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Academy of Breastfeeding Medicine Clinical Protocol #19: Breastfeeding Promotion in the Prenatal Period (Revised
Anna Jack1, Caroline Mullin2, Elizabeth Brown3
1Department of Family Medicine, East Ridge Family Medicine, Department of Pediatrics, Division of Breastfeeding and Lactation Medicine, University of Rochester, Rochester, New York, USA.
Insights
Prenatal breastfeeding education and support, including discussing benefits and risks, can improve breastfeeding initiation and duration. This guidance should be patient-centered, culturally sensitive, and integrated into routine prenatal care.
Area of Science:
- Medicine
- Public Health
- Pediatrics
Background:
- The 2015 clinical protocol on breastfeeding promotion has been updated by the Academy of Breastfeeding Medicine.
- Prenatal breastfeeding promotion is crucial for improving breastfeeding initiation and duration.
- Interventions during the prenatal period should be part of a comprehensive breastfeeding support program.
Purpose of the Study:
- To review evidence and provide recommendations for prenatal breastfeeding promotion.
- To guide clinicians and health workers in supporting breastfeeding during the prenatal period.
- To enhance breastfeeding education for prenatal care providers.
Main Methods:
- Review of current evidence on prenatal breastfeeding promotion.
- Development of updated clinical recommendations.
- Inclusion of topics such as breastfeeding benefits, physiology, postpartum support, and risks of supplementation.
- Emphasis on patient-centered, culturally sensitive, and low-literacy education.
- Integration of various healthcare professionals and telecommunication modalities.
Main Results:
- Prenatal breastfeeding promotion and normalization positively impact breastfeeding outcomes.
- Routine discussion of breastfeeding at prenatal visits is recommended.
- Identification and management of risk factors for breastfeeding challenges are essential.
- Culturally sensitive and patient-centered counseling, including family involvement, is advised.
- Multidisciplinary and multimodal approaches to prenatal breastfeeding support are effective.
Conclusions:
- Prenatal breastfeeding support is a vital component of comprehensive breastfeeding care.
- Clinicians should provide structured, evidence-based guidance during prenatal visits.
- Tailored and accessible education is key to successful breastfeeding outcomes.
- Ongoing education for healthcare providers is necessary for effective implementation.
Abstract:
Background: The Academy of Breastfeeding Medicine revised the 2015 version of this clinical protocol to review the evidence and provide recommendations related to breastfeeding promotion in the prenatal period. Key Information: Promoting and normalizing breastfeeding in the prenatal period can improve breastfeeding outcomes including initiation and duration of breastfeeding. Ideally, prenatal interventions should be a part of a comprehensive longitudinal breastfeeding support program. Recommendations: Clinicians or other health workers should discuss breastfeeding at each prenatal visit. Counseling topics should include the health benefits of breastfeeding versus not breastfeeding, the basics of breastfeeding (e.g., physiology, positioning), what to expect of hospital-based and immediate postpartum breastfeeding support (i.e., Baby-Friendly Ten Steps), and the risks of unnecessary supplementation. Medical, anatomical, and other risk factors for breastfeeding challenges should be identified, and targeted anticipatory guidance should be given. Prenatal counseling should include distribution of structured breastfeeding education at low literacy levels and in the parent's preferred language. Counseling should be culturally sensitive and patient-centered, including family members when appropriate. Prenatal support may integrate various health workers (e.g., medical doctors, midwives, community health workers, lactation consultants, among others) and include various modalities including telecommunication. Enhancing breastfeeding education for prenatal care providers is also imperative. Additional themes related to implementation of recommendations for specific populations are also reviewed.
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