(P10-082-24) Barriers and Facilitators to Adhere to Updated Breastfeeding Recommendations of the American Academy of Pediatrics

Objectives: In July of 2022, the American Academy of Pediatrics (AAP) updated its breastfeeding recommendations to encourage parents to breastfeed for at least 24 months if it is mutually desired by mother and child (from a previous recommendation of at least 12 months). This was based on evidence of the importance of continuing breastfeeding on the health and well-being of the mother and the child. We conducted a narrative literature review to describe the different factors potentially affecting the implementation of the updated AAP guidelines.

Methods: The review was based on the National Institute on Minority Health and Health Disparities Research Framework that operationalizes different levels and domains of influence. First we included the two published AAP articles describing the new recommendations and associated papers (such as those referenced in the articles). Then, we conducted a series of PubMed searches, filtered for publication date to the last 10 years (from 2013-2023), including the terms breastfeeding, maternal milk, human milk, breastfeeding initiation, breastfeeding continuation, exclusive breastfeeding, infant feeding and those identified based on our theoretical framework.

Results: We identified a total of 88 articles. Important factors were identified at the individual behavioral domain and the interpersonal level of influence. Barriers to adhering to AAP recommendations at these levels included social discomfort, physical discomfort, and lack of support. Conversely, factors supporting adherence included positive breastfeeding perceptions, feeling confident in breastfeeding knowledge, and availability of support groups.

Conclusions: This review highlighted important factors associated with adherence to the updated AAP breastfeeding recommendations at the individual and interpersonal levels, and at the behavioral domain. Results can inform future interventions to improve the implementation of the new guidelines and support breastfeeding continuation in the US.

Funding Sources: Indiana University Bloomington School of Public Health (No external funding)