Back to Search Results

Evidence-Based Updates on the First Week of Exclusive Breastfeeding Among Infants ≥35 Weeks.

Department of Pediatrics, Cooper Medical School, Rowan University and Children's Regional Hospital at Cooper, Cooper University Health Care, Camden, New Jersey; winter-lori@CooperHealth.edu. Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville, Virginia. Division of Neonatology, Departments of Pediatrics and. American University of the Caribbean School of Medicine, Sint Maarten, Netherlands Antilles. Department of Family Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island. Division of Neonatology, Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina. Division of Neonatology, Department of Pediatrics, University of North Carolina Hospitals, Chapel Hill, North Carolina. Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York. Department of Food and Nutrition, University of North Carolina Health Care, Chapel Hill, North Carolina; and. Department of Clinical Sciences, College of Medicine, Florida State University, Tallahassee, Florida. Obstetrics and Gynecology, School of Medicine and. Department of Maternal and Child Health and Carolina Global Breastfeeding Institute, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Pediatrics. 2020;(4)
Full text from:

Other resources

Abstract

The nutritional and immunologic properties of human milk, along with clear evidence of dose-dependent optimal health outcomes for both mothers and infants, provide a compelling rationale to support exclusive breastfeeding. US women increasingly intend to breastfeed exclusively for 6 months. Because establishing lactation can be challenging, exclusivity is often compromised in hopes of preventing feeding-related neonatal complications, potentially affecting the continuation and duration of breastfeeding. Risk factors for impaired lactogenesis are identifiable and common. Clinicians must be able to recognize normative patterns of exclusive breastfeeding in the first week while proactively identifying potential challenges. In this review, we provide new evidence from the past 10 years on the following topics relevant to exclusive breastfeeding: milk production and transfer, neonatal weight and output assessment, management of glucose and bilirubin, immune development and the microbiome, supplementation, and health system factors. We focus on the early days of exclusive breastfeeding in healthy newborns ≥35 weeks' gestation managed in the routine postpartum unit. With this evidence-based clinical review, we provide detailed guidance in identifying medical indications for early supplementation and can inform best practices for both birthing facilities and providers.