Thursday, March 19, 2009

Strong Evidence Base for Benefits of Breastfeeding

New Rochelle, NY, March 19, 2009—Breastfeeding offers irrefutable and long-lasting health benefits for both mother and baby, which are supported by a comprehensive body of scientific research, including original articles and reviews such as those in Breastfeeding Medicine, the peer-reviewed journal of the Academy of Breastfeeding Medicine. The Academy is a global organization of physicians dedicated to the promotion, protection, and support of breastfeeding through education, research, and advocacy ( www.bfmed.org).

According to leaders of the Academy, despite a sound scientific basis for the advantages of breastfeeding, dissenting opinions that aim to discredit breastfeeding, and question its relevance for women, receive exposure in the mass media such as the recent article in The Atlantic. Critics of breastfeeding do a disservice to new mothers around the world who seek the facts about the proven health benefits of breastfeeding as they often misrepresent the scientific findings and wrongly base global recommendations on the experiences and views of select groups of women.

Clinical and basic science research supports the role of breastfeeding in the development of a baby’s immune system and the presence of maternal antibodies protect infants against infection. Artificial feeding is also associated with increased risk of common disorders of early childhood such as ear infections, asthma, skin disorders, digestive problems, and respiratory tract infections. Studies have also linked artificial feeding to increased risk for obesity, type 1 and 2 diabetes, childhood leukemia, sudden infant death syndrome (SIDS), and necrotizing enterocolitis. Mothers benefit as well, and a history of breastfeeding has been associated with a reduced risk of type 2 diabetes and of breast and ovarian cancer.

With this growing body of evidence, and increasing support among health and medical professionals, breastfeeding rates in the U.S. are in fact on the rise. “But we are reminded as articles like this arise that misinformation abounds. Our goal is to continue to educate healthcare professionals to support mothers who understand the singular importance of breastfeeding and choose to do so,” remarks Caroline J. Chantry, MD, President of the Academy.

“The Academy of Breastfeeding Medicine encourages all women to make an informed choice when faced with the question of how to feed their infants based on strong, well-referenced scientific information. The data are compelling, scientific, and reinforced constantly. Breastfeeding for the new mother may not always be easy, but it is important and rewarding for both mother and infant,” says Ruth A. Lawrence, MD, Editor-in-Chief of Breastfeeding Medicine, from the Department of Pediatrics, University of Rochester School of Medicine and Dentistry.

The Academy promotes the development and dissemination of clinical practice guidelines, and offers clinical protocols for the care of breastfeeding mothers and infants which are available on the Agency for Healthcare Research and Quality’s (AHRQ) National Guideline Clearinghouse website. The education of physicians and other healthcare professionals is the continuing goal of its Annual International Meeting; the 2009 Meeting will be held November 5-8 in Williamsburg, VA.

Breastfeeding Medicine is an authoritative, peer-reviewed, multidisciplinary journal published quarterly. The journal publishes original scientific articles, reviews, and case studies on a broad spectrum of topics in lactation medicine. It presents evidence-based research advances and explores the immediate and long-term outcomes of breastfeeding, including the epidemiologic, physiologic, and psychological benefits of breastfeeding. The Academy's complete position statement appears on the Academy website ( www.bfmed.org).

Wednesday, March 18, 2009

Evidence Increases for Risks in Cesarean Surgery as National Rate Continues to Rise

WASHINGTON (March 18, 2009)— As research continues to mount for the risks of cesarean surgery, the Centers for Disease Control released new, staggering statistics today reporting that 31.8% of women endure birth by cesarean in the United States (2007). This announcement comes after the release of significant findings from the New England Journal of Medicine reinforcing that birth by cesarean surgery before 39 weeks of pregnancy causes increased complications in newborns.

Despite the latest advances in medical technology, health care providers cannot determine a baby’s due date with 100% accuracy. Therefore, cesarean surgeries scheduled before a woman’s estimated due date could result in a baby born as early as 36 weeks to a few days before the baby is actually due. During the last few weeks of pregnancy, a baby’s lungs mature and a protective layer of fat forms, both of which are vital developments for a healthy baby. In addition, babies need time for their lung cells to shift from being fluid producing to fluid absorbing cells. Without time during labor to prepare the baby to breathe, lungs cells may not be ready. Thus, babies born by cesarean surgery, even when they are full-term, need to go to an intensive care unit more frequently than babies who were born vaginally to get help breathing.

Research published in the New England Journal of Medicine (NEJM) supports earlier findings that cesarean surgery performed prior to 39 weeks of pregnancy increases poor outcomes in babies. Of the babies in the NEJM study born before 39 weeks, more than 26% had complications, including the need to be on a ventilator, respiratory distress syndrome, low blood sugar and severe infection (sepsis).

“Overuse of cesarean surgery complicates the otherwise natural process of birth,” says Lamaze Institute Chair Debra Bingham, LCCE, MS, RN, DrPH, “Allowing the natural process to occur not only reduces risks for mothers in this and future pregnancies, but also reduces health risks for her baby.”

Spontaneous labor is almost always the best indication for a baby’s physical readiness for life outside of the womb. As one of the key steps to a healthy birth, Lamaze International recommends that women let labor begin on its own. Allowing labor to begin naturally increases the likelihood that a baby is healthy and ready for birth. When a birth outcome is good, mother and baby can bond and start breastfeeding immediately after birth—both of which provide the best start for a baby’s growth and development.

Lamaze International President Pam Spry, PhD, CNM, FACNM, LCCE says, “Maternity care in the United States is at a crossroads. The most commonly used practices don’t align with the best evidence for a healthy birth.” The Milbank Report’s Evidence-Based Maternity Care: What It Is and What It Can Achieve reveals that several routine maternity care practices, including cesarean surgery, contradict best evidence and are overused in the United States.

Cesarean surgery—a major abdominal surgery—also carries risks for women, such as blood loss, clotting, infection and severe pain, and poses future risks, such as infertility and complications during future pregnancies such as stillbirth and placenta problems like percreta and accreta, which can lead to excessive bleeding, bladder injury, hysterectomy and maternal death. The research is clear, however, that when medically necessary, cesarean surgery can be a lifesaving procedure for both mother and baby, and worth the risks involved.

Two of the most important decisions a woman can make are where she gives birth and who she chooses as her care provider. Lamaze International has developed tools to help women with these decisions, including the questions to ask and other reference material. Visit http://magazine.lamaze.org/ to learn more about the Lamaze during pregnancy, birth and beyond.