Newly Updated Breastfeeding Guidelines from the AAP

The American Academy of Pediatrics (AAP) has updated its breastfeeding guidelines for the first time in a decade.⁷ The goal of the updated guidelines “is to support optimal health and nutrition for the child and mother and support parents in meeting their breastfeeding goals.”²

As with any new announcement regarding guidance for your child, parents may have mixed feelings, and questions may undoubtedly arise. To help answer your questions, the AAP has all the data and research to support its latest recommendations. So, let’s dive in and take a deeper look at the new breastfeeding guidelines so you can feel confident about your decisions for you and your growing little one.

Fast Facts: Breastfeeding Recommendations

The updated breastfeeding guidelines explain the benefits of breastfeeding, feeding recommendations, and overall support needed for a mother to breastfeed her child successfully. And an important highlight to note is that the AAP continues to support exclusive breastfeeding for up to six months of age but now includes support of breastfeeding “as long as mutually desired by the mother and child for two years or beyond” as compared to the AAP 2012 recommendation of one year or longer.²

The 2022 guidance from the AAP for breastfeeding includes:

• Exclusive breastfeeding for approximately six months.
• Introduction of appropriate, complementary solid foods at six months.
• And continued breastfeeding as long as mom and baby desire for two years or beyond.^1,2

Benefits of Breastfeeding: An Overview

Breastfeeding is an excellent source of nutrition. The nutrients in human milk have a powerful effect on a child’s growth and development, help protect against many diseases and illnesses, and foster an incredibly intimate bond between mother and child. Breast milk supports a child’s growing needs during infancy and has positive lasting effects throughout the child’s life.¹

Research has shown breastfeeding can decrease the risk of your child developing certain diseases and illnesses. Some health concerns^1,2 that breastfeeding can reduce the risk of include:

• Lower respiratory tract infections
• Ear infections
• Gastrointestinal disorders
• Asthma
• Eczema
• Diabetes
• Obesity
• Childhood leukemia

An additional benefit of breastfeeding is that human milk contains antibodies. Throughout the entire breastfeeding process, antibodies are passed to the baby through breast milk that can help prevent and fight infections. “Through these antibodies,” the report says, “the mother can pass on some protection from an infectious illness she had in the past and those she gets while breastfeeding.”⁴

The AAP also supports breastfeeding as a strategy to decrease the risk of Sudden Infant Death Syndrome (SIDS). Studies have shown that breastfeeding is associated with a reduction in SIDS by 40% at two months and 64% if breastfeeding was longer than six months.¹

Besides positive benefits for the baby, breastfeeding plays a valuable role in supporting mothers’ health. After birth, breastfeeding can help decrease the amount of postpartum bleeding. Breastfeeding causes your body to release the hormone oxytocin, which helps the uterus to contract and return to its regular size.³ It has also been shown that breastfeeding moms have a lower risk of developing breast, ovarian, and endometrial cancer, type 2 diabetes, and hypertension.^1,2

From One Year to Two and Beyond

You may wonder why the AAP would change its breastfeeding guidelines from one to two years.

From birth to 2 years old, your little one goes through one of the most active stages of neurologic development.¹ Brain development depends on many factors, including proper nutrition.⁵ During this development period, the health risks of hypertension, obesity, and diabetes are “believed to be programmed.”¹  Breast milk can play a crucial role in minimizing the risk of these listed health concerns.

Preliminary data has shown that breast milk is a significant source of “macronutrients and immunologic factors” that benefit the growing 2-year-old.¹ In year two, breast milk is composed of significantly higher concentrations of protein, lactoferrin, lysozyme, and immunoglobulin A than milk in year one.¹ These components are essential in supporting your toddler’s growth and development.

The AAP has also found that breastfeeding over a year increases a mom’s health benefits. A “longer duration of breastfeeding is associated with decreased risk of developing breast and ovarian cancer in the mother.”¹ Other health benefits include decreased risk of maternal diabetes mellitus and hypertension. Not only does a longer duration of breastfeeding generate health benefits, but it has also shown to increase maternal attachment to her child, showing “increases in observed maternal sensitivity,” such as responsiveness to the child and reading the child’s cues.¹

AAP Call to Action

If you have breastfed in the past or are currently breastfeeding, you may know that it isn’t as easy as you may have once anticipated. On top of some physical challenges you and your baby may have to overcome, breastfeeding may also come with social challenges. There are many factors at play that can hinder a mother from reaching the recommended two years of breastfeeding. The new guidelines may also be overwhelming to some.

Fear not; in the AAP’s recommendations, there is a call to action, advocating for more healthcare, social, and workplace support for breastfeeding mothers. Start-to-finish support for breastfeeding mothers will help increase breastfeeding rates and success for families. The short and long-term impact breastfeeding can have on a child’s life is so beneficial that the AAP considers it a significant public health intervention.¹

Breastfeeding Support Equals Success

The AAP breastfeeding guidelines encourage more support and intervention by healthcare professionals immediately after birth in hospitals and birthing centers. Some recommended interventions include immediate skin-to-skin contact, minimizing the amount of time baby and mother are separated, as well as help from a skilled lactation support team.²

When the baby returns home, the AAP recommends a schedule of multiple visits to the pediatrician during the first weeks of life. The AAP highlights a pediatrician’s important role in supporting a successful breastfeeding journey². This is a critical time for the pediatrician to assess how baby and mother are doing with breastfeeding while helping to work through any problems. The pediatrician should encourage questions, offer education and guidance, and make referrals as needed for support. The pediatrician must be educated about the health benefits of breastfeeding and up-to-date knowledge of how to best support a mother and child’s breastfeeding relationship.¹

Workplace Support Recommendation

Even with maternity leave, women may have to return to their workplace just a few short weeks after their baby’s birth. Workplaces must support these breastfeeding mothers to help achieve the AAP recommended length of breastfeeding. Some supportive measures recommended by the AAP include; paid maternity leave, a lactation room, on-site childcare, and a reasonable break time for pumping throughout the mother’s work day.^1,2 Implementing these support measures has even shown benefits to employers with improved employee productivity and loyalty⁶.

The common factor in seeing successful breastfeeding relationships is support. Breastfeeding mothers need support! “Non-nutritive” parents, family members, and friends can help. Cheer your mama friends on and let them know what they are doing for their baby is amazing.

Contraindications to Breastfeeding

While breastfeeding is the standard recommendation for a baby’s nutrition, there are certain medical circumstances where breastfeeding would be contraindicated. These circumstances include, but are not limited to, an infant with galactosemia or a mother with human immunodeficiency virus (HIV), human T-cell lymphotropic virus type I or II infection, untreated brucellosis, or suspected or confirmed Ebola virus.²

Also, the AAP recommends not breastfeeding if a mother uses illicit drugs because of their effects on the infant’s neurobehavioral development.² You should speak to your pediatrician and health care provider to discuss any possible contraindications for breastfeeding.

The decision to breastfeed is highly personal. And the overall beneficial impact that breastfeeding has on a child’s growth and development is immense. So the new AAP policy offers breastfeeding guidelines to promote optimal health for both baby and mom. Please ask your healthcare providers for information to help you make an informed decision for you and your little one.