For the first time in a decade, the American Academy of Pediatrics (AAP) has updated its breastfeeding guidelines. While the new policy statement continues to recommend exclusive breastfeeding until 6 months of age, the major change is that the organization now supports continued breastfeeding for two years or more.
The AAP also recognizes that more social and workplace support is needed to make extended breastfeeding happen. However, nursing for any length of time is taxing, and these days, mothers are more burned out than ever. So, what should you think about these new guidelines?
Let’s break down the AAP’s new recommendations and what they mean for you.
Timing is everything
While Dr. Joan Meek, the lead author of the policy statement, insists that the updated guidelines have been in the works for years, the timing of its release feels tone-deaf. To begin with, we seem caught in an endless pandemic where the job of childcare has fallen mainly to mothers, leaving them burned out and fleeing the workplace in record numbers. Being told to breastfeed longer may feel like an unwelcome addition to an already overflowing plate.
Being told to breastfeed longer may feel like an unwelcome addition to an already overflowing plate.
In addition, we’re in the middle of a formula shortage, which has many mothers already feeling stressed about how to feed their babies. Finally, seeing Roe v. Wade overturned has scores of women worried about restrictions on their physical autonomy and wary of being told what to do with their bodies.
Workplace support for breastfeeding remains a fantasy
Putting the bad timing of the AAP’s release aside, there are some positive messages in the policy statement. The guidelines state, “Mothers who decide to breastfeed beyond the first year need support. They often report feeling ridiculed or alienated in their choice and conceal their breastfeeding behavior to minimize unsolicited judgment and comments.”
This reads like an attempt to destigmatize longer-term breastfeeding and an admonition against judging moms for their personal choices, which is great! It’s exciting to see a major, well-respected medical organization like the AAP recognize how important it is to support mothers no matter how they choose to feed their children.
However, the needed breastfeeding “support” the AAP mentions has yet to materialize for many women. Currently, only 23 percent of non-government workers have access to paid family leave. And the PUMP Act, a bill that would have enshrined protections for breastfeeding on the job into law, recently failed in the Senate. A follow-up bill also seems doomed.
The guidelines for pediatricians are confusing
Beyond institutionalizing support for breastfeeding in the workplace, pediatricians are another key line of support for new moms. Yet the AAP guidance for pediatricians around the topic of breastfeeding is confusing. They are instructed to have “nonjudgmental conversations” with parents about the benefits of breastfeeding but also to “discourage the use of non-medically indicated supplementation with commercial infant formula.” So what’s a medical professional to do? And how are women supposed to trust that they’re getting the right advice?
Reading between the lines of “new evidence” on breastfeeding
Finally, while the AAP has cited “new evidence” on the benefits of breastfeeding as the reason for releasing the updated policy, the data on breastfeeding remains mixed. Economist and Brown professor, Emily Oster, devotes an entire chapter of her book, Cribsheet, to examine all the relevant breastfeeding data and its mixed outcomes. The chapter is available for free here.
This is not to say that the decision whether to breastfeed or not should be purely data-based. Some mothers simply enjoy the experience, the convenience, or have another reason for choosing to breastfeed. And shouldn’t that alone be enough for mothers to receive support for their breastfeeding choices? Why should breastfeeding only be supported if the data says it’s good for babies? Where are the moms in this equation?
What the new guidelines mean for you
Always trying to do the “right” thing in motherhood can be exhausting. It’s easy to get so caught up thinking about what’s best for the baby that we forget about what we need as mothers. The bottom line is that you know what’s best for you and your baby. You alone know how and if breastfeeding will work for you, whether it’s for two days or two years.
It’s easy to get so caught up thinking about what’s best for the baby that we forget about what we need as mothers.
Regardless of what form your feeding journey takes, the two questions to ask yourself are, “Is my baby healthy?” and “Is my personal mental health in good shape?” If you can answer yes to both questions, you’re doing something right.
If you struggle with those questions, talk to your pediatrician (provided they’re supportive of all feeding choices). Tell your partner or a trusted friend how you’re feeling. If breastfeeding is an obstacle to your or your baby’s health (mental or physical) then it may be time to consider other options—regardless of the AAP’s guidelines.