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Comment & Response
March 2, 2020

Extending Personalized Medicine from Mothers to Newborns—Reply

Author Affiliations
  • 1Boston Medical Center, Department of Pediatrics, Boston University School of Medicine, Boston, Massachusetts
  • 2Vermont Oxford Network, Burlington
  • 3Robert Larner College of Medicine, Department of Pediatrics, University of Vermont, Burlington
  • 4Department of Mathematics and Statistics, University of Vermont College of Engineering and Mathematical Sciences, Burlington
JAMA Pediatr. Published online March 2, 2020. doi:10.1001/jamapediatrics.2019.6266

In Reply We thank Triunfo for her interest and thoughtful comments to our article in JAMA Pediatrics, “National Trends in the Provision of Human Milk at Hospital Discharge Among Very-Low-Birth-Weight [VLBW] Infants.”1 We whole-heartedly agree with the 2 main points brought forward for further discussion. Regarding the first point, we agree that discussions regarding health benefits of human milk should begin during the prenatal course with obstetrical clinicians because most mothers make decisions about infant feeding before delivery. The American College of Obstetrics and Gynecology (ACOG) stresses the importance of the role of the obstetrician in breastfeeding support and strongly recommends incorporating education and lactation support into routine prenatal care, including helping women make informed choices about their breastfeeding goals, assessment of previous breastfeeding difficulties and experiences, and providing accurate advice regarding safe medication use while breastfeeding. Regarding women with preterm infants, ACOG recommends that these women should receive anticipatory guidance on establishing a full milk supply and that “hospital staff should facilitate early, frequent milk expression within 1 hour of delivery, if possible.”2

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