AAP Updates Policy Statement on Breastfeeding and the Use of Human Milk

June 4, 2022

The American Academy of Pediatrics (AAP) has FINALLY updated its policy statement on Breastfeeding and the Use of Human Milk to align with the World Health Organization (WHO).

This is the academy’s first update on the policy in the past decade and though we’re seeing a lot of reaction and misinformation on social media and news coverage regarding the policy change and timing of the announcement, it’s important to be aware of the facts.

We must be careful not to take the AAP’s position out of context. For example, “The American Academy of Pediatrics (AAP) recommends exclusive breastfeeding for approximately 6 months after birth. Furthermore, the AAP supports continued breastfeeding, along with appropriate complementary foods introduced at about 6 months, as long as mutually desired by mother and child for 2 years or beyond.”

“Mutually desired by mother and child” is key here. Not every family can or wants to feed human milk to their child, and those families deserve the same compassion and quality of care as chest/breastfeeding families. 

Having the country’s leading pediatrics association explicitly support breastfeeding for “2 years or beyond” is critical in fighting against the misconception that feeding human milk after 6 months is unnecessary or indulgent. This also strengthens the argument for federal law to expand its workplace protections for lactating employees beyond its current 12-month limit.

We encourage you to read the full policy statement and technical report yourself, so you can accurately advise those with whom you work AND to help correct the misinformation being spread online and in both professional and casual conversations. The technical report goes into deeper detail on infant and maternal outcomes compared to the policy statement. 

Aside from alignment with the World Health Organization, what AAP’s updated policy acknowledges the critical role pediatricians play in supporting lactation and the acknowledgement of equity issues and lack of social support that contribute to the gap between families’ chest/breastfeeding intentions and outcomes.

The California Breastfeeding Coalition agrees “pediatricians are ideally positioned to serve as breastfeeding educators and [should] not solely delegate this role to staff or nonmedical or lay volunteers. Pediatricians’ direct communication with families that breastfeeding is a medical and health priority can increase initiation, duration, and exclusivity.”

As a human milk feeding and lactation organization that applies a racial equity lens and reproductive justice framework to our work, we believe the inclusion of recommendations regarding adoption, surrogacy and gender-diverse families is important in the policy update. 

Additionally, we’re pleased to see the AAP’s key recommendations include:

  • implementing maternity care practices aligned with the WHO Ten Steps to Successful Breastfeeding;
  • fully supporting parental feeding decisions without pressure or guilt by any member of the health care team
  • a focus on skin-to-skin contact, frequent feeding and readily available skilled lactation support;
  • avoiding unnecessary disruption to chest/breastfeeding;
  • implementing lactation supportive policies and practices in office and partnership with community resources to improve chest/breastfeeding support;
  • advocating for socially/culturally sensitive policies that support lactating families and address inequities to eliminate disparities in chest/breastfeeding;
  • assisting parents who have given birth to preterm or other vulnerable infants to establish a full milk supply by working with hospital staff to facilitate early, frequent milk expression;
  • explicitly recommending pasteurized donor human milk for very low birth weight infants when their parent’s milk is not available or requires supplementation;
  • supporting lactation-supportive policies, such as universal paid maternity leave, lactation rights, insurance coverage for lactation support and breast pumps, on-site child care; universal workplace break time with a clean, private location for expressing milk, the right to feed expressed milk, and the right to breastfeed in child care centers and lactation rooms in school; and
  • tracking national breastfeeding rates through the age of 2 years.

By providing such clear guidance in its policy statement and technical report, the AAP has provided a roadmap that any health care provider can use in supporting the families they serve in achieving the feeding experience they envision. In light of this statement and its recommendations, there is no excuse for a health care provider not to be knowledgeable of the benefits of lactation to both parent and child and skilled in supporting family feeding decisions.