Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

USPSTF Recommendations to Support Breastfeeding

JAMA; 2016 Oct 25; Bibbins-Domingo, et al

The US Preventive Services Task Force (USPSTF) has issued a statement that recommends providing interventions in the primary care setting during pregnancy and after birth to support breastfeeding. This recommendation updates the 2008 USPSTF recommendation on primary care interventions to promote and support breastfeeding. USPSTF findings and conclusions included:

• Interventions to support breastfeeding can increase the rate and duration of breastfeeding.

• Interventions to support breastfeeding, including professional and peer support, and formal education, change behavior and that the harms of these interventions are no greater than small.

• Interventions to support breastfeeding have an overall moderate net benefit.

Citation: Bibbins-Domingo, K, US Preventive Services Task Force. Primary care interventions to support breastfeeding. US Preventive Services Task Force recommendation statement. JAMA. 2016;316(16):1688-1693. doi:10.1001/jama.2016.14697.

Commentary: Breastfeeding has been shown to provide important health benefits both for children and mothers who breastfeed. The benefits of breastfeeding for children include decreased rates of acute otitis media, asthma, atopic dermatitis, gastrointestinal tract infection, and decreased subsequent development of many chronic conditions including obesity, diabetes, and high blood pressure. The health benefits to mothers include a reduced risk of maternal breast and ovarian cancer as well as a reduced risk of type 2 diabetes. Currently in the US, about 80% of mothers begin to breastfeed, but many do not continue breastfeeding. Rates of exclusive breastfeeding through 3 and 6 months are 43% and 22%.1 As reviewed in the USPSTF document, this is an area that has been studied a great deal and over 43 trials found that breastfeeding support and education interventions are associated with a higher likelihood of continuing breastfeeding for up to 6 months. This support increases persistence of breastfeeding by approximately 20%. As in many areas, our support for patients to do the correct things makes a difference in their lives that is often greater than we realize. —Neil Skolnik, MD

1. Centers for Disease Control and Prevention. CDC National Immunization Survey: Breastfeeding among US children born 2002–2012. http://www .cdc.gov/breastfeeding/data/nis_data/index.htm. Accessed November 4, 2016.