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The Academy of Breastfeeding Medicine Protocol Committee

BACKGROUND

Galactogogues (or lactogogues) are medications or other substances believed to assist initiation, maintenance, or augmentation of the rate of maternal milk synthesis. Because perceived or actual low milk supply is one of the most common reasons given for discontinuing breastfeeding, both mothers and health professionals have sought medication(s) to address this concern. Evaluation of evidence-based studies and emerging information regarding more serious potential side effects of some galactogogues have resulted in a recent shift in the Academy of Breastfeeding Medicine’s recommendations regarding these drugs and herbs. In 2004, the previous version of this protocol used existing evidence that prescription galactogogues were effective and described when and how to use them. Emerging data suggest that we should exercise more caution in recommending these drugs to induce or increase the rate of milk secretion in lactating women, particularly in women without specific risk factors for insufficient milk supply.

Original Protocol March 2004; Revision #1 March 2010

The Academy of Breastfeeding Medicine Protocol Committee

Background

Breastfeeding mothers may encounter unforeseen reasons for separation from their infants, but more often women need to express and store milk for planned events, lifestyle flexibility, and returning to work. Knowledge of appropriate human milk handling and storage is essential for breastfeeding success.

The Academy of Breastfeeding Medicine Protocol Committee
BREASTFEEDING MEDICINE Volume 5, Number 6, 2010

Background

Newborns and young infants routinely experience pain associated with commonly used invasive procedures such as blood sampling and intramuscular injections (e.g., vaccinations, vitamin K) and, in some countries, circumcision (the removal of some or all of the foreskin [prepuce] from the penis). Reduction of pain is both a professional imperative and an ethical expectation because untreated pain has detrimental consequences such as greater pain sensitivity in later childhood and may lead to permanent neuroanatomical and behavioral abnormalities as demonstrated in animal models. Moreover, pain is a source of concern and distress for new parents and may disturb mother–infant bonding.

The Academy of Breastfeeding Medicine Protocol Committee

The purpose of this protocol is to promote a philosophy and practice of maternal–infant care that advocates breastfeeding. Care should support the normal physiologic functions involved in the establishment of this maternal–infant process and assist families choosing to breastfeed with initiating and developing a successful and satisfying experience.

This policy is based on recommendations from the most recent breastfeeding policy statements published by the Office on Women’s Health of the U.S. Department of Health and Human Services, the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, the American Academy of Family Physicians, the World Health Organization, the Academy of Breastfeeding Medicine, and the UNICEF/World Health Organization evidence-based Ten Steps to Successful Breastfeeding.

The Academy of Breastfeeding Medicine Protocol Committee
BREASTFEEDING MEDICINE Volume 5, Number 2, 2010

Purpose

1. To provide guidance in distinguishing those causes of jaundice in the newborn that are directly related to breastfeeding from those that are not directly related to breastfeeding.

The Academy of Breastfeeding Medicine Protocol Committee
BREASTFEEDING MEDICINE Volume 4, Number 4, 2009

Goal

The choice of breastfeeding by the pregnant or newly postpartum woman with a history of past or current drug abuse is challenging for many reasons. The purpose of this protocol is to provide evidence-based guidelines for the evaluation and management of the drug-dependent woman choosing to breastfeed.

The Academy of Breastfeeding Medicine

BACKGROUND

Given early opportunities to breastfeed, breastfeeding assistance, and instruction, the vast majority of mothers and babies will successfully establish breastfeeding. Although some infants may not successfully latch and feed during the first day (24 hours) of life, they will successfully establish breastfeeding with time, appropriate evaluation, and minimal intervention.

The Academy of Breastfeeding Medicine Protocol Committee
BREASTFEEDING MEDICINE Volume 4, Number 2, 2009

Background

Engorgement has been defined as “the swelling and distension of the breasts, usually in the early days of initiation of lactation, caused by vascular dilation as well as the arrival of the early milk.” The concept put forward by Newton and Newton in 1951 suggested that alveolar distension from milk then led to compression of surrounding ducts, which subsequently led to secondary vascular and lymphatic compression. Some degree of breast fullness in the second stage of lactogenesis is considered normal and reassuring to the mother and healthcare provider.

The Academy of Breastfeeding Medicine Protocol Committee
BREASTFEEDING MEDICINE Volume 4, Number 1, 2009

Background
BREASTFEEDING PROVIDES ideal infant nutrition and is the physiologic norm for mothers and children. Mothers often make a decision regarding breastfeeding early in prenatal care, and many have already decided whether to breastfeed prior to conception.

The Academy of Breastfeeding Medicine Board of Directors
BREASTFEEDING MEDICINE Volume 3, Number 4, 2008

THE SCIENCE OF BREASTFEEDING and human lactation requires that physicians of many specialties have a collaborative forum to promote progress in physician education and research. In order to optimize breastfeeding practices universally, physicians must learn evidence-based breastfeeding medicine, skills, and attitudes. There have been relatively few physicians committed to these goals, therefore requiring an establishment of a dedicated organization to meet the unique educational needs of physicians.

Cynthia R. Howard MD, MPH, FABM; Rosha Champion McCoy MD
Academy of Breastfeeding Medicine Protocol Committee, November 16, 2002

BACKGROUND

Hospital policies and routines greatly influence breastfeeding success. The Baby Friendly Hospital Initiative has defined the Ten Steps to Successful Breastfeeding, and recent research has again verified that “This Baby-Friendly designation has proven to be an effective strategy to increase breastfeeding initiation rates in US hospital settings.”

The Academy of Breastfeeding Medicine

Breastfeeding Medicine Volume 3, Number 3, 2008

INTRODUCTION

Mastitis is a common condition in lactating women; estimates from prospective studies range from 3% to 20% depending on the definition and length of postpartum followup.

The Academy of Breastfeeding Medicine Protocol Committee

Breastfeeding Medicine, Volume 3, Number 1, 2008

Background

With estimates of between 5% and 25% of women experiencing depression in the postpartum year, it is critical that healthcare providers consider all treatment options, including the risks and benefits for nursing mothers.

Rosha Champion McCoy MD
Consultant: James McKenna J. PhD
The Academy of Breastfeeding Medicine Protocol Committee
Breastfeeding Medicine, Volume 3, Number 1, 2008

BACKGROUND

The terms co-sleeping and bed sharing are often used interchangeably. However, bed sharing is only one form of co-sleeping. Co-sleeping, in reality, refers to the diverse ways in which infants sleep in close social and/or physical contact with a caregiver (usually the mother).