Breast-feeding exclusively for 4 to 6 months is best for most infants. It is rare for formula milk to be preferable. According to a synthesis of rigorous studies evaluating the factors promoting breast-feeding, counselling mothers before birth encourages them to choose breast-feeding and for a longer period. Skin-to-skin contact between mother and infant for at least 30 minutes and feeding as soon as possible after birth should be encouraged.
Practical support showing mothers how to breast-feed efficiently contributes to success, especially with first-time mothers. Feeding on demand, with no restrictions on frequency or duration, encourages women to continue breast-feeding.
Keeping the infant in the mother’s bedroom day and night, from day one, does not seem to affect the amount of sleep the mother gets and seems the best way to ensure successful breast-feeding.
If the child has to be separated from the mother, using a breast pump from the start, and frequently, promotes milk production. Giving the infant formula milk should be avoided. Use of dummies or "pacifiers" tends to be associated with failed attempts at breast-feeding.
All this advice is only effective if a breast-feeding policy is in place: training health professionals as breast-feeding counsellors; promoting breast-feeding in maternity hospitals and banning all promotion of formula milk; and making working conditions compatible with breast-feeding.
©Prescrire August 2009
Source: "Promouvoir un allaitement maternel, Troisième partie". Rev Prescrire 2008; 28 (299): 689-692.
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