Evidence-Based Updates on the First Week of Exclusive Breastfeeding Among Infants ≥35 Weeks.
Lori Feldman-Winter1, Ann Kellams2, Sigal Peter-Wohl3
1Department of Pediatrics, Cooper Medical School, Rowan University and Children's Regional Hospital at Cooper, Cooper University Health Care, Camden, New Jersey; winter-lori@CooperHealth.edu.
Pediatrics
|March 13, 2020
Summary
Exclusive breastfeeding offers significant health benefits for mothers and infants. This review guides clinicians in supporting successful exclusive breastfeeding and identifying early supplementation needs.
Area of Science:
- Pediatrics
- Neonatology
- Public Health
Background:
- Human milk's nutritional and immunologic benefits support maternal and infant health.
- Exclusive breastfeeding is intended by many US mothers but often challenged by lactation difficulties.
- Early identification of lactation challenges is crucial for successful breastfeeding continuation.
Purpose of the Study:
- To review recent evidence on exclusive breastfeeding in healthy newborns.
- To provide guidance on assessing milk transfer, neonatal weight, and output.
- To inform clinical practices regarding supplementation, immune development, and health systems.
Main Methods:
- Systematic review of evidence from the past 10 years.
- Focus on healthy newborns ≥35 weeks' gestation in routine postpartum settings.
- Analysis of topics including milk production, neonatal assessment, glucose/bilirubin management, and microbiome.
Main Results:
- Identifiable risk factors for impaired lactogenesis exist.
- Normative patterns of breastfeeding in the first week are key to early assessment.
- Evidence supports specific medical indications for early supplementation.
Conclusions:
- Clinicians need to recognize normal breastfeeding patterns and potential challenges.
- Evidence-based guidance can optimize exclusive breastfeeding practices.
- Best practices for birthing facilities and providers can improve breastfeeding outcomes.
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