Breastfeeding Handbook for Physicians was written with the goal of provid-
ing physicians in all specialties with a concise reference and teaching aid
on breastfeeding and human lactation. The hope for this book is that with
enhanced knowledge of breastfeeding, from physiology to clinical practice,
the physician will be in a far better position to comfortably promote and
support breastfeeding and lead the team of collaborating health care providers.
This handbook represents the collaborative eﬀorts of the American Academy
of Pediatrics and the American College of Obstetricians and Gynecologists.
As beﬁts a book written jointly by diﬀerent specialties, it addresses collabora-
tion among physicians and between physicians and other health care profes-
sionals, especially lactation specialists. We recognize and acknowledge that the
physician is at the center of a larger health care team of professionals involved
with the medical care of the infant and mother. As such, the concept of the
medical home for both infant and mother is stressed, and it is therefore also
understandable that all physicians should receive appropriate education in
breastfeeding and human lactation.
Nonetheless, even though this book is designed primarily for physicians,
use by other health professionals is welcomed, including nurses and nurse
practitioners, midwives, dietitians, and lactation specialists. This handbook
serves as a bridge between all health care professionals interested in achieving
coordinated and optimal care for infants and mothers.
This revision also comes at an important time in the United States when
there is an increased national interest in supporting breastfeeding and human
lactation. As reported by the Centers for Disease Control and Prevention
(CDC), US breastfeeding rates are increasing, with 77% initiation and 26%
as the rate for any breastfeeding at 12 months. However, there is still room
for improvement, with the rate of exclusive breastfeeding at 6 months being
16%, only 6% of births occurring at Baby-Friendly facilities, and 25% of
all newborns routinely receiving formula in the ﬁrst 48 hours! The CDC
reports these yearly statistical updates on breastfeeding, cultural diversity
issues, and hospital practice assessments; implements research in the ﬁeld
of human milk and lactation (see Appendix); and now includes exclusive
breastfeeding rates through 1 year, workplace accommodations for lactation,
and births in Baby-Friendly hospitals. The Joint Commission now assesses
exclusive breastfeeding rates in birth hospitals.
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