USPSTF recommends counseling to support breastfeeding

Key takeaways:

• Interventions may benefit infant and maternal health.
• Interventions increased the rate of breastfeeding throughout the first several months of life.
• Several factors can affect breastfeeding rates.

The U.S. Preventive Services Task Force released a draft recommendation encouraging physicians to provide counseling that supports breastfeeding to people who are pregnant or who recently gave birth.

The recommendation, a B grade, is an update to the task force’s 2016 recommendation on interventions that support breastfeeding.

“Breastfeeding can help babies stay healthy by reducing their risk of infections and making it less likely that they’ll develop conditions like asthma,” USPSTF member Esa Davis, MD, MPH, said in a press release. “While the decision to breastfeed is a personal one and often affected by conditions outside of the mom’s control, there are proven ways to support those who choose to breastfeed.”

According to the task force, breastfeeding has proven benefits for infants, like reducing the risk for chronic diseases, and could have health benefits for the person breastfeeding.

The USPSTF added that breastfeeding rates “remain modest” in the United States despite the benefits. CDC data showed that 78.6% of infants born in 2019 received any breast milk at 1 month of life, which decreased to 55.8% at 6 months.

Interventions supporting breastfeeding may include education and social, practical or psychological support and can be provided individually or combined by clinicians, other health care professionals or peers, the task force explained.

In the draft evidence report, the researchers reviewed 90 randomized controlled trials evaluating interventions in primary care settings that support breastfeeding to determine health outcomes and harms.

They found that there was mixed evidence across 10 studies on the interventions’ effects on infant health, like gastrointestinal outcomes, the number of health care visits for respiratory tract illnesses and otitis media.

The report conveyed that more favorable health outcomes among infants born to interventions vs. those in control groups, but very few differences achieved statistical significance.

Meanwhile, nine studies showed that mothers using interventions had better symptom scores for anxiety, depression and well-being compared with mothers in control groups, but the differences did not achieve statistical significance.

The researchers also noted that the interventions corresponded with greater rates of any and exclusive breastfeeding at less than 3 months, 3 to 6 months and at 6 months or greater, whereas there were no indications of harm related to the interventions.

The USPSTF underlined that there are many societal, cultural, historical and structural factors that could influence breastfeeding rates, such as access to interventions.

The task force thus advised clinicians to be mindful of factors affecting disparities within breastfeeding rates and that not all people can or choose to breastfeed.

“It can often be hard for moms to get the support they need to breastfeed for as long as they’d like,” USPSTF member James Stevermer, MD, MSPH, said in the release. “We need to make it easier for new parents to get help and are calling for more research to better understand the barriers to breastfeeding, as well as how to reduce them.”

Comments on the draft recommendation can be submitted here from Oct. 22 through Nov. 18.

References:

• Behavioral counseling interventions to support breastfeeding: U.S. Preventive Services Task Force draft recommendation statement. Available at: https://www.uspreventiveservicestaskforce.org/uspstf/draft-recommendation/breastfeeding-interventions. Published Oct. 22, 2024. Accessed Oct. 22, 2024.
• CDC. Breastfeeding report card. Available at: https://www.cdc.gov/breastfeeding/data/reportcard.htm. Accessed Oct. 22, 2024.
• Interventions to support breastfeeding: Updated evidence report and systematic review for the U.S. Preventive Services Task Force. Available at: https://www.uspreventiveservicestaskforce.org/uspstf/document/draft-evidence-review/breastfeeding-interventions. Published Oct. 22, 2024. Accessed Oct. 22, 2024.
• U.S. Preventive Services Task Force issues draft recommendation statement on interventions to support breastfeeding. Available at: https://www.uspreventiveservicestaskforce.org/uspstf/sites/default/files/file/supporting_documents/breastfeeding-interventions-draft-rec-bulletin.pdf. Published Oct. 22, 2024. Accessed Oct. 22, 2024.