Breastfeeding Medicine

Physicians blogging about breastfeeding

Archive for the ‘The Ten Steps’ Category

I #March4Nutrition to make #breastfeeding a right, not a privilege

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I #March4Nutrition because breastfeeding is a powerful predictor of health and wellbeing for mothers and infants — and yet, too many families face barriers that prevent them from achieving their own breastfeeding goals.

Families who want to breastfeed navigate a veritable minefield of “Booby Traps.” Many maternity providers have minimal training in lactation support, and providers may not ask about breastfeeding during prenatal care — or spend only seconds on the topic — missing the opportunity to address concerns and provide guidance.  Parents are inundated with misleading materials from infant formula manufacturers, promising that their product is “designed to be like breast milk” or will magically convince fussy babies to sleep through the night. Indeed, in a study, mothers looking at formula advertisements voiced concerns that their milk didn’t have added vitamins, so perhaps it would be healthier to formula feed.

At birth, too few families receive evidence-based maternity care that gets infant feeding off to an optimal start. For example, putting a baby skin-to-skin for the first hour of life increases breastfeeding duration by as much as 6 weeks — yet 28% of US hospitals do not provide such care to most women.  Skin-to-skin is one of the World Health Organization Ten Steps to Successful Breastfeeding. Hospitals that implement all ten can be designated as “Baby Friendly” – but currently, only 11.5% of US maternity centers meet that standard. It’s worth noting that we are making progress — just 2.9% of hospitals were Baby Friendly in 2007 — but 88% of families are still hobbled at the starting gates when they start their breastfeeding journey.

Read the rest of this entry »

Written by astuebe

March 19, 2015 at 7:08 pm

ABM Protocol and Statement Updates!

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Today I wear my dual hats as ABM Protocol Chair and ABM Blogger.  It came to the attention of the Protocol Committee that there were typos/errors in a couple of our ABM protocols after publication.  Two protocols have been corrected in the on-line copies for Breastfeeding Medicine previously, and have now been updated on the ABM website as of today. 

Here are the corrections that have been made:

1.  Protocol #3—Supplementation—Volume 4, Number 3:

  Table 3, page 178  under “Time” the second line was originally printed 24-28 hours; correction is 24-48 hours.

2.  Protocol #7—Model Hospital Policy—Volume 5, Number 4:

  Page 176 and in the listing of the Ten Steps.  Step #6: only the US version require that hospitals purchase their formula.  The original published text stated: 

   6.  Give newborn infants no food or drink other than breast milk, unless medically indicated. (A hospital must pay fair market price for all formula and infant feeding supplies that it uses and cannot accept free or heavily discounted formula and supplies.)

Now it correctly and in keeping with the original, international Ten Steps says:

  6. Give newborn infants no food or drink other than breast milk, unless medically indicated.

I will let you know if any future changes occur in published protocols or statements. 

And by the way, the just published issue of Breastfeeding Medicine contains ABM’s second Statement, Educational Objectives and Skills for the Physician with Respect to Breastfeeding.  Check it out in the latest Journal (Breastfeeding Medicine. April 2011, 6(2): 99-105).  Our first ABM Statement, Position on Breastfeeding (Breastfeeding Medicine 2008;3(4):267-270), can be found under the “About Us” tab on our web page right now.  As we now have two statements, and several more on the way, we are setting up a “Statements” section on our Protocol page to make them easy to find all in one place.  Please be a little patient with us!  Our newest statement will be on our website soon!

Kathleen Marinelli MD, IBCLC, FABM is a neonatologist a Board member of the Academy of Breastfeeding Medicine, and Chair of the ABM Protocol Committee.

Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Written by kmarinellimd

April 11, 2011 at 5:04 pm

“A sucker born every minute”: pacifiers and breastfeeding

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For new moms, deciding about whether to offer a pacifier to a newborn, like deciding whether to breastfeed, can be an emotionally loaded decision.  Newborns need to suck – for non-nutritive (comfort) as well as nutritive (food) reasons.  I can’t count the number of times I’ve heard “that baby is using [me/you/her mom] as a pacifier!” from parents and nursery nurses during the first hours of life.

When I hear that, I can’t help but to cringe and comment that pacifiers were invented as a substitute for moms, not vice versa.   The physiology of lactation requires frequent suckling and emptying of the breast to establish and maintain a mom’s milk supply.  So it makes sense that giving a pacifier to a newborn who wants to suckle, instead of letting him nurse, could adversely affect his mom’s milk supply as well as his own growth.  Thus physicians who want to support breastfeeding usually caution new parents about the use of pacifiers before breastfeeding is well established, usually about two weeks after birth. ( Avoidance of artificial teats or pacifiers is, in fact, one of the WHO/UNICEF Ten Steps to Successful Breastfeeding.)

However, it has been difficult to find definitive scientific evidence to support this advice.  And as a mom, I well remember the frustration of seemingly incessant newborn breastfeeding.  That’s why I was hopeful when I saw the abstract for a new Cochrane meta-analysis that suggests pacifiers need not be avoided. Read the rest of this entry »

Written by neobfmd

April 8, 2011 at 9:24 am

WABA Global Breastfeeding Partners’ Forum

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The World Alliance for Breastfeeding Action (WABA) is organizing the Global Breastfeeding Partners’ Forum (GBPF) on October 17 to 18 in Penang, Malaysia. This two-day forum will have as main theme “Enabling Mothering: Keeping mothers and babies together”, focusing on the expanded Baby Friendly Hospital Initiative (BFHI)  and maternity protection and support for working women. WABA’s Core Partners, participants and speakers from around the world will be sharing new technical knowledge and programmatic updates in the areas of the expanded BFHI maternity protection. Among the purposes of this meeting is to further collaboration with WABA’s Core Partners and other participants to plan and advance the common vision and strategic direction of the breastfeeding movement.

The Academy of Breastfeeding Medicine is a Core Partner and the physicians’ arm of WABA. ABM representatives will be actively participating in this forum looking for strategies to help promote effectively the expanded BFHI among physicians around the world. Physicians are key care providers to increase the BFHI and achieve the Innocenti Declaration goals globally. All ABM physicians should enthusiastically embrace the tenets of the Innocenti Declaration as the premium policy for infant and child health promotion and a necessary public health strategy around the world.

We invite all ABM members to sign the ABM/WABA Physician’s Pledge to Promote, Protect and Support Breastfeeding. The Physician’s Pledge is a vehicle for all physicians to declare their support for the Innocenti Declaration Goals and to “go on record” as a breastfeeding-friendly practitioner. Please fax your signed Physician’s Pledge to ABM at its USA headquarters, 914-740-2101, or mailed to: Academy of Breastfeeding Medicine, 140 Huguenot Street, 3rd floor, New Rochelle, New York 10801, USA.

Ana M. Parrilla-Rodríguez, MD, MPH, is a public health physician, breastfeeding researcher and clinician, and associate professor of the Maternal and Child Program at the University of Puerto Rico School of Public Health. She is a member and a Fellow of the Academy of Breastfeeding Medicine.
Posts on this blog reflect the opinions of individual ABM members, not the organization as a whole.

Written by Ana Parrilla-Rodríguez, MD

October 27, 2010 at 10:35 pm

Why ‘Beetlejuice’ is a losing argument to bolster breastfeeding

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I’ve been thinking a lot about Similac’s recent recall of 5 million cans of formula thought to contain beetle parts, and what it means for breastfeeding advocacy. At first blush, it looks like a slam dunk argument to encourage more moms to breastfeed. Faced with a decision between bug-part-tainted powder and mom’s milk, surely more moms will want to breastfeed. Read the rest of this entry »

Written by astuebe

October 8, 2010 at 8:31 am

The Breastfeeding Cheerleader

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Support of our peers is important in so many aspects of our life, and for women it is very true for the new mother who is breastfeeding.  As we celebrate The Ten Steps to Successful Breastfeeding this week, we can’t forget the importance of breastfeeding support after the mom leaves the hospital with baby in tow. Read the rest of this entry »

Written by NKSriraman

August 3, 2010 at 8:26 pm

Celebrating Skin to Skin

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In honor of World Breastfeeding Week, I wanted to write something about the importance of skin to skin contact for mothers and babies at delivery. As a practicing OB this is something I try to encourage.

I believe that skin to skin contact immediately following delivery should be routinely practiced for healthy mother infant dyads with term deliveries. This helps support the “10 Steps” as it encourages breastfeeding initiation within the first 30 minutes after delivery. Much of the medical technology involved in childbirth helps us recognize when problems occur. It can also help us recognize when mothers and infants are healthy at birth. This should be the expected situation for normal birth. Read the rest of this entry »

Written by vpdn

August 2, 2010 at 6:07 am

Posted in policy, The Ten Steps


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