Excerpted from the Policy
Statement on Breastfeeding from the American Academy of Pediatrics.
1. Human milk
is the preferred feeding for all infants, including premature
and sick newborns, with rare exceptions. The ultimate decision
on feeding of the infant is the mother's. When direct breastfeeding
is not possible, expressed human milk, fortified when necessary
for the premature infant, should be provided.
2. Breastfeeding
should begin as soon as possible after birth, usually
within the first hour.
3. Newborns should
be nursed whenever they show signs of hunger, such as
increased alertness or activity, mouthing, or rooting. Crying
is a late indicator of hunger.
4. No supplements (water,
glucose water, formula, and so forth) should be given to breastfeeding
newborns unless a medical indication exists. With sound breastfeeding
knowledge and practices, supplements rarely are needed. Supplements
and pacifiers should be avoided whenever possible and, if used
at all, only after breastfeeding is well established.
5. When discharged
before forty-eight hours after delivery, all breastfeeding
mothers and their newborns should be seen by a pediatrician or
other knowledgeable healthcare practitioner when the newborn
is two to four days of age. In addition to determination of
infant weight and general health assessment, breastfeeding
should be observed and evaluated for evidence of successful
breastfeeding behavior.
6. Exclusive breastfeeding
is ideal nutrition and sufficient to support optimal growth
and development for approximately the first six months
after birth. Gradual introduction of iron-enriched solid foods
in the second half of the first year should complement the
breast-milk diet. It is recommended that breastfeeding continue
for at least twelve months and thereafter for as long as mutually
desired.
7. In the first six
months, water, juice, and other foods are generally unnecessary for
breastfed infants.
8. Should hospitalization
of the breastfeeding mother or infant be necessary, every
effort should be made to maintain breastfeeding, preferably
directly, or by pumping the breasts and feeding expressed breast
milk, if necessary.
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