Medicamentsen-ligne vous propose les traitements dont vous avez besoin afin de prendre soin de votre santé sexuelle. Avec plus de 6 ans d'expérience et plus de 80.000 clients francophones, nous étions la première clinique fournissant du
acheter cialis original en France à vente en ligne et le premier vendeur en ligne de Cialis dans le monde. Pourquoi prendre des risques si vous pouvez être sûr avec Medicamentsen-ligne - Le service auquel vous pouvez faire confiance.
AMERICAN ACADEMY OF PEDIATRICS
Organizational Principles to Guide and Define the Child Health Care System and/or Improve the Health of All Children
Breastfeeding and the Use of Human Milk
Considerable advances have occurred in
tions are consistent with the goals and objectives of
recent years in the scientific knowledge of the benefits of
Healthy People 2010
,4 the Department of Health and
breastfeeding, the mechanisms underlying these bene-
Human Services’ HHS Blueprint for Action on Breastfeed-
fits, and in the clinical management of breastfeeding.
,5 and the United States Breastfeeding Committee’s
This policy statement on breastfeeding replaces the 1997
Breastfeeding in the United States: A National Agenda
policy statement of the American Academy of Pediatrics
This statement provides the foundation for issues
and reflects this newer knowledge and the supporting
publications. The benefits of breastfeeding for the in-
related to breastfeeding and lactation management
fant, the mother, and the community are summarized,
for other AAP publications including the New Moth-
and recommendations to guide the pediatrician and other
er’s Guide to Breastfeeding
7 and chapters dealing with
health care professionals in assisting mothers in the ini-
breastfeeding in the AAP/American College of Ob-
tiation and maintenance of breastfeeding for healthy
stetricians and Gynecologists Guidelines for Perinatal
term infants and high-risk infants are presented. The
,8 the Pediatric Nutrition Handbook
,9 the Red
policy statement delineates various ways in which pedi-
,10 and the Handbook of Pediatric Environmental
atricians can promote, protect, and support breastfeeding
not only in their individual practices but also in the
hospital, medical school, community, and nation. Pedi-
atrics 2005;115:496–506; breast, breastfeeding, breast milk,
human milk, lactation.
Child Health Benefits
Human milk is species-specific, and all substitute
feeding preparations differ markedly from it, making
ABBREVIATIONS. AAP, American Academy of Pediatrics; WIC,Supplemental Nutrition Program for Women, Infants, and Children;
human milk uniquely superior for infant feeding.12
CMV, cytomegalovirus; G6PD, glucose-6-phosphate dehydrogenase.
Exclusive breastfeeding is the reference or normativemodel against which all alternative feeding methods
must be measured with regard to growth, health,
Extensive research using improved epidemio- development,andallothershort-andlong-termout-
logic methods and modern laboratory tech-
comes. In addition, human milk-fed premature in-
niques documents diverse and compelling ad-
fants receive significant benefits with respect to host
vantages for infants, mothers, families, and society
protection and improved developmental outcomes
from breastfeeding and use of human milk for infant
compared with formula-fed premature infants.13–22
feeding.1 These advantages include health, nutri-
From studies in preterm and term infants, the fol-
tional, immunologic, developmental, psychologic,
lowing outcomes have been documented.
social, economic, and environmental benefits. In1997, the American Academy of Pediatrics (AAP)
published the policy statement Breastfeeding and the
Research in developed and developing countries
Use of Human Milk
.2 Since then, significant advances
of the world, including middle-class populations in
in science and clinical medicine have occurred. This
developed countries, provides strong evidence that
revision cites substantial new research on the impor-
human milk feeding decreases the incidence and/or
tance of breastfeeding and sets forth principles to
severity of a wide range of infectious diseases23 in-
guide pediatricians and other health care profession-
cluding bacterial meningitis,24,25 bacteremia,25,26 di-
als in assisting women and children in the initiation
arrhea,27–33 respiratory tract infection,22,33–40 necro-
and maintenance of breastfeeding. The ways pedia-
tizing enterocolitis,20,21 otitis media,27,41–45 urinary
tricians can protect, promote, and support breast-
tract infection,46,47 and late-onset sepsis in preterm
feeding in their individual practices, hospitals, med-
infants.17,20 In addition, postneonatal infant mortal-
ical schools, and communities are delineated, and the
ity rates in the United States are reduced by 21% in
central role of the pediatrician in coordinating breast-
feeding management and providing a medical homefor the child is emphasized.3 These recommenda-
Some studies suggest decreased rates of sudden
infant death syndrome in the first year of life49–55 and
doi:10.1542/peds.2004-2491PEDIATRICS (ISSN 0031 4005). Copyright 2005 by the American Acad-
reduction in incidence of insulin-dependent (type 1)
and non–insulin-dependent (type 2) diabetes melli-
tus,56–59 lymphoma, leukemia, and Hodgkin dis-
mothers who are using drugs of abuse (“street
ease,60–62 overweight and obesity,19,63–70 hypercho-
drugs”); and mothers who have herpes simplex le-
lesterolemia,71 and asthma36–39 in older children and
sions on a breast (infant may feed from other breast
adults who were breastfed, compared with individ-
if clear of lesions). Appropriate information about
uals who were not breastfed. Additional research in
infection-control measures should be provided to
In the United States, mothers who are infected
with human immunodeficiency virus (HIV) have
Breastfeeding has been associated with slightly en-
been advised not to breastfeed their infants.112 In
hanced performance on tests of cognitive develop-
developing areas of the world with populations at
ment.14,15,72–80 Breastfeeding during a painful proce-
increased risk of other infectious diseases and nutri-
dure such as a heel-stick for newborn screening
tional deficiencies resulting in increased infant death
rates, the mortality risks associated with artificialfeeding may outweigh the possible risks of acquiring
Maternal Health Benefits
HIV infection.113,114 One study in Africa detailed in 2
Important health benefits of breastfeeding and lac-
reports115,116 found that exclusive breastfeeding for
tation are also described for mothers.83 The benefits
the first 3 to 6 months after birth by HIV-infected
include decreased postpartum bleeding and more
mothers did not increase the risk of HIV transmis-
rapid uterine involution attributable to increased
sion to the infant, whereas infants who received
concentrations of oxytocin,84 decreased menstrual
mixed feedings (breastfeeding with other foods or
blood loss and increased child spacing attributable to
milks) had a higher rate of HIV infection compared
lactational amenorrhea,85 earlier return to prepreg-
with infants who were exclusively formula-fed.
nancy weight,86 decreased risk of breast cancer,87–92
Women in the United States who are HIV-positive
decreased risk of ovarian cancer,93 and possibly de-
should not breastfeed their offspring. Additional
creased risk of hip fractures and osteoporosis in the
studies are needed before considering a change from
CONDITIONS THAT ARE NOT
In addition to specific health advantages for in-
CONTRAINDICATIONS TO BREASTFEEDING
fants and mothers, economic, family, and environ-
Certain conditions have been shown to be compat-
mental benefits have been described. These benefits
ible with breastfeeding. Breastfeeding is not contra-
include the potential for decreased annual health
indicated for infants born to mothers who are hepa-
care costs of $3.6 billion in the United States97,98; de-
titis B surface antigen–positive,111 mothers who are
creased costs for public health programs such as the
infected with hepatitis C virus (persons with hepati-
Special Supplemental Nutrition Program for Women,
tis C virus antibody or hepatitis C virus-RNA–posi-
Infants, and Children (WIC)99; decreased parental em-
tive blood),111 mothers who are febrile (unless cause
ployee absenteeism and associated loss of family in-
is a contraindication outlined in the previous sec-
come; more time for attention to siblings and other
tion),117 mothers who have been exposed to low-
family matters as a result of decreased infant illness;
level environmental chemical agents,118,119 and
decreased environmental burden for disposal of for-
mothers who are seropositive carriers of cytomega-
mula cans and bottles; and decreased energy demands
lovirus (CMV) (not recent converters if the infant is
for production and transport of artificial feeding prod-
term).111 Decisions about breastfeeding of very low
ucts.100–102 These savings for the country and for fam-
birth weight infants (birth weight Ͻ1500 g) by moth-
ilies would be offset to some unknown extent by in-
ers known to be CMV-seropositive should be made
creased costs for physician and lactation consultations,
with consideration of the potential benefits of human
increased office-visit time, and cost of breast pumps
milk versus the risk of CMV transmission.120,121
and other equipment, all of which should be covered
Freezing and pasteurization can significantly de-
by insurance payments to providers and families.
Tobacco smoking by mothers is not a contraindi-
CONTRAINDICATIONS TO BREASTFEEDING
cation to breastfeeding, but health care professionals
Although breastfeeding is optimal for infants,
should advise all tobacco-using mothers to avoid
there are a few conditions under which breastfeeding
smoking within the home and to make every effort to
may not be in the best interest of the infant. Breast-
wean themselves from tobacco as rapidly as possi-
feeding is contraindicated in infants with classic
galactosemia (galactose 1-phosphate uridyltrans-
Breastfeeding mothers should avoid the use of
ferase deficiency)103; mothers who have active un-
alcoholic beverages, because alcohol is concentrated
treated tuberculosis disease or are human T-cell lym-
in breast milk and its use can inhibit milk produc-
photropic virus type I– or II–positive104,105; mothers
tion. An occasional celebratory single, small alcoholic
who are receiving diagnostic or therapeutic radioac-
drink is acceptable, but breastfeeding should be
tive isotopes or have had exposure to radioactive
materials (for as long as there is radioactivity in the
For the great majority of newborns with jaundice
milk)106–108; mothers who are receiving antimetabo-
and hyperbilirubinemia, breastfeeding can and
lites or chemotherapeutic agents or a small number
should be continued without interruption. In rare
of other medications until they clear the milk109,110;
instances of severe hyperbilirubinemia, breastfeed-
Breastfeeding Rates for Infants in the United States: Any (Exclusive)
NA indicates that the data are not available.
ing may need to be interrupted temporarily for a
lack of guidance and encouragement from health
Data indicate that the rate of initiation and dura-
RECOMMENDATIONS ON BREASTFEEDING FOR
tion of breastfeeding in the United States are well
HEALTHY TERM INFANTS
below the Healthy People 2010
goals (see Table 1).4,125
1. Pediatricians and other health care professionals
Furthermore, many of the mothers counted as breast-
should recommend human milk for all infants in
feeding were supplementing their infants with for-
whom breastfeeding is not specifically contrain-
mula during the first 6 months of the infant’s life.5,126
dicated and provide parents with complete, cur-
Although breastfeeding initiation rates have in-
rent information on the benefits and techniques
creased steadily since 1990, exclusive breastfeeding
of breastfeeding to ensure that their feeding de-
initiation rates have shown little or no increase over
that same period of time. Similarly, 6 months after
• When direct breastfeeding is not possible, ex-
birth, the proportion of infants who are exclusively
breastfed has increased at a much slower rate than
ed.150,151 If a known contraindication to breast-
that of infants who receive mixed feedings.125 The
feeding is identified, consider whether the
AAP Section on Breastfeeding, American College of
contraindication may be temporary, and if so,
Obstetricians and Gynecologists, American Acad-
advise pumping to maintain milk production.
emy of Family Physicians, Academy of Breastfeeding
Before advising against breastfeeding or rec-
Medicine, World Health Organization, United Na-
tions Children’s Fund, and many other health orga-
benefits of breastfeeding against the risks of
nizations recommend exclusive breastfeeding for the
first 6 months of life.‡2,127–130 Exclusive breastfeeding
2. Peripartum policies and practices that optimize
is defined as an infant’s consumption of human milk
breastfeeding initiation and maintenance should
with no supplementation of any type (no water, no
juice, no nonhuman milk, and no foods) except for
• Education of both parents before and after
vitamins, minerals, and medications.131 Exclusive
delivery of the infant is an essential compo-
breastfeeding has been shown to provide improved
nent of successful breastfeeding. Support and
protection against many diseases and to increase the
encouragement by the father can greatly assist
likelihood of continued breastfeeding for at least the
the mother during the initiation process and
Obstacles to initiation and continuation of breast-
arise. Consistent with appropriate care for the
feeding include insufficient prenatal education about
mother, minimize or modify the course of ma-
breastfeeding132,133; disruptive hospital policies and
ternal medications that have the potential for
practices134; inappropriate interruption of breast-
altering the infant’s alertness and feeding be-
feeding135; early hospital discharge in some popula-
havior.152,153 Avoid procedures that may inter-
tions136; lack of timely routine follow-up care and
fere with breastfeeding or that may traumatize
postpartum home health visits137; maternal employ-
the infant, including unnecessary, excessive, and
ment138,139 (especially in the absence of workplace
overvigorous suctioning of the oral cavity,
facilities and support for breastfeeding)140; lack of
esophagus, and airways to avoid oropharyngeal
family and broad societal support141; media por-
mucosal injury that may lead to aversive feeding
trayal of bottle feeding as normative142; commercial
promotion of infant formula through distribution of
3. Healthy infants should be placed and remain in
hospital discharge packs, coupons for free or dis-
direct skin-to-skin contact with their mothers im-
counted formula, and some television and general
mediately after delivery until the first feeding is
magazine advertising143,144; misinformation; and
accomplished.156–158• The alert, healthy newborn infant is capable of
latching on to a breast without specific assis-
‡ There is a difference of opinion among AAP experts on this matter. The
tance within the first hour after birth.156 Dry
Section on Breastfeeding acknowledges that the Committee on Nutritionsupports introduction of complementary foods between 4 and 6 months of
the infant, assign Apgar scores, and perform
age when safe and nutritious complementary foods are available.
the initial physical assessment while the infant
is with the mother. The mother is an optimal
clearly communicated to both parents and to
heat source for the infant.159,160 Delay weigh-
ing, measuring, bathing, needle-sticks, and
8. All breastfeeding newborn infants should be
eye prophylaxis until after the first feeding is
seen by a pediatrician or other knowledgeable and
completed. Infants affected by maternal med-
experienced health care professional at 3 to 5 days
ications may require assistance for effective
of age as recommended by the AAP.124,176,177
latch-on.156 Except under unusual circum-
• This visit should include infant weight; phys-
stances, the newborn infant should remain
ical examination, especially for jaundice and
with the mother throughout the recovery pe-
hydration; maternal history of breast problems
(painful feedings, engorgement); infant elimi-
4. Supplements (water, glucose water, formula, and
nation patterns (expect 3–5 urines and 3– 4
other fluids) should not be given to breastfeeding
stools per day by 3–5 days of age; 4 – 6 urines
newborn infants unless ordered by a physician
and 3– 6 stools per day by 5–7 days of age);
when a medical indication exists.148,162–165
and a formal, observed evaluation of breast-
5. Pacifier use is best avoided during the initiation
feeding, including position, latch, and milk
of breastfeeding and used only after breastfeed-
transfer. Weight loss in the infant of greater
than 7% from birth weight indicates possible
• In some infants early pacifier use may interfere
breastfeeding problems and requires more in-
with establishment of good breastfeeding prac-
tensive evaluation of breastfeeding and possi-
tices, whereas in others it may indicate the pres-
ble intervention to correct problems and im-
ence of a breastfeeding problem that requires
9. Breastfeeding infants should have a second am-
• This recommendation does not contraindicate
bulatory visit at 2 to 3 weeks of age so that the
pacifier use for nonnutritive sucking and oral
health care professional can monitor weight gain
training of premature infants and other special
and provide additional support and encourage-
ment to the mother during this critical period.
6. During the early weeks of breastfeeding, moth-
10. Pediatricians and parents should be aware that
ers should be encouraged to have 8 to 12 feed-
exclusive breastfeeding is sufficient to supportoptimal growth and development for approxi-
ings at the breast every 24 hours, offering the
mately the first 6 months of life‡ and provides
breast whenever the infant shows early signs of
continuing protection against diarrhea and respi-
hunger such as increased alertness, physical ac-
ratory tract infection.30,34,128,178–184 Breastfeeding
should be continued for at least the first year of
• Crying is a late indicator of hunger.171 Appro-
life and beyond for as long as mutually desired
priate initiation of breastfeeding is facilitated
by continuous rooming-in throughout the day
• Complementary foods rich in iron should be
and night.172 The mother should offer both
breasts at each feeding for as long a period as
months of age.186–187 Preterm and low birth
the infant remains at the breast.173 At each
weight infants and infants with hematologic
feed the first breast offered should be alter-
disorders or infants who had inadequate iron
nated so that both breasts receive equal stim-
stores at birth generally require iron supple-
ulation and draining. In the early weeks after
mentation before 6 months of age.148,188–192
Iron may be administered while continuing
aroused to feed if 4 hours have elapsed since
• Unique needs or feeding behaviors of individ-
• After breastfeeding is well established, the fre-
ual infants may indicate a need for introduc-
quency of feeding may decline to approxi-
tion of complementary foods as early as 4
mately 8 times per 24 hours, but the infant
months of age, whereas other infants may not
may increase the frequency again with growth
be ready to accept other foods until approxi-
spurts or when an increase in milk volume is
• Introduction of complementary feedings be-
7. Formal evaluation of breastfeeding, including
fore 6 months of age generally does not in-
observation of position, latch, and milk transfer,
crease total caloric intake or rate of growth
should be undertaken by trained caregivers at least
and only substitutes foods that lack the pro-
twice daily and fully documented in the record
during each day in the hospital after birth.174,175
• During the first 6 months of age, even in hot
• Encouraging the mother to record the time
climates, water and juice are unnecessary for
and duration of each breastfeeding, as well as
breastfed infants and may introduce contami-
urine and stool output during the early days
of breastfeeding in the hospital and the first
• Increased duration of breastfeeding confers
weeks at home, helps to facilitate the evalua-
significant health and developmental benefits
tion process. Problems identified in the hospi-
for the child and the mother, especially in
tal should be addressed at that time, and a
delaying return of fertility (thereby promoting
• There is no upper limit to the duration of
feeding alternative for infants whose mothers are
breastfeeding and no evidence of psychologic
unable or unwilling to provide their own milk.
Human milk banks in North America adhere to
into the third year of life or longer.197
national guidelines for quality control of screening
• Infants weaned before 12 months of age
and testing of donors and pasteurize all milk be-
should not receive cow’s milk but should re-
fore distribution.206–208 Fresh human milk from
unscreened donors is not recommended because
11. All breastfed infants should receive 1.0 mg of
of the risk of transmission of infectious agents.
vitamin K1 oxide intramuscularly after the first
• Precautions should be followed for infants with
feeding is completed and within the first 6 hours
glucose-6-phosphate dehydrogenase (G6PD) defi-
ciency. G6PD deficiency has been associated with
• Oral vitamin K is not recommended. It may
an increased risk of hemolysis, hyperbiliru-
not provide the adequate stores of vitamin K
binemia, and kernicterus.209 Mothers who breast-
necessary to prevent hemorrhage later in in-
feed infants with known or suspected G6PD defi-
fancy in breastfed infants unless repeated
ciency should not ingest fava beans or medications
doses are administered during the first 4
such as nitrofurantoin, primaquine phosphate, or
phenazopyridine hydrochloride, which are known
12. All breastfed infants should receive 200 IU of
to induce hemolysis in deficient individuals.210,211
oral vitamin D drops daily beginning during thefirst 2 months of life and continuing until the
ROLE OF PEDIATRICIANS AND OTHER HEALTH
daily consumption of vitamin D-fortified for-
CARE PROFESSIONALS IN PROTECTING,
PROMOTING, AND SUPPORTING
• Although human milk contains small amounts
of vitamin D, it is not enough to prevent rick-
Many pediatricians and other health care profes-
ets. Exposure of the skin to ultraviolet B wave-
sionals have made great efforts in recent years to
lengths from sunlight is the usual mechanism
support and improve breastfeeding success by fol-
for production of vitamin D. However, signif-
lowing the principles and guidance provided by
icant risk of sunburn (short-term) and skin
the AAP,2 the American College of Obstetricians
cancer (long-term) attributable to sunlight ex-
and Gynecologists,127 the American Academy of
posure, especially in younger children, makes
Family Physicians,128 and many other organiza-
it prudent to counsel against exposure to sun-
tions.5,6,8,130,133,142,162 The following guidelines
light. Furthermore, sunscreen decreases vita-
summarize these concepts for providing an opti-
13. Supplementary fluoride should not be provided
• From 6 months to 3 years of age, the decision
• Promote, support, and protect breastfeeding en-
whether to provide fluoride supplementation
thusiastically. In consideration of the extensively
should be made on the basis of the fluoride
published evidence for improved health and de-
concentration in the water supply (fluoride
velopmental outcomes in breastfed infants and
supplementation generally is not needed un-
their mothers, a strong position on behalf of
less the concentration in the drinking water is
Ͻ0.3 ppm) and in other food, fluid sources,
• Promote breastfeeding as a cultural norm and en-
courage family and societal support for breast-
14. Mother and infant should sleep in proximity to
each other to facilitate breastfeeding.203
• Recognize the effect of cultural diversity on breast-
15. Should hospitalization of the breastfeeding
feeding attitudes and practices and encourage
mother or infant be necessary, every effort
variations, if appropriate, that effectively promote
should be made to maintain breastfeeding, pref-
and support breastfeeding in different cultures.
erably directly, or pumping the breasts and feed-
• Become knowledgeable and skilled in the physiol-
ogy and the current clinical management of breast-
ADDITIONAL RECOMMENDATIONS FOR
• Encourage development of formal training in
• Hospitals and physicians should recommend hu-
breastfeeding and lactation in medical schools, in
man milk for premature and other high-risk in-
residency and fellowship training programs, and
fants either by direct breastfeeding and/or using
the mother’s own expressed milk.13 Maternal sup-
• Use every opportunity to provide age-appropriate
port and education on breastfeeding and milk ex-
breastfeeding education to children and adults in
pression should be provided from the earliest pos-
the medical setting and in outreach programs for
sible time. Mother-infant skin-to-skin contact and
direct breastfeeding should be encouraged as earlyas feasible.204,205 Fortification of expressed human
milk is indicated for many very low birth weight
• Work collaboratively with the obstetric commu-
infants.13 Banked human milk may be a suitable
nity to ensure that women receive accurate and
sufficient information throughout the perinatal pe-
• Encourage employers to provide appropriate facil-
riod to make a fully informed decision about in-
ities and adequate time in the workplace for
breastfeeding and/or milk expression.
• Work collaboratively with the dental community
• Encourage child care providers to support breast-
to ensure that women are encouraged to continue
feeding and the use of expressed human milk pro-
to breastfeed and use good oral health practices.
Infants should receive an oral health-risk assess-
• Support the efforts of parents and the courts to
ment by the pediatrician between 6 months and 1
ensure continuation of breastfeeding in separation
year of age and/or referred to a dentist for evalu-
ation and treatment if at risk of dental caries or
• Provide counsel to adoptive mothers who decide
to breastfeed through induced lactation, a process
• Promote hospital policies and procedures that fa-
requiring professional support and encourage-
cilitate breastfeeding. Work actively toward elim-
inating hospital policies and practices that discour-
• Encourage development and approval of govern-
age breastfeeding (eg, promotion of infant formula
mental policies and legislation that are supportive
in hospitals including infant formula discharge
of a mother’s choice to breastfeed.
packs and formula discount coupons, separationof mother and infant, inappropriate infant feeding
images, and lack of adequate encouragement and
• Promote continued basic and clinical research in
support of breastfeeding by all health care staff).
the field of breastfeeding. Encourage investigators
Encourage hospitals to provide in-depth training
and funding agencies to pursue studies that fur-
in breastfeeding for all health care staff (including
ther delineate the scientific understandings of lac-
physicians) and have lactation experts available at
tation and breastfeeding that lead to improved
clinical practice in this medical field.216
• Provide effective breast pumps and private lacta-
tion areas for all breastfeeding mothers (patients
and staff) in ambulatory and inpatient areas of the
Although economic, cultural, and political pres-
sures often confound decisions about infant feeding,
• Develop office practices that promote and support
the AAP firmly adheres to the position that breast-
breastfeeding by using the guidelines and materi-
feeding ensures the best possible health as well as the
als provided by the AAP Breastfeeding Promotion
best developmental and psychosocial outcomes for
in Physicians’ Office Practices program.214
the infant. Enthusiastic support and involvement of
• Become familiar with local breastfeeding resources
pediatricians in the promotion and practice of breast-
(eg, WIC clinics, breastfeeding medical and nurs-
feeding is essential to the achievement of optimal
ing specialists, lactation educators and consult-
infant and child health, growth, and development.
ants, lay support groups, and breast-pump rentalstations) so that patients can be referred appropri-
ately.215 When specialized breastfeeding services
are used, the essential role of the pediatrician as
the infant’s primary health care professional
within the framework of the medical home needs
• Encourage adequate, routine insurance coverage
for necessary breastfeeding services and supplies,
including the time required by pediatricians and
other licensed health care professionals to assess
and manage breastfeeding and the cost for the
• Develop and maintain effective communication
and coordination with other health care profes-
sionals to ensure optimal breastfeeding education,
support, and counseling. AAP and WIC breast-
feeding coordinators can facilitate collaborative re-
lationships and develop programs in the commu-nity and in professional organizations for support
• Advise mothers to continue their breast self-exam-
inations on a monthly basis throughout lactationand to continue to have annual clinical breast ex-
1. Kramer MS, Chalmers B, Hodnett ED, et al. Promotion of Breastfeed-
ing Intervention Trial (PROBIT): a randomized trial in the Republic ofBelarus. JAMA.
2. American Academy of Pediatrics, Work Group on Breastfeeding.
• Encourage the media to portray breastfeeding as
Breastfeeding and the use of human milk. Pediatrics.
3. American Academy of Pediatrics, Medical Home Initiatives for Chil-
28. Howie PW, Forsyth JS, Ogston SA, Clark A, Florey CD. Protective
dren With Special Needs Project Advisory Committee. The medical
effect of breast feeding against infection. BMJ.
29. Kramer MS, Guo T, Platt RW, et al. Infant growth and health outcomes
4. US Department of Health and Human Services. Healthy People 2010:
associated with 3 compared with 6 mo of exclusive breastfeeding. Am J
—Volumes I and II
. Washington, DC: US Department
of Health and Human Services, Public Health Service, Office of the
30. Popkin BM, Adair L, Akin JS, Black R, Briscoe J, Flieger W. Breast-
Assistant Secretary for Health; 2000:47– 48
feeding and diarrheal morbidity. Pediatrics.
1990;86:874 – 882
5. US Department of Health and Human Services. HHS Blueprint for
31. Beaudry M, Dufour R, Marcoux S. Relation between infant feeding
Action on Breastfeeding
. Washington, DC: US Department of Health and
and infections during the first six months of life. J Pediatr.
Human Services, Office on Women’s Health; 2000
6. United States Breastfeeding Committee. Breastfeeding in the United
32. Bhandari N, Bahl R, Mazumdar S, Martines J, Black RE, Bhan MK.
States: A National Agenda
. Rockville, MD: US Department of Health and
Effect of community-based promotion of exclusive breastfeeding on
Human Services, Health Resources and Services Administration, Ma-
diarrhoeal illness and growth: a cluster randomized controlled trial.
Infant Feeding Study Group. Lancet.
7. American Academy of Pediatrics. New Mother’s Guide to Breastfeeding
33. Lopez-Alarcon M, Villalpando S, Fajardo A. Breast-feeding lowers the
Meek JY, ed. New York, NY: Bantam Books; 2002
frequency and duration of acute respiratory infection and diarrhea in
8. American Academy of Pediatrics, American College of Obstetricians
infants under six months of age. J Nutr.
1997;127:436 – 443
and Gynecologists. Guidelines for Perinatal Care
. Gilstrap LC, Oh W,
34. Bachrach VR, Schwarz E, Bachrach LR. Breastfeeding and the risk of
eds. 5th ed. Elk Grove Village, IL: American Academy of Pediatrics;
hospitalization for respiratory disease in infancy: a meta-analysis. Arch
Pediatr Adolesc Med.
9. American Academy of Pediatrics, Committee on Nutrition. Pediatric
35. Oddy WH, Sly PD, de Klerk NH, et al. Breast feeding and respiratory
. Kleinman RE, ed. 5th ed. Elk Grove Village, IL:
morbidity in infancy: a birth cohort study. Arch Dis Child.
10. American Academy of Pediatrics. Red Book: 2003 Report of the Committee
36. Chulada PC, Arbes SJ Jr, Dunson D, Zeldin DC. Breast-feeding and the
on Infectious Diseases
. Pickering LK, ed. 26th ed. Elk Grove Village, IL:
prevalence of asthma and wheeze in children: analyses from the Third
National Health and Nutrition Examination Survey, 1988 –1994. J Al-
11. American Academy of Pediatrics, Committee on Environmental
lergy Clin Immunol.
Health. Handbook of Pediatric Environmental Health
. Etzel RA, Balk SJ,
37. Oddy WH, Peat JK, de Klerk NH. Maternal asthma, infant feeding, and
eds. 2nd ed. Elk Grove Village, IL: American Academy of Pediatrics;
the risk of asthma in childhood. J Allergy Clin Immunol.
38. Gdalevich M, Mimouni D, Mimouni M. Breast-feeding and the risk of
12. Hambraeus L, Forsum E, Lo¨nnerdal B. Nutritional aspects of breast
bronchial asthma in childhood: a systematic review with meta-analysis
milk and cow’s milk formulas. In: Hambraeus L, Hanson L, MacFar-
of prospective studies. J Pediatr.
lane H, eds. Symposium on Food and Immunology
. Stockholm, Sweden:
39. Oddy WH, Holt PG, Sly PD, et al. Association between breast feeding
and asthma in 6 year old children: findings of a prospective birth
13. Schanler RJ. The use of human milk for premature infants. Pediatr Clin
cohort study. BMJ.
40. Wright AL, Holberg CJ, Taussig LM, Martinez FD. Relationship of
14. Lucas A, Morley R, Cole TJ. Randomised trial of early diet in preterm
infant feeding to recurrent wheezing at age 6 years. Arch Pediatr
babies and later intelligence quotient. BMJ.
15. Horwood LJ, Darlow BA, Mogridge N. Breast milk feeding and cog-
41. Saarinen UM. Prolonged breast feeding as prophylaxis for recurrent
nitive ability at 7– 8 years. Arch Dis Child Fetal Neonatal Ed.
otitis media. Acta Paediatr Scand.
42. Duncan B, Ey J, Holberg CJ, Wright AL, Martinez FD, Taussig LM.
16. Amin SB, Merle KS, Orlando MS, Dalzell LE, Guillet R. Brainstem
Exclusive breast-feeding for at least 4 months protects against otitis
maturation in premature infants as a function of enteral feeding type.
43. Owen MJ, Baldwin CD, Swank PR, Pannu AK, Johnson DL, Howie
17. Hylander MA, Strobino DM, Dhanireddy R. Human milk feedings and
VM. Relation of infant feeding practices, cigarette smoke exposure,
infection among very low birth weight infants. Pediatrics.
and group child care to the onset and duration of otitis media with
Available at: www.pediatrics.org/cgi/content/full/102/3/e38
18. Hylander MA, Strobino DM, Pezzullo JC, Dhanireddy R. Associa-
effusion in the first two years of life. J Pediatr.
tion of human milk feedings with a reduction in retinopathy of
44. Paradise JL, Elster BA, Tan L. Evidence in infants with cleft palate that
prematurity among very low birthweight infants. J Perinatol.
breast milk protects against otitis media. Pediatrics.
45. Aniansson G, Alm B, Andersson B, et al. A prospective cohort study on
19. Singhal A, Farooqi IS, O’Rahilly S, Cole TJ, Fewtrell M, Lucas A. Early
breast-feeding and otitis media in Swedish infants. Pediatr Infect Dis J.
nutrition and leptin concentrations in later life. Am J Clin Nutr.
46. Pisacane A, Graziano L, Mazzarella G, Scarpellino B, Zona G. Breast-
20. Schanler RJ, Shulman RJ, Lau C. Feeding strategies for premature
feeding and urinary tract infection. J Pediatr.
infants: beneficial outcomes of feeding fortified human milk versus
47. Marild S, Hansson S, Jodal U, Oden A, Svedberg K. Protective effect of
preterm formula. Pediatrics.
breastfeeding against urinary tract infection. Acta Paediatr.
21. Lucas A, Cole TJ. Breast milk and neonatal necrotising enterocolitis.
48. Chen A, Rogan WJ. Breastfeeding and the risk of postneonatal death in
22. Blaymore Bier J, Oliver T, Ferguson A, Vohr BR. Human milk reduces
outpatient upper respiratory symptoms in premature infants during
their first year of life. J Perinatol.
49. Horne RS, Parslow PM, Ferens D, Watts AM, Adamson TM. Compar-
23. Heinig MJ. Host defense benefits of breastfeeding for the infant. Effect
ison of evoked arousability in breast and formula fed infants. Arch Dis
of breastfeeding duration and exclusivity. Pediatr Clin North Am.
50. Ford RPK, Taylor BJ, Mitchell EA, et al. Breastfeeding and the risk of
24. Cochi SL, Fleming DW, Hightower AW, et al. Primary invasive Hae-
sudden infant death syndrome. Int J Epidemiol.
type b disease: a population-based assessment of
51. Mitchell EA, Taylor BJ, Ford RPK, et al. Four modifiable and other
risk factors. J Pediatr.
major risk factors for cot death: the New Zealand study. J Paediatr Child
25. Istre GR, Conner JS, Broome CV, Hightower A, Hopkins RS. Risk
factors for primary invasive Haemophilus influenzae
52. Scragg LK, Mitchell EA, Tonkin SL, Hassall IB. Evaluation of the cot
risk from day care attendance and school-aged household members.
death prevention programme in South Auckland. N Z Med J.
26. Takala AK, Eskola J, Palmgren J, et al. Risk factors of invasive Hae-
53. Alm B, Wennergren G, Norvenius SG, et al. Breast feeding and the
type b disease among children in Finland. J Pediatr.
sudden infant death syndrome in Scandinavia, 1992–95. Arch Dis Child.
27. Dewey KG, Heinig MJ, Nommsen-Rivers LA. Differences in morbidity
54. McVea KL, Turner PD, Peppler DK. The role of breastfeeding in
between breast-fed and formula-fed infants. J Pediatr.
sudden infant death syndrome. J Hum Lact.
55. Mosko S, Richard C, McKenna J. Infant arousals during mother-infant
82. Carbajal R, Veerapen S, Couderc S, Jugie M, Ville Y. Analgesic effect of
bed sharing: implications for infant sleep and sudden infant death
breast feeding in term neonates: randomized controlled trial. BMJ.
syndrome research. Pediatrics.
56. Gerstein HC. Cow’s milk exposure and type 1 diabetes mellitus. A
83. Labbok MH. Effects of breastfeeding on the mother. Pediatr Clin North
critical overview of the clinical literature. Diabetes Care.
57. Kostraba JN, Cruickshanks KJ, Lawler-Heavner J, et al. Early exposure
84. Chua S, Arulkumaran S, Lim I, Selamat N, Ratnam SS. Influence of
to cow’s milk and solid foods in infancy, genetic predisposition, and
breastfeeding and nipple stimulation on postpartum uterine activity.
the risk of IDDM. Diabetes.
Br J Obstet Gynaecol.
1994;101:804 – 805
58. Pettit DJ, Forman MR, Hanson RL, Knowler WC, Bennett PH. Breast-
85. Kennedy KI, Labbok MH, Van Look PF. Lactational amenorrhea
feeding and the incidence of non-insulin-dependent diabetes mellitus
method for family planning. Int J Gynaecol Obstet.
in Pima Indians. Lancet.
86. Dewey KG, Heinig MJ, Nommsen LA. Maternal weight-loss patterns
59. Perez-Bravo E, Carrasco E, Guitierrez-Lopez MD, Martinez MT, Lopez
during prolonged lactation. Am J Clin Nutr.
G, de los Rios MG. Genetic predisposition and environmental factors
87. Newcomb PA, Storer BE, Longnecker MP, et al. Lactation and a
leading to the development of insulin-dependent diabetes mellitus in
reduced risk of premenopausal breast cancer. N Engl J Med.
Chilean children. J Mol Med.
60. Davis MK. Review of the evidence for an association between infant
88. Collaborative Group on Hormonal Factors in Breast Cancer. Breast
feeding and childhood cancer. Int J Cancer Suppl.
cancer and breastfeeding: collaborative reanalysis of individual data
61. Smulevich VB, Solionova LG, Belyakova SV. Parental occupation and
from 47 epidemiological studies in 30 countries, including 50302
other factors and cancer risk in children: I. Study methodology and
women with breast cancer and 96973 women without the disease.
non-occupational factors. Int J Cancer.
62. Bener A, Denic S, Galadari S. Longer breast-feeding and protection
89. Lee SY, Kim MT, Kim SW, Song MS, Yoon SJ. Effect of lifetime
against childhood leukaemia and lymphomas. Eur J Cancer.
lactation on breast cancer risk: a Korean women’s cohort study. Int J
63. Armstrong J, Reilly JJ, Child Health Information Team. Breastfeeding
and lowering the risk of childhood obesity. Lancet.
90. Tryggvadottir L, Tulinius H, Eyfjord JE, Sigurvinsson T. Breastfeeding
64. Dewey KG, Heinig MJ, Nommsen LA, Peerson JM, Lonnerdal B.
and reduced risk of breast cancer in an Icelandic cohort study. Am J
Breast-fed infants are leaner than formula-fed infants at 1 year of age:
the DARLING study. Am J Clin Nutr.
91. Enger SM, Ross RK, Paganini-Hill A, Bernstein L. Breastfeeding expe-
65. Arenz S, Ruckerl R, Koletzko B, Von Kries R. Breast-feeding and
rience and breast cancer risk among postmenopausal women. Cancer
childhood obesity—a systematic review. Int J Obes Relat Metab Disord.
Epidemiol Biomarkers Prev.
92. Jernstrom H, Lubinski J, Lynch HT, et al. Breast-feeding and the risk of
66. Grummer-Strawn LM, Mei Z. Does breastfeeding protect against pe-
breast cancer in BRCA1 and BRCA2 mutation carriers. J Natl Cancer
diatric overweight? Analysis of longitudinal data from the Centers for
Disease Control and Prevention Pediatric Nutrition Surveillance Sys-
93. Rosenblatt KA, Thomas DB. Lactation and the risk of epithelial ovarian
2004;113(2). Available at: www.pediatrics.org/cgi/
cancer. WHO Collaborative Study of Neoplasia and Steroid contracep-
tives. Int J Epidemiol.
67. Stettler N, Zemel BS, Kumanyika S, Stallings VA. Infant weight gain
94. Cumming RG, Klineberg RJ. Breastfeeding and other reproductive
and childhood overweight status in a multicenter, cohort study. Pedi-
factors and the risk of hip fractures in elderly women. Int J Epidemiol.
68. Gillman MW, Rifas-Shiman SL, Camargo CA, et al. Risk of overweight
95. Lopez JM, Gonzalez G, Reyes V, Campino C, Diaz S. Bone turnover
among adolescents who were breastfed as infants. JAMA.
and density in healthy women during breastfeeding and after wean-
ing. Osteoporos Int.
69. Toschke AM, Vignerova J, Lhotska L, Osancova K, Koletzko B, von
96. Paton LM, Alexander JL, Nowson CA, et al. Pregnancy and lactation
Kries R. Overweight and obesity in 6- to 14-year old Czech children
have no long-term deleterious effect on measures of bone mineral in
in 1991: protective effect of breast-feeding. J Pediatr.
healthy women: a twin study. Am J Clin Nutr.
97. Weimer J. The Economic Benefits of Breast Feeding: A Review and Analysis
70. American Academy of Pediatrics, Committee on Nutrition. Prevention
Food Assistance and Nutrition Research Report No. 13. Washington,
of pediatric overweight and obesity. Pediatrics.
2003;112:424 – 430
DC: Food and Rural Economics Division, Economic Research Service,
71. Owen CG, Whincup PH, Odoki K, Gilg JA, Cook DG. Infant feeding
and blood cholesterol: a study in adolescents and a systematic review.
98. Ball TM, Wright AL. Health care cost of formula-feeding in the first
year of life. Pediatrics.
1999;103:870 – 876
72. Horwood LJ, Fergusson DM. Breastfeeding and later cognitive and
99. Tuttle CR, Dewey KG. Potential cost savings for Medi-Cal, AFDC, food
stamps, and WIC programs associated with increasing breast-feeding
among low-income Hmong women in California. J Am Diet Assoc.
73. Anderson JW, Johnstone BM, Remley DT. Breast-feeding and cognitive
development: a meta-analysis. Am J Clin Nutr.
100. Cohen R, Mrtek MB, Mrtek RG. Comparison of maternal absenteeism
74. Jacobson SW, Chiodo LM, Jacobson JL. Breastfeeding effects on intel-
and infant illness rates among breast-feeding and formula-feeding
ligence quotient in 4- and 11-year-old children. Pediatrics.
women in two corporations. Am J Health Promot.
Available at: www.pediatrics.org/cgi/content/full/103/5/e71
101. Jarosz LA. Breast-feeding versus formula: cost comparison. Hawaii Med
75. Reynolds A. Breastfeeding and brain development. Pediatr Clin North
102. Levine RE, Huffman SL, Center to Prevent Childhood Malnutrition.
76. Mortensen EL, Michaelsen KF, Sanders SA, Reinisch JM. The associa-
The Economic Value of Breastfeeding, the National, Public Sector, Hos-
tion between duration of breastfeeding and adult intelligence. JAMA.
pital and Household Levels: A Review of the Literature
. Washington, DC:
77. Batstra L, Neeleman, Hadders-Algra M. Can breast feeding modify the
Social Sector Analysis Project, Agency for International Development;
adverse effects of smoking during pregnancy on the child’s cognitive
development? J Epidemiol Community Health.
103. Chen Y-T. Defects in galactose metabolism. In: Behrman RE, Kliegman
78. Rao MR, Hediger ML, Levine RJ, Naficy AB, Vik T. Effect of breast-
RM, Jenson HB, eds. Nelson Textbook of Pediatrics.
16th ed. Philadelphia,
feeding on cognitive development of infants born small for gestational
age. Acta Paediatr.
104. Ando Y, Saito K, Nakano S, et al. Bottle-feeding can prevent transmis-
79. Bier JA, Oliver T, Ferguson AE, Vohr BR. Human milk improves
sion of HTLV-I from mothers to their babies. J Infect.
cognitive and motor development of premature infants during in-
105. Centers for Disease Control and Prevention and USPHS Working
fancy. J Hum Lact.
Group. Guidelines for counseling persons infected with human T-
80. Feldman R, Eidelman AI. Direct and indirect effects of breast-milk on
lymphotropic virus type I (HTLV-1) and type II (HTLV-II). Ann Intern
the neurobehavioral and cognitive development of premature infants.
106. Gori G, Cama G, Guerresi E, et al. Radioactivity in breastmilk and
81. Gray L, Miller LW, Phillip BL, Blass EM. Breastfeeding is analgesic in
placenta after Chernobyl accident [letter]. Am J Obstet Gynecol.
healthy newborns. Pediatrics.
107. Robinson PS, Barker P, Campbell A, Henson P, Surveyor I, Young PR.
131. Institute of Medicine, Committee on Nutritional Status During Preg-
Iodine-131 in breast milk following therapy for thyroid carcinoma.
nancy and Lactation. Nutrition During Lactation
. Washington, DC: Na-
tional Academy Press; 1991:24 –25, 161–171, 197–200
108. Bakheet SM, Hammami MM. Patterns of radioiodine uptake by the
132. The Ross Mothers Survey. Breastfeeding Trends Through 2002
lactating breast. Eur J Nucl Med.
1994;21:604 – 608
Park, IL: Ross Products Division, Abbot Laboratories; 2002
109. Egan PC, Costanza ME, Dodion P, Egorin MJ, Bachur NR. Doxorubicin
133. World Health Organization and United Nations Children’s Fund. Pro-
and cisplatin excretion into human milk. Cancer Treat Rep.
tecting, Promoting and Supporting Breast-Feeding: The Special Role of Ma-
. Geneva, Switzerland: World Health Organization;
110. American Academy of Pediatrics, Committee on Drugs. Transfer of
drugs and other chemicals into human milk. Pediatrics.
134. Powers NG, Naylor AJ, Wester RA. Hospital policies: crucial to breast-
feeding success. Semin Perinatol.
111. American Academy of Pediatrics. Transmission of infectious agents
135. Freed GL, Clark SJ, Sorenson J, Lohr JA, Cefalo R, Curtis P. National
via human milk. In: Pickering LK, ed. Red Book: 2003 Report of the
assessment of physicians’ breast-feeding knowledge, attitudes, train-
Committee on Infectious Diseases
. 26th ed. Elk Grove Village, IL: Amer-
ing, and experience. JAMA.
ican Academy of Pediatrics; 2003:118 –121
136. Braveman P, Egerter S, Pearl M, Marchi K, Miller C. Problems associ-
112. Read JS; American Academy of Pediatrics, Committee on Pediatric
ated with early discharge of newborn infants. Pediatrics.
AIDS. Human milk, breastfeeding, and transmission of human immu-
nodeficiency virus type 1 in the United States. Pediatrics.
137. Williams LR, Cooper MK. Nurse-managed postpartum home care. J
Obstet Gynecol Neonatal Nurs.
113. World Health Organization. HIV and Infant Feeding: A Guide for Health
138. Gielen AC, Faden RR, O’Campo P, Brown CH, Paige DM. Maternal
Care Managers and Supervisors
. Publication Nos. WHO/FRH/NUT/
employment during the early postpartum period: effects on initiation
98.2, UNAIDS/98.4, UNICEF/PD/NUT/(J)98.2. Geneva, Switzerland:
and continuation of breast-feeding. Pediatrics.
139. Ryan AS, Martinez GA. Breast-feeding and the working mother: a
114. Kourtis AP, Buteera S, Ibegbu C, Belec L, Duerr A. Breast milk and
HIV-1: vector of transmission or vehicle of protection? Lancet Infect Dis.
140. Frederick IB, Auerback KG. Maternal-infant separation and breast-
feeding. The return to work or school. J Reprod Med.
115. Coutsoudis A, Pillay K, Spooner E, Kuhn L, Coovadia HM. Influence
141. Spisak S, Gross SS. Second Followup Report: The Surgeon General’s Work-
of infant-feeding patterns on early mother-to-child transmission of
shop on Breastfeeding and Human Lactation
. Washington, DC: National
HIV-I in Durban, South Africa: a prospective cohort study. South
Center for Education in Maternal and Child Health; 1991
African Vitamin A Study Group. Lancet.
142. World Health Assembly. International Code of Marketing of Breast-Milk
116. Coutsoudis A, Rollins N. Breast-feeding and HIV transmission: the
. Resolution of the 34th World Health Assembly. No. 34.22,
jury is still out. J Pediatr Gastroenterol Nutr.
2003;36:434 – 442
Geneva, Switzerland: World Health Organization; 1981
117. Lawrence RA, Lawrence RM. Appendix E. Precautions and breastfeed-
143. Howard CR, Howard FM, Weitzman ML. Infant formula distribution
ing recommendations for selected maternal infections. In: Breastfeeding:
and advertising in pregnancy: a hospital survey. Birth.
A Guide for the Medical Profession
. 5th ed. St Louis, MO: Mosby Inc;
144. Howard FM, Howard CR, Weitzman M. The physician as advertiser:
the unintentional discouragement of breast-feeding. Obstet Gynecol.
118. Berlin CM Jr, LaKind JS, Sonawane BR, et al. Conclusions, research
needs, and recommendations of the expert panel: Technical Work-
145. Freed GL, Jones TM, Fraley JK. Attitudes and education of pediatric
shop on Human Milk Surveillance and Research for Environmental
house staff concerning breast-feeding. South Med J.
Chemicals in the United States. J Toxicol Environ Health A.
146. Williams EL, Hammer LD. Breastfeeding attitudes and knowledge of
pediatricians-in-training. Am J Prev Med.
119. Ribas-Fito N, Cardo E, Sala M, et al. Breastfeeding, exposure to or-
147. Gartner LM. Introduction. Breastfeeding in the hospital. Semin Perina-
ganochlorine compounds, and neurodevelopment in infants. Pediatrics.
2003;111(5). Available at: www.pediatrics.org/cgi/content/full/111/
148. American Academy of Pediatrics, Committee on Nutrition. Breastfeed-
ing. In: Kleinman RE, ed. Pediatric Nutrition Handbook
. 5th ed. Elk
120. Hamprecht K, Maschmann J, Vochem M, Dietz K, Speer CP, Jahn G.
Grove Village, IL: American Academy of Pediatrics; 2004:55– 85
Epidemiology of transmission of cytomegalovirus from mother to
149. American Dietetic Association. Position of the American Dietetic
preterm infant by breastfeeding. Lancet.
Association: breaking the barriers to breastfeeding. J Am Diet Assoc.
121. Yasuda A, Kimura H, Hayakawa M, et al. Evaluation of cytomegalo-
virus infections transmitted via breast milk in preterm infants with a
150. Schanler RJ, Hurst NM. Human milk for the hospitalized preterm
real-time polymerase chain reaction assay. Pediatrics.
infant. Semin Perinatol.
1994;18:476 – 484
151. Lemons P, Stuart M, Lemons JA. Breast-feeding the premature infant.
122. Friis H, Andersen HK. Rate of inactivation of cytomegalovirus in raw
banked milk during storage at Ϫ20 degrees C and pasteurisation. Br
152. Kron RE, Stein M, Goddard KE. Newborn sucking behavior affected
Med J (Clin Res Ed).
by obstetric sedation. Pediatrics.
123. Anderson PO. Alcohol and breastfeeding. J Hum Lact.
153. Ransjo-Arvidson AB, Matthiesen AS, Lilja G, Nissen E, Widstrom AM,
124. American Academy of Pediatrics, Subcommittee on Hyperbiliru-
Uvnas-Moberg K. Maternal analgesia during labor disturbs newborn
binemia. Management of hyperbilirubinemia in the newborn infant 35
behavior: effects on breastfeeding, temperature, and crying. Birth.
or more weeks of gestation. Pediatrics.
125. Ryan AS, Wenjun Z, Acosta A. Breastfeeding continues to increase into
154. Widstrom A-M, Thingstrom-Paulsson J. The position of the tongue
the new millennium. Pediatrics.
during rooting reflexes elicited in newborn infants before the first
126. Polhamus B, Dalenius K, Thompson D, et al. Pediatric Nutrition Sur-
suckle. Acta Paediatr.
veillance 2001 Report
. Atlanta, GA: US Department of Health and Hu-
155. Wolf L, Glass RP. Feeding and Swallowing Disorders in Infancy: Assess-
man Services, Centers for Disease Control and Prevention; 2003
ment and Management
. San Antonio, TX: Harcourt Assessment, Inc;
127. American College of Obstetricians and Gynecologists. Breastfeeding:
maternal and infant aspects. ACOG Educational Bulletin Number 258
156. Righard L, Alade MO. Effect of delivery room routine on success of
Washington, DC: American College of Obstetricians and
first breast-feed. Lancet.
157. Wiberg B, Humble K, de Chateau P. Long-term effect on mother-infant
128. American Academy of Family Physicians. AAFP Policy Statement on
behavior of extra contact during the first hour post partum. V. Fol-
. Leawood, KS: American Academy of Family Physicians;
low-up at three years. Scand J Soc Med. 1989;17:181–191
158. Mikiel-Kostyra K, Mazur J, Boltruszko I. Effect of early skin-to-skin
129. Fifty-Fourth World Health Assembly. Global Strategy for Infant and
contact after delivery on duration of breastfeeding: a prospective co-
Young Child Feeding. The Optimal Duration of Exclusive Breastfeeding
hort study. Acta Paediatr.
Geneva, Switzerland: World Health Organization; 2001
159. Christensson K, Siles C, Moreno L, et al. Temperature, metabolic
130. United Nations Children’s Fund. Breastfeeding: Foundation for a Healthy
adaptation and crying in healthy, full-term newborns cared for skin-
. New York, NY: United Nations Children’s Fund; 1999
to-skin or in a cot. Acta Paediatr.
1992;81:488 – 493
160. Van Den Bosch CA, Bullough CH. Effect of early suckling on term
185. Sugarman M, Kendall-Tackett KA. Weaning ages in a sample of Amer-
neonates’ core body temperature. Ann Trop Paediatr.
ican women who practice extended breastfeeding. Clin Pediatr (Phila).
161. Sosa R, Kennell JH, Klaus M, Urrutia JJ. The effect of early mother-
186. Dallman PR. Progress in the prevention of iron deficiency in infants.
infant contact on breast feeding, infection and growth. In: Lloyd JL, ed.
Acta Paediatr Scand Suppl.
Breast-feeding and the Mother
. Amsterdam, Netherlands: Elsevier; 1976:
187. Domellof M, Lonnerdal B, Abrams SA, Hernell O. Iron absorption in
breast-fed infants: effects of age, iron status, iron supplements, and
162. American Academy of Pediatrics, American College of Obstetricians
complementary foods. Am J Clin Nutr.
and Gynecologists. Care of the neonate. In: Gilstrap LC, Oh W, eds.
188. American Academy of Pediatrics, Committee on Fetus and Newborn,
Guidelines for Perinatal Care
. 5th ed. Elk Grove Village, IL: American
and American College of Obstetricians and Gynecologists. Nutritional
needs of preterm neonates. In: Guidelines for Perinatal Care
. 5th ed.
163. Shrago L. Glucose water supplementation of the breastfed infant dur-
Washington, DC: American Academy of Pediatrics, American College
ing the first three days of life. J Hum Lact.
of Obstetricians and Gynecologists; 2002:259 –263
164. Goldberg NM, Adams E. Supplementary water for breast-fed babies in
189. American Academy of Pediatrics, Committee on Nutrition. Nutritional
a hot and dry climate—not really a necessity. Arch Dis Child.
needs of the preterm infant. In: Kleinman RE, ed. Pediatric Nutrition
. 5th ed. Elk Grove Village, IL: American Academy of
165. Eidelman AI. Hypoglycemia in the breastfed neonate. Pediatr Clin
190. Pisacane A, De Vizia B, Valiante A, et al. Iron status in breast-fed
166. Howard CR, Howard FM, Lamphear B, de Blieck EA, Eberly S, Law-
infants. J Pediatr.
1995;127:429 – 431
rence RA. The effects of early pacifier use on breastfeeding duration.
191. Griffin IJ, Abrams SA. Iron and breastfeeding. Pediatr Clin North Am.
1999;103(3). Available at: www.pediatrics.org/cgi/content/
192. Dewey KG, Cohen RJ, Rivera LL, Brown KH. Effects of age of intro-
167. Howard CR, Howard FM, Lanphear B, et al. Randomized clinical trial
duction of complementary foods on iron status of breastfed infants in
of pacifier use and bottle-feeding or cupfeeding and their effect on
Honduras. Am J Clin Nutr.
1998;67:878 – 884
193. Naylor AJ, Morrow AL. Developmental Readiness of Normal Full Term
168. Schubiger G, Schwarz U, Tonz O. UNICEF/WHO Baby-Friendly Hos-
Infants to Progress From Exclusive Breastfeeding to the Introduction of
pital Initiative: does the use of bottles and pacifiers in the neonatal
Complementary Foods: Reviews of the Relevant Literature Concerning
nursery prevent successful breastfeeding? Neonatal Study Group. Eur
Infant Immunologic, Gastrointestinal, Oral Motor and Maternal Repro-
ductive and Lactational Development
. Washington, DC: Wellstart In-
169. Kramer MS, Barr RG, Dagenais S, et al. Pacifier use, early weaning, and
ternational and the LINKAGES Project/Academy of Educational
cry/fuss behavior: a randomized controlled trial. JAMA.
194. Cohen RJ, Brown KH, Canahuati J, Rivera LL, Dewey KG. Determi-
170. Gunther M. Instinct and the nursing couple. Lancet.
nants of growth from birth to 12 months among breast-fed Honduran
171. Klaus MH. The frequency of suckling. A neglected but essential
infants in relation to age of introduction of complementary foods.
ingredient of breast-feeding. Obstet Gynecol Clin North Am.
195. Ashraf RN, Jalil F, Aperia A, Lindblad BS. Additional water is not
172. Procianoy RS, Fernandes-Filho PH, Lazaro L, Sartori NC, Drebes S.
needed for healthy breast-fed babies in a hot climate. Acta Paediatr.
The influence of rooming-in on breastfeeding. J Trop Pediatr.
196. Huffman SL, Ford K, Allen H, Streble P. Nutrition and fertility in
173. Anderson GC. Risk in mother-infant separation postbirth. Image J Nurs
Bangladesh: breastfeeding and post partum amenorrhoea. Popul Stud
174. Riordan J, Bibb D, Miller M, Rawlins T. Predicting breastfeeding
197. Dettwyler KA. A time to wean: the hominid blueprint for the natural
duration using the LATCH breastfeeding assessment tool. J Hum Lact.
age of weaning in modern human populations. In: Stuart-Macadam P,
Dettwyler KA, eds. Breastfeeding: Biocultural Perspectives
175. Hall RT, Mercer AM, Teasley SL, et al. A breast-feeding assessment
score to evaluate the risk for cessation of breast-feeding by 7 to 10 days
198. American Academy of Pediatrics, Committee on Nutrition. Iron forti-
of age. J Pediatr.
2002;141:659 – 664
fication of infant formulas. Pediatrics.
176. American Academy of Pediatrics, Committee on Practice and Ambu-
199. American Academy of Pediatrics, Committee on Fetus and Newborn.
latory Medicine. Recommendations for preventive pediatric health
Controversies concerning vitamin K and the newborn. Pediatrics.
177. American Academy of Pediatrics, Committee on Fetus and Newborn.
200. Hansen KN, Ebbesen F. Neonatal vitamin K prophylaxis in Denmark:
Hospital stay for healthy term newborns. Pediatrics.
three years’ experience with oral administration during the first three
178. Ahn CH, MacLean WC Jr. Growth of the exclusively breast-fed infant.
months of life compared with one oral administration at birth. Acta
179. Brown KH, Dewey KG, Allen LH. Complementary Feeding of Young
201. Gartner LM, Greer FR; American Academy of Pediatrics, Section on
Children in Developing Countries: A Review of Current Scientific Knowl-
Breastfeeding and Committee on Nutrition. Prevention of rickets and
. Publication No. WHO/NUT/98.1. Geneva, Switzerland: World
vitamin D deficiency: new guidelines for vitamin D intake. Pediatrics.
180. Heinig MJ, Nommsen LA, Peerson JM, Lonnerdal B, Dewey KG. Intake
202. Centers for Disease Control and Prevention. Recommendations for
and growth of breast-fed and formula-fed infants in relation to the
using fluoride to prevent and control dental caries in the United States.
timing of introduction of complementary foods: the DARLING study.
MMWR Recomm Rep.
Davis Area Research on Lactation, Infant Nutrition, and Growth. Acta
203. Blair PS, Fleming PJ, Smith IJ, et al. Babies sleeping with parents:
case-control study of factors influencing the risk of the sudden infant
181. Kramer MS, Kakuma R. The Optimal Duration of Exclusive Breastfeeding.
death syndrome. BMJ.
A Systematic Review
. Geneva, Switzerland: World Health Organization;
204. Charpak N, Ruiz-Pelaez JG, Figueroa de C Z, Charpak Y. Kangaroo
mother versus traditional care for newborn infants Յ2000 grams: a
182. Chantry CJ, Howard CR, Auinger P. Breastfeeding fully for 6 months
randomized, controlled trial. Pediatrics.
vs. 4 months decreases risk of respiratory tract infection [abstract
205. Hurst N, Valentine CJ, Renfro L, Burns P, Ferlic L. Skin-to-skin holding
in the neonatal intensive care influences maternal milk volume. J
183. Dewey KG, Cohen RJ, Brown KH, Rivera LL. Effects of exclusive
breastfeeding for four versus six months on maternal nutritional status
206. Hughes V. Guidelines for the establishment and operation of a human
and infant motor development: results of two randomized trials in
milk bank. J Hum Lact.
Honduras. J Nutr.
207. Human Milk Banking Association of North America. Guidelines for
184. Butte NF, Lopez-Alarcon MG, Garza C. Nutrient Adequacy of Exclusive
Establishment and Operation of a Donor Human Milk Bank
. Raleigh, NC:
Breastfeeding for the Term Infant During the First Six Months of Life
Human Milk Banking Association of North America Inc; 2003
Geneva, Switzerland: World Health Organization; 2002
208. Arnold LD. Clinical uses of donor milk. J Hum Lact.
209. Kaplan M, Hammerman C. Severe neonatal hyperbilirubinemia: a
214. American Academy of Pediatrics, Breastfeeding Promotion in Physi-
potential complication of glucose-6-phosphate dehydrogenase defi-
cians’ Office Practices Program. Elk Grove Village, IL: American Acad-
ciency. Clin Perinatol.
210. Kaplan M, Vreman HJ, Hammerman C, Schimmel MS, Abrahamov A,
215. Freed GL, Clark SJ, Lohr JA, Sorenson JR. Pediatrician involvement in
Stevenson DK. Favism by proxy in nursing glucose-6-dehydrogenase-
breast-feeding promotion: a national study of residents and practitio-
deficient neonates. J Perinatol.
1995;96:490 – 494
211. Gerk PM, Kuhn RJ, Desai NS, McNamara PJ. Active transport of
216. Brown LP, Bair AH, Meier PP. Does federal funding for breastfeeding
nitrofurantoin into human milk. Pharmacotherapy.
2001;21:669 – 675
research target our national health objectives? Pediatrics.
212. American Academy of Pediatrics, Section on Pediatric Dentistry. Oral
Available at: www.pediatrics.org/cgi/content/full/111/4/e360
health risk assessment timing and establishment of the dental home.Pediatrics.
213. Fewtrell MS, Lucas P, Collier S, Singhal A, Ahluwalia JS, Lucas A.
Randomized trial comparing the efficacy of a novel manual breast
All policy statements from the American Academy of
pump with a standard electric breast pump in mothers who delivered
Pediatrics automatically expire 5 years after publication unless
preterm infants. Pediatrics.
reaffirmed, revised, or retired at or before that time.
5 • CONTENUTO DEI FITOTERAPICI: POCHE CERTEZZE, RAGIONEVOLI DUBBI Albert Szent-Györgyi, premio Nobel nel 1937 per studi fondamen-tali sulla vitamina C, era solito ripetere che se si studiassero con mag-giore attenzione le sostanze che già abbiamo sugli scaffali delle farma-cie e/o dei laboratori si conseguirebbero probabilmente risultati più si-gnificativi e utili per l’uomo che
PRESCRIBING INFORMATION ©2011 GlaxoSmithKline Inc. All Rights Reserved ®K-10 is a registered trademark, used under license by GlaxoSmithKline Inc. PRESCRIBING INFORMATION NAME OF DRUG (Potassium Chloride Solution, 10%) THERAPEUTIC CLASSIFICATION INDICATIONS The prevention and treatment of hypokalemic states which may occur in conjunction with diuretic therapy, di