Interventions Intended to Support Breastfeeding: Updated Assessment of Benefits and Harms

Valerie Flaherman, MD, MPH1; Isabelle Von Kohorn, MD, PhD

“Counseling mothers to avoid giving infants any food or drink other than breast milk during the newborn period is step 6 of the BFHI and one of the primary care interventions most commonly used to support breastfeeding. Three randomized trials have specifically examined the effectiveness of counseling to avoid giving newborns any food or drink other than breast milk; none showed a beneficial effect of such counseling on breastfeeding duration. Studies examining counseling to avoid giving newborns any food or drink other than breast milk were not included in the evidence review. The authors did include several studies examining the effectiveness of multiple-component interventions that incorporated such counseling. These studies also did not show a beneficial effect on breastfeeding outcomes.”

“Lack of proven efficacy for exclusive breastfeeding during the newborn period to improve breastfeeding duration is important, because exclusivity during the newborn period may not be free of potential harm. For example, the onset of copious breast milk production varies. For women who have scant colostrum and no copious milk production for 4 to 7 days, exclusive breastfeeding in the first few days after birth is associated with increased risk of hyperbilirubinemia, dehydration, and readmission. Although these conditions are generally mild and often resolve rapidly, their frequency is high; 1% to 2% of all US newborns require readmission in the first week after birth, and the risk is approximately doubled for those exclusively breastfed. If counseling to avoid food and drink other than breast milk is not an effective method to support breastfeeding, the frequent low morbidity and rare high morbidity outcomes could potentially be avoided without reducing breastfeeding duration.”

Read more at Journal of the American Medical Association.

Read the Fed is Best summary of this article: Recent Article Discusses WHO Recommendation to Avoid Supplementation in Newborns Involves Risks and Does Not Improve Breastfeeding Rates