07/13/2022
Let's discuss the AAP statement on breastfeeding that has been getting a lot of attention lately.
To start off, I think it's important to actually take a minute and read the policy statement https://publications.aap.org/pediatrics/article/150/1/e2022057988/188347/Policy-Statement-Breastfeeding-and-the-Use-of?_ga=2.231953243.595107921.1657676621-443866733.1657047394
The media has been feeding a frenzy highlighting a polarized debate that is taking us far afield from the actual statement.
The purpose of the statement is not to add another unattainable goal for mothers/parents, increase guilt, or make you feel like you are falling short if you don't breastfeed until 2+. I understand why an official statement from the AAP might be triggering for some moms/parents but let's look at some of the direct quotes from the statement with the following context:
The World Health Organization has been reccomending breastfeeding for "up to 2 years of age and beyond" for years. The AAP has finally caught up to this GLOBAL reccomendation.
That means that up until now if you breastfed past the age of 1, you were technically extending breastfeeding, whereas if you stepped outside of the US you would following the WHO based norm for breastfeeding.
It's extremely likely that if you breastfed past one year, you encountered some kind of judgement, stigmitization, or comment, subtle or overt, that suggested that what you were doing was out of the norm. Now imagine if that comes from the very person that you trust for your child's health- your pediatrician.
According to the statement, "There is evidence that only one-half of mothers who breastfeed past 1 year discuss their decision with their pediatric primary care provider and that 38% of women who reported that their provider was unsupportive of breastfeeding past the first year elected to change their pediatric primary care provider."
So think about it this way, the AAP's primary audience are pediatric providers. This statement is suggesting that a significant number of pediatric providers were unsupportive of mothers/parents breastfeeding past 1 year.
Instead of worrying about the pressure this puts on parents to breastfeed, try looking at it as the AAP urging pediatric providers to stop judging and be more supportive of breastfeeding until 2 years and beyond. Reform by provider agencies for providers.
On the flip side, in case there were providers that were pressuring families to breastfeed the AAP says "Pediatricians can review the importance of exclusive breastfeeding and ensure mothers and families are fully informed about their decisions, while at the same time engaging in nonjudgmental conversations about the family’s personal goals for breastfeeding. Exclusive or any breastfeeding is not always possible, despite the best of intentions, and these mothers and families need special support to overcome the disappointment that may accompany breastfeeding difficulties."
I choose to celebrate the AAP statement which supports
1.MORE CHOICE: "breastfeeding...as long as mutually desired by mother and child for 2 years or beyond"
2. LESS JUDGEMENT and calls for
3. INCREASED SUPPORT to meet each families' goals. "Mothers who decide to breastfeed beyond the first year need support. They often report feeling ridiculed or alienated in their choice and conceal their breastfeeding behavior to minimize unsolicited judgment and comments."
The AAP flat our reccomends these three efforts.
The real question is how can we now get legislation to support lactation services without barriers to each and every family CHOOSING to breastfeed to get the crucial support they need.
That's a post for another time.
Stay tuned for my CBS TV appearance discussing this topic!
