by Eric Fein, MD
New York Times columnist Nicholas Kristof said it best: “Can you name a miracle food that is universally available, free, and can save children’s lives and maybe even make them smarter?” (Kristof, 2013) Helping all babies around the world to obtain this miracle food, breastmilk, could save the lives of 800,000 children per year and prevent 20,000 deaths per year from breast cancer. Relative to formula feeding and controlling for confounders, breastfeeding infants is associated with slightly increased intelligence, and decreased morbidity and mortality from SIDS, diarrheal illnesses, pneumonia, otitis media, bronchiolitis, and possibly obesity and type 2 diabetes. Breastfeeding mothers have a reduced risk of breast and ovarian cancer, and type 2 diabetes (Cesar G Victora, 2016).
Unfortunately, the moms and babies we treat at Harbor-UCLA, who have higher rates of these diseases, have lower breastfeeding rates. In LA County in 2010, the LA Mommy and Baby Project reports that at 3 months of age 74% of white infants were breastfeeding, compared to 56% of Hispanics and 44% of African Americans. Common reasons cited for not breastfeeding include: perception of inadequate supply, pain, and the need to return to work, complaints we hear commonly as pediatricians both in the nursery or NICU and in clinic (French JI, 2012).
Fortunately, Harbor-UCLA has been designated as Baby-Friendly®, which means that we follow the “The Ten Steps to Successful Breastfeeding.” A recent systematic review of the efficacy of the Baby-Friendly Hospital Initiative, citing data from rich and poor countries around the world, reports a dose-response relationship between the number of steps women are exposed to and the likelihood of positive breastfeeding outcomes (Pérez-Escamilla R, 2016).
Here are some other steps you can take to help you and your patients:
• Educate yourself and others on breastfeeding medicine (https://www2.aap.org/breastfeeding/curriculum/)
• Familiarize yourself with the Academy of Breastfeeding Medicine’s clinical protocols (http://www.bfmed.org/Resources/Protocols.aspx)
• Refer your breastfeeding patients to their local WIC office (http://www.phfewic.org/ links to Torrance WIC offices and the breastfeeding telephone helpline)
• Advocate for improved paid parental leave. (Evidence of health benefits can be found here: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4934583/. Improved paid parental leave improves breastfeeding rates and infant mortality as a whole.) See this link for specific policies to advocate for: http://breastfeedla.org/legislationpolicy/