Breastfeeding Promotion in the Prenatal Setting

The primary healthcare provider should be involved in each of the following steps, in cooperation with a multidisciplinary team that includes other healthcare professionals and healthcare workers (e.g., including, but not limited to, doctors, nurses, midwives, medical assistants, various lactation specialists/consultants [International Board Certified Lactation Consultants, in particular when their expertise is needed], nutritionists, doulas, health and breastfeeding educators, and peer support). (, )

Educate staff to promote, protect, and support breastfeeding. (, )

Have a written breastfeeding policy to facilitate such support. (III, )

Literature and samples provided by artificial infant formula companies should not be used in healthcare settings, as this advertising has been demonstrated to decrease breastfeeding initiation and shorten duration, and it constitutes a breach of the World Health Organization’s International Code of Marketing of Breast-milk Substitutes. (, )

Intention to breastfeed should be included as part of all transfer-of-care materials, including prenatal records and hospital and birth center discharge summaries.

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Create breastfeeding friendly office spaces, including safe, clean, and comfortable spaces for patients and staff to breastfeed or express milk, as well as posters and artwork supporting breastfeeding. For more details see the Academy of Breastfeeding Medicine’s Protocol #14: ‘‘Breastfeeding Friendly Physician’s Office.’’ (III)

Community-based interventions have shown significant success in improving breastfeeding outcomes. (, )

Partner with local and regional organizations in order to maximize patient services and support (e.g., local, regional, and national maternal– child organizations, local La Leche League International groups, community health workers, health departments, local or regional maternity hospitals or birth centers, not-for-profit organizations, breastfeeding peer counseling programs; supplemental food programs [such as the Special Supplemental Nutrition Program for Women, Infant and Children in the United States], and home visiting programs). (, )

Be aware of local community and professional breastfeeding support services and understand the particular content and services provided. Make available current listings of such support to women throughout their pregnancy. (, )

Consider the use of prenatal home-visiting programs, particularly in underserved areas or populations, while ensuring that providers have been adequately trained. (, )