Having Enough Milk to Sustain a Lactation Journey: A Call to Action

ICM supports WHO,UNICEF, 2020 recommendations for all newborn to receive exclusive breastmilk and breastfeeding for the initial 6 months, with continued breastfeeding for 2 years and beyond.
Breast feeding rates continue to be suboptimal across the world, with infant formula sales increasing by 50% over the last 20 years.
For some newborns failure to breastfeed exposes them to disease and death. But for many women, inability to establish breastfeeding and an adequate milk supply leads to early cessation of breastfeeding.
This paper identifies those women who are more likely to encounter issues establishing breastfeeding where the physiology of lactation is disrupted.
It outlines the conditions and circumstances that hinder normal development of breast tissue, the physiological production of milk and the contributing factors related to the mother, the infant or to the birth.
Recognising these risk factors provides an opportunity for midwives and other health workers to intervene to encourage lactation rather than treat low milk supply in the days following birth. The first few days after birth are a critical window to optimize milk production. Strategies such as prenatal education, early skin-to-skin contact, support to latch within the first hour, rooming-in, no supplementation that is not medically indicated, and no pacifiers are effective.
Clinician support is vital to identify risk factors for establishing lactation, to provide education for the mother and her family network, and to proactively plan to increase supply from the outset. Breastfeeding shouldn’t be just for women without complications and risk factors.
ICM calls on midwives to increase knowledge and skills and step up to support women postnatally. By adopting policies and attitudes that value women and breastfeeding we are taking action to help women to breastfeed for longer.