Human milk is recognized as the optimal feeding for all infants because of its proven health benefits to infants and their mothers. The World Health organization (WHO), the American Academy of Pediatrics (AAP), the American College of Obstetricians and Gynecologists (ACOG), and the United States Preventive Services Task Force all recommend breastfeeding for the first six months of life [1-4]. (See "Infant benefits of breastfeeding" and "Maternal and economic benefits of breastfeeding".)
In the United States, the Goals for Healthy People 2020 include the initiation of breastfeeding in 82 percent of newborns, and any continued breastfeeding in 61 percent of six month old infants . Successful achievement of these goals is dependent upon health care professionals providing antenatal and postnatal breastfeeding education and support. In particular, the delivery and hospital experience should promote and support initiation of breastfeeding to enhance the probability of successful breastfeeding.
The initiation of breastfeeding during the birth hospitalization will be reviewed here. Factors that influence the parental decision on whether to breastfeed, parental educational and supportive programs for breastfeeding, the composition of human milk, and complications of breastfeeding are discussed separately. (See "Breastfeeding: Parental education and support" and "Nutritional composition of human milk for full-term infants" and "Common problems of breastfeeding and weaning".)
During the birth hospitalization, higher initiation rates of breastfeeding occur in facilities with clinical practice policies that promote breastfeeding [6-13].
These policies are best summarized by the Ten Steps to Successful Breastfeeding developed by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF) as criteria for a Baby-Friendly Hospital [4,7,14]. They include the following: