Breastfeeding provides numerous health benefits for mother and baby, but the mechanics of getting started can prove challenging for both parties. What’s more, continuing through the recommended 12 months or more, with exclusive breastfeeding for the first six months, can be tricky for busy moms.
Promising news arrived in this year’s Breastfeeding Report Card, issued by the U.S. Centers for Disease Control and Prevention (CDC), which documents statistics about breastfeeding practices and supports in states. Susan Crowe, MD, director of outpatient breast feeding medicine services at Lucile Packard Children’s Hospital and an obstetrician and gynecologist at Stanford, is one of the educators helping more hospitals, workplaces and new parents latch on to breastfeeding-friendly practices. She answers questions on the subject below.
The latest CDC Breastfeeding Report Card showed improvement over the last 10 years in the number of women who breastfed their babies at least some of time during the first year of life. What medical or cultural factors do you think have most significantly influenced change in this direction?
There are multiple factors that have likely influenced this increase. The majority of women choose to breastfeed their babies, and the quality of maternity care they receive during the hospital stay has a direct impact on breastfeeding success. The Maternity Practices in Infant Nutrition and Care (mPINC) survey, which has been sent out every two years by the CDC since 2007, shows that our country is improving hospital care practices and helping to support women to establish breastfeeding. For example, more babies and mothers are spending time together after delivery. And when babies and moms share a hospital room, often referred to as “rooming-in,” moms find it easier to learn when their babies are ready to eat by watching for infant feeding cues. In addition, the mPINC survey has shown that 54.4 percent of infants in 2011 received skin-to-skin contact after a vaginal birth, up from 40.8 percent in 2007. Both of these practices increase breastfeeding success and lead to higher rates of breastfeeding.
The CDC report notes that skin-to-skin practice – placing a newborn directly on the mother’s skin after birth – is becoming more common in hospitals. How do you educate hospital staff and new parents to encourage this practice? What barriers still exist?
In the ideal setting, infants are placed skin-to-skin (STS) on the mom’s chest immediately after delivery. The infant can be dried there, and then the infant will go through natural developmental stages that will lead to a baby suckling at the breast. This process often takes longer than 30 minutes, but most babies will latch on to the breast with minimal assistance if allowed to be together skin-to-skin with their mother. Although this process sounds simple, there are many barriers that exist – some are preventable, but others are not. At delivery, some babies require immediate attention from a pediatric team in order to have a smooth and safe transition to breathing after birth. An infant may require oxygen supplementation at delivery, which is difficult to provide without temporary separation from the mom. A mom may experience a medical emergency that prevents her from being able to hold her baby immediately. During a C-section, a baby can be placed STS at delivery, but an additional hospital staff member must be present to ensure that the baby is properly cared for and observed during the time after delivery. That being said, most situations allow for STS time to take place very soon (if not immediately) after birth. At LPCH, we are educating moms during their pregnancies about the importance of STS, and a multidisciplinary task force has been formed to educate staff and remove barriers to STS both at vaginal and C-section deliveries.
What are some of the medical benefits of skin-to-skin contact? What, if any, are the risks?
The medical benefits of STS at delivery extend beyond breastfeeding. Babies who are STS more easily maintain normal body temperatures, blood sugars and heart rates. They also cry less and have a better chance of successfully breastfeeding. There are no known risks to STS when mother and infant do not require other medical treatment.
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