PHCNEWS

22A September/October 2001

Reprint requests: NAPNAP National Office, 1101 Kings Highway North, Suite 206, Cherry Hill, NJ 08034.

J Pediatr Health Care. (2001). 15, 22A.

Copyright © 2001 by the National Association of Pediatric Nurse Practitioners.

0891-5245/2001/$35.00 + 0 25/8/117957

doi:10.1067/mph.2001.117957

BreastfeedingOne goal of the National Association ofPediatric Nurse Practitioners (NAPNAP)is to enhance the quality of healthcare for all children. To support thisgoal, NAPNAP encourages nutritionalpractices that contribute to optimumchild health, growth, and development.NAPNAP identifies breastfeeding as thenatural and preferred method of infantfeeding and human milk as superior toall substitute feeding options. Breast-feeding provides complete infant nutri-tion and immunologic protection, facil-itates maternal-infant attachment, andreduces health care costs (Montgomery& Splett, 1997). Additional advantagesfor infants, families, and society includepositive developmental and psychoso-cial benefits, maternal health advanta-ges, and environmental protection. Be-nefits of breastfeeding are maximizedwith exclusive breastfeeding for about6 months and continued breastfeedingthrough the first 12 months and beyond(American Academy of Pediatrics, 1997;American College of Obstetricians andGynecologists, 2000; American DieteticAssociation, 1997; Department of Healthand Human Services, 2000; United StatesBreastfeeding Committee, 2000).

Breastfeeding promotion and supportare an integral component of pediatrichealth care. Pediatric nurse practitioners(PNPs) should advocate breastfeedingby providing families with accurate andcurrent information on the benefits ofbreastfeeding and eliminating barriersto breastfeeding. PNPs should have asignificant impact on breastfeedingpractices by supporting breastfeedingefforts of patients and implementingstrategies for increasing breastfeedingrates and duration, including anticipa-tory guidance and clinical assistance.

PNP educational programs shouldprepare PNPs for primary, secondary,and tertiary care management of thebreastfeeding dyad, providing a solidknowledge base and skill level to effec-tively manage the care of breastfeed-ing infants. NAPNAP recommends thatall PNP educational programs pro-vide comprehensive, culturally appro-priate, and research-based education

and clinical experiences in lactation andbreastfeeding. NAPNAP encouragescontinuing education in this area.

NAPNAP recognizes that there maybe individual circumstances in whichbreastfeeding is contraindicated. PNPsshould use appropriate breastfeeding-focused resources to advise women re-garding issues related to breastfeeding,maternal health, and medications.

NAPNAP encourages its member-ship to:1. provide leadership in facilitating an

informed choice on infant feedingpractices by families through pa-tient education programs promot-ing breastfeeding.

2. actively promote and support breastfeeding within their individual prac-tice settings and the community atlarge.

3. participate in the design and imple-mentation of local and national poli-cies that promote and support breast-feeding and remove barriers to breast-feeding, including in the workplace.

4. work with birthing facilities to en-sure that evidenced-based guidelinesand practices (ie, The Baby FriendlyHospital Initiative) conducive to lac-tation are implemented (Randolphet al., 1994).

5. support the goals of Healthy People2010 to increase breastfeeding ratesto 75% at birth, 50% continuationuntil 6 months of age, and 25% con-tinuation at 12 months and beyond(Healthy People 2010, 1999).

6. serve as an educational resource forother health care professionals re-garding the benefits of breastfeeding,thus correcting personal biases andknowledge deficits that may hinderbreastfeeding promotion.

In summary, NAPNAP acknowl-edges the importance of breastfeed-

ing to infants, mothers, families, andsociety. Further, NAPNAP encouragesPNPs to promote, protect, and sup-port breastfeeding as normal, expect-ed, and achievable.

REFERENCESAmerican Academy of Pediatrics. (1997). Breast-

feeding and the use of human milk. Pediatrics,100, 1035-1039.

American College of Obstetricians and Gynecolo-gists. (2000). Breastfeeding: Maternal and infantaspects. ACOG Educational Bulletin, 258, 3-15.

American Dietetic Association. (1997). Promotionof breast-feeding. Journal of the American Dietet-ic Association, 97, 662-6.

Department of Health and Human Services. (2000).HHS Blueprint for action on breastfeeding[On-line]. Available: http://www.4woman.gov/Breastfeeding/bluprntbk2.pdf

Healthy People 2010. (1999). Breastfeeding, new-born screening, and service systems [On-line].Available: http://www.health.gov/healthypeople/Document/HTML/Volume2/16MICH.htm#_TOC494699668

International Lactation Consultant Association.(1999). Evidence-based guidelines for breastfeedingmanagement during the first fourteen days.Raleigh, NC: Author.

Montgomery, D. L., & Splett, P. L. (1997). Econom-ic benefit of breast-feeding infants enrolled inWlC. Journal of American Dietetic Association, 97,379-385.

Morrison, P. (1999). HIV and infant feeding: Tobreastfeed or not to breastfeed: The dilemmaof competing risks. Breastfeeding Review, 7(3),11-20.

Randolph, L., Cooper, L., Fonseca-Becker, F., York,M., & McIntosh, M. (1994). Baby Friendly Hospi-tal Initiative feasibility study: Final report.Healthy Mothers, Healthy Babies NationalCoalition Expert Working Group (internal doc-ument). Washington, DC: U.S. Department ofHealth and Human Services.

United States Breastfeeding Committee. (2000,August). Statement on exclusive breastfeeding.Presented at the bi-annual meeting of the Unit-ed States Breastfeeding Committee, Washing-ton, DC.

Approved: April 1993Revised and approved by Executive Board:

March 2001Designation–Regular

Position Statement