American entity gives new guidelines on breastfeeding and baby sleep

A new guideline from the American Academy of Pediatrics recommends exclusive breastfeeding for the first six months of a baby’s life. After the first semester, experts recommend continuing breastfeeding and introducing appropriate complementary foods.

The recommendations were published in the July issue of Pediatrics Magazine, where the entity showed evidence of the benefits of exclusive breastfeeding.

“The AAP views breastfeeding as a public health imperative as well as an equity issue,” said Lawrence Noble, co-author of the document “Breastfeeding and the Use of Human Milk.”

The text points out that “the short- and long-term medical and neurodevelopmental advantages of breastfeeding make it a public health imperative.”

According to the organization, there are antimicrobial, anti-inflammatory, immunoregulatory and live leukocyte agents that contribute to the development of the child’s immune system. The guidelines point out that exclusive breastfeeding in the first semester decreases rates of lower respiratory tract infection, severe diarrhea, otitis media and obesity.

The benefits also extend to the mother. “Studies and meta-analyses have also confirmed the impact of breastfeeding for more than 12 months on maternal health in reducing maternal rates of type 2 diabetes mellitus, hypertension, breast cancer, and ovarian cancer.”

According to Rosângela Gomes dos Santos, pediatrician and president of the Department of Breastfeeding of the Pediatric Society of São Paulo, “this appreciation of human milk is very important because it is in line with the recommendations of the WHO [Organização Mundial da Saúde]”.

The doctor points out that, in addition to the health benefits of mother and child, the practice of breastfeeding benefits the environment. “It takes 4,000 liters of water to produce one kilo of formula. [usada como substituta do leite materno]”, he says.

Another point highlighted is how the racial issue impacts breastfeeding. The document states that the lack of adequate breastfeeding has a disproportionate impact on the non-Hispanic black population in the US. According to the expert, the same happens in Brazil.

“By the graphs, it is possible to see that the poorest societies and black women breastfeed less and this is already a social inequality”, says Santos.

According to the latest ENANI (National Study of Child Food and Nutrition), carried out by the UFRJ (Federal University of Rio de Janeiro) in conjunction with the Oswaldo Cruz Foundation, the UERJ (Rio de Janeiro State University) and the UFF ( Universidade Federal Fluminense), in only 62.4% of cases the baby is started breastfeeding right after birth.

Both the entity and Santos reinforce the importance of ensuring the protection of breastfeeding. “Women who are in informal work and are not covered by maternity leave or another law that ensures breastfeeding have to give up their babies very early,” says the pediatrician.

adoption and breastfeeding

The academy recommends using the term “breastfeeding” as it can be more accurate and inclusive when it comes to lactation and physiology in gender-diverse families, such as those where trans men are responsible for breastfeeding.

Adoptive families can resort to milk banks to carry out the Adoptive Lactation process, which makes it possible to start producing their own breast milk.

If they have donors, male homosexual families can also count on the support of banks, which will carry out the process of pasteurizing the milk for the baby so as not to run the risk of cross-breastfeeding.

In Brazil, the difficulty in accessing breast milk by adopters is supplied by the Brazilian Human Milk Network and its more than 300 banks throughout the country.

Sleep and other recommendations

In another document published in June, the American Academy of Pediatrics provides recommendations on sleep in order to avoid sudden infant death syndrome.

The organization says babies up to six months should sleep in their parents’ room, but on a separate flat surface. The organization says bed-sharing is not recommended “under any circumstances”.

It is also recommended that babies be put to sleep on their backs until the child reaches 1 year of age. There is a risk of raising the head of the crib. “Babies cannot be placed on a 30-degree incline without sliding down.” Therefore, the sleeping surface must be “firm, flat and not sloped to avoid suffocation”.

Parents are also advised “to place the baby on their tummy while they are awake and supervised for short periods of time, starting shortly after hospital discharge, gradually increasing to at least 15 to 30 minutes total daily until 7 weeks of age.”

The gym does not recommend swaddling the baby as “as a strategy to calm him down”, as “it may increase the risk of suffocation if the swaddled child rolls over to the prone position”.