Breastfeeding has long been encouraged by doctors, but new guidelines from the American Academy of Pediatrics (AAP) are ruffling parents’ feathers. Last week, the AAP released an updated policy statement that says the organization supports breastfeeding for at least two years. As parents grapple with an ongoing pandemic, loss of reproductive rights, food and formula shortages and so much more, the recommendations are being called out by many parents as unrealistic.
What are the AAP recommendations for breastfeeding?
Previously, AAP guidance supported breastfeeding exclusively for at least the first six months of a new baby’s life and continuing for one year or more. Now, the organization says doctors should advocate for breastfeeding “as mutually desired by mother and child for 2 years or beyond.”
“There are continued benefits from breastfeeding beyond one year, and up to two years especially in the mother,” the AAP says in a press release. “Long-term breastfeeding is associated with protections against diabetes, high blood pressure, and cancers of the breast and ovaries.”
In addition to extending the recommended length of breastfeeding, the AAP policy statement also recommends:
- Hospitals implement more practices to promote and initiate breastfeeding.
- Care providers do more to support breastfeeding moms.
- Employers and governments implement more policies to facilitate breastfeeding.
What parents are saying about the new AAP recommendations
While the AAP policy statement is in line with recommendations from the World Health Organization, the decision to advocate for longer breastfeeding rubbed some parents the wrong way. The U.S. makes it notoriously difficult for parents to breastfeed, particularly since the country lacks paid maternity leave and many of the social supports new parents need to establish and maintain a breastfeeding relationship.
Only slightly more than half of U.S. babies are still breastfed at 6 months old. Racial and socioeconomic disparities also play a major role in who is able to breastfeed. Lower income women are less likely to initiate breastfeeding, according to the AAP. Black parents are also less likely than white, Hispanic or Asian parents to breastfeed. The latest CDC data shows breastfeeding is initiated with 69.5% of Black infants, versus 85.9% of white infants, and factors like income, education and access to support may play a role.
Given all factors that make extended breastfeeding difficult, moms took to Twitter to express their annoyance and tell the folks at the AAP they need a reality check.
“The world is going to hell and the AAP is worried about breastfeeding rather than the structural conditions that make it harder to parent and putting their energy there,” one person writes. “You know what’s been shown to be great for kids? Stable housing. Food security. Freedom from violence.”
“Seriously? That’s what’s best for mothers?” Another person asks. “A country that doesn’t even have mandated parental leave, and they want women to nurse toddlers?”
One doctor says that extended breastfeeding is a beneficial practice, but it’s also true that it’s just not feasible for everyone.
“Extended breastfeeding is great if it’s what a parent wants. But providing breastmilk takes work,” she writes. “The benefits of breastmilk don’t always outweigh the real challenges of getting it, especially when it’s not a main source of nutrition. Only you know what’s right for your family.”
What the updated AAP policy means for parents
The latest guidance from the AAP is a suggestion, not a command, and the organization does recognize that there are institutional struggles that make extended breastfeeding more difficult. As a part of the policy update and to support breastfeeding parents, the organization calls for things like:
- Paid parental leave.
- Insurance coverage for lactation support.
- On-site child care.
- Universal workplace break-time.
- Lactation rooms.
But, as many of the parents who spoke out on Twitter note, those things are easier said than done. In June, the U.S. senate voted against the PUMP for Nursing Mothers Act, a bill that would have extended breastfeeding protections for nine million working moms. Additionally, less than 23% of workers had access to paid family and medical leave in 2021.
The policy changes encouraged by the AAP would likely improve life for many working parents, but U.S. leaders and employers have yet to prove that they’re willing to do much to enact benefits like on-site child care or paid leave. When that’s the case, it’s no wonder why many parents think the AAP’s policy statement feels more like wishful thinking than functional guidance.
Ultimately, many parents just want guidance that meets them where they are and is accessible within the current constraints of American life. If the recommendations they get include lofty goals for which there is little existing social support, it may feel less like help and more like breastfeeding parents are being set up for failure.
