1. Opportunities to Promote Breastfeeding Preconception Education in school systems Pediatric and adolescent visits Gynecologic visits Breast examinations Copyright © 2003, Rev 2005 American Academy of Pediatrics

2. Opportunities to Promote Breastfeeding Early pregnancy Perform breast examination. Discuss normal anatomy and physiology. Assess previous surgeries, scars, biopsies. Talk about previous breastfeeding experiences. Provide positive support for benefits of breastfeeding. Copyright © 2003, Rev 2005 American Academy of Pediatrics

3. Opportunities to Promote Breastfeeding Prenatal visits Provide appropriate literature, resources. Refer for prenatal and breastfeeding classes. Refer to pediatrician for prenatal visit. Avoid formula coupons or products. Copyright © 2003, Rev 2005 American Academy of Pediatrics

4. Opportunities to Promote Breastfeeding Peripartum/postpartum Provide supportive delivery environment. Facilitate early skin-to-skin contact. Dry, warm, and place on mothers abdomen. Have trained professionals to assist mother if needed. Initiate breastfeeding within the first hour after delivery. Copyright © 2003, Rev 2005 American Academy of Pediatrics

5. Baby Friendly Hospital Initiative 10 Steps 1.Have a written breastfeeding policy that is routinely communicated to all health care staff. 2.Train all health care staff in skills necessary to implement this policy. 3.Inform all pregnant women about the benefits and management of breastfeeding. 4.Help mothers initiate breastfeeding within 1 hour of birth. 5.Show mothers how to breastfeed and maintain lactation, even if separated from infants. Hospital Policies to Support Breastfeeding Copyright © 2003, Rev 2005 American Academy of Pediatrics

6. 6.Give newborn infants nothing other than breastmilk, unless medically indicated. 7.Practice rooming-in 24 hours a day. 8.Encourage breastfeeding on demand. 9.Give no artificial nipples or pacifiers. 10.Foster the establishment of breastfeeding support groups. Hospital Policies to Support Breastfeeding Baby Friendly Hospital Initiative 10 Steps Copyright © 2003, Rev 2005 American Academy of Pediatrics

7. Community Support Knowledgeable physicians Lactation specialists Hospital support groups WIC programs La Leche League International Copyright © 2003, Rev 2005 American Academy of Pediatrics

8. The Breastfeeding Friendly Doctors Office Encourage women/staff to breastfeed in the office. Display pictures of breastfeeding infants. Avoid distributing infant formula or coupons. Copyright © 2003, Rev 2005 American Academy of Pediatrics

9. How Long to Breastfeed? Exclusively for about the first 6 months of life Continuing for at least the first year of life, with addition of solids Thereafter, for as long as mutually desired by mother and child Copyright © 2003, Rev 2005 American Academy of Pediatrics Photo © Mary Boyd, MD, FAAP

10. Summary Breastfeeding is preferred feeding for almost all infants. Mothers should be informed of the benefits of breastfeeding. Supplementation is rarely indicated and interferes with successful lactation. Breastfeeding should be actively supported and promoted in the medical community and society. Women should feel comfortable continuing to breastfeed for as long as desired. Copyright © 2003, Rev 2005 American Academy of Pediatrics