There are many ways obstetricians and gynecologists can help mothers reach their breastfeeding goals even long after delivery – and doctors should continue playing their part, urged the American College of Obstetricians and Gynecologists (ACOG).

At the same time, the group supports a mother’s decision to discontinue or refuse breastfeeding based on her own informed decision, it says in an update to its 2007 opinion.

ACOG is now one with other organizations, such as the American Academy of Pediatrics (AAP) and the Association of Women’s Health, Obstetric and Neonatal Nurses (AWHONN), in recommending breastfeeding for up to one year. It also promotes exclusive breastfeeding for an infant’s first six months of life.

ACOG says that ob-gyns are “uniquely positioned” to support breastfeeding mothers due to their expertise and advocacy in women’s health.

“[O]bstetric providers can and must help, both by assisting their patients and by advocating for policies and practices that enable women to achieve their goals," says Dr. Alison Stuebe, lead author of the updated committee opinion.

Talks on breastfeeding should begin early in pregnancy. Doctors must know a woman's breastfeeding history, concerns and risk factors. 

The group, however, calls on providers to respect a woman's decision on whether she will initiate, proceed with or discontinue breastfeeding. 

“[Ob-gyns should be recognizing that [a mother] is uniquely qualified to decide whether exclusive breastfeeding, mixed feeding or formula feeding is optimal for her and her infant,” the opinion says.

Breastfeeding is an integral part of caring for women and their babies during and after childbirth, with steps such as rooming-in and feeding on demand.

These practices are also recommended for cesarean deliveries, where skin-to-skin contact between mother and baby has been linked to a reduced need for formula milk. Cesarean birth, however, has been associated with lower breastfeeding rates, and this is where greater support and encouragement from ob-gyns is needed. 

Drug safety is another critical matter. There are medications that should not be taken while pregnant but may be safe while one is lactating.

ACOG also reiterates its support for related maternal rights that in turn help sustain breastfeeding. It highlights the roles of benefits such as paid maternity leaves, on-site childcare, break time and a suitable breastfeeding location in encouraging women to breastfeed. 

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