AAP Updates Breastfeeding Guidelines Extending Breastfeeding To Two Years Or More

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The American Academy of Pediatrics (AAP) has been busy recently and for the first time in 10 years have now changed the breastfeeding guidelines. 

Earlier this month, the organization issued new recommendations regarding safe sleep for infants in an effort to reduce the number of SIDS-related deaths in babies.

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These new guidelines come on the heels of the Safe Sleep for Babies Act of 2021, which was signed into law on May 16.

The law bans the manufacture and sale of crib bumpers or inclined sleepers.

In addition to using a firm, flat, non-inclined sleep surface with no loose bedding, the AAP also advises AGAINST bed-sharing (although room-sharing is endorsed).

And now, the AAP is once again taking a look at its current policies in regard to infants, and making changes.

For the first time in 10 years, the AAP has updated its recommendation on breastfeeding.

A young mother is breatfeeding her big toddler on a bench by the sea
Adobe Photostock

For the past decade, the AAP has recommended breastfeeding exclusively for 6 months and continuing for 1 year or longer as “mutually desired by parent and infant.”

Now, in a new policy statement published on Monday, the organization is extending the recommended length of breastfeeding to two years or more. 

It cites “significant health benefits to infant and mother” as the overarching reason for the change. 

While FED IS BEST, there is no doubt that breastfeeding does come with a number of unique health benefits.

According to Joan Younger Meek, MD, MS, RD, FAAP, FABM, IBCLC, and lead author of the AAP’s published report:

“Human milk is all a baby needs for the first six months of life.

Breast milk is unique in its nutrients and protective effects, and really quite remarkable when you look at what it does for a child’s developing immune system.”

Research has shown that breastfeeding is linked to decreased rates of lower respiratory tract infections, severe diarrhea, ear infections, and obesity. It is also associated with a lower risk of sudden infant death syndrome.

And the benefits are not only reserved for babies. Mothers benefit from breastfeeding as well.

The AAP states that “long-term breastfeeding is associated with protection against diabetes, high blood pressure, and cancers of the breast and ovaries.”

However, health benefits alone are not enough to make change happen.

The AAP recognizes that this advice comes amidst overwhelming challenges.

While in theory, extending breastfeeding to two years sounds easy enough, the reality we are living in proves otherwise.

Our society does not support mothers. Full stop.

The title of the AAP’s press release alone points to this – “American Academy of Pediatrics Calls For More Support For Breastfeeding Mothers Within Updated Policy Recommendations.

It even prefaces the release with the following:

“AAP identifies stigma, lack of support and workplace barriers as obstacles that hinder continued breastfeeding.”

It reiterates the need for social and systemic changes in its tweet announcing the updated guidelines. 

Words are easy. Real change, however, is not. Particularly given our current climate.

As one Twitter user commented, the timing of this is somewhat ironic, not to mention tone-deaf:

Lawrence Noble, MD, FAAP, FABM, IBCLC, co-author of the AAP’s policy statement and technical report, says that breastfeeding is a public health imperative.

The goal is to have medical professionals provide “nonjudgmental support, information and help to guide families in feeding their infant.”:

“The AAP views breastfeeding as a public health imperative and also as an equity issue.

Pediatricians and other medical professionals can help mothers meet their intended goals for breastfeeding and provide care that is inclusive, equitable, and culturally sensitive.”

But it’s not just a need for equity or lack of information that’s the issue.

“Encouraging change” doesn’t go nearly far enough. Society’s overall views around mothers need to change. And this is no small feat.  

Societal support for mothers is severely lacking. 

Paid maternity leave is abysmal, at best. If you are even lucky enough to have an employer that offers this in the first place.

Lack of flexible work options, insurance coverage, designated breastfeeding areas, postpartum mental health support, affordable on-site childcare…the list goes on and on.

Not to mention, the judgment and backlash mothers face when they are seen breastfeeding a toddler in public. 

Additionally, breastfeeding doesn’t work for all mothers.

Myself included.

Recognizing this, reducing the stigma surrounding this, and supporting these mothers in their journey is just as important as supporting the women who are able to, or choose to, breastfeed.

Yes, social and systemic changes are needed and the fact that the AAP acknowledges this is a good first step. However, we still have a long way to go in making them happen.

 

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