medicine Bloggers. I applaud your goal of preventing supplementation in the hospital. I would suggest one way to promote exclusivity would be to change our message to new and expectant mothers to a more positive, enabling (“you have what it takes in any scenario”) and informative one. Perhaps you may find this a helpful tool, a short (12 min.) video, available to all on the Stanford website. We’ve been using it in L&D, though not in a study format.
      “A Mother’s Touch, Breastfeeding in the First Hour” https://med.stanford.edu/newborns/professional-education/breastfeeding/breastfeeding-in-the-first-hour.html was produced with two goals: First, to provide expectant parents in L&D with a concise, upbeat, multicultural educational tool to prevent problems and the need for supplementation. Second, to abbreviate staff time spent educating and managing both low and high risk dyads. (access with any search engine except Internet Explorer. Chrome OK)
      Jane Morton (drjanemorton@gmail.com)

      Jane Morton, MD

      April 28, 2017 at 10:04 am

  2. If only Dr. Amy Tuteur and her followers were willing to learn more about the benefits of breastmilk feeding.

    Jeanne Batacan

    April 15, 2017 at 2:55 pm


Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s

%d bloggers like this: