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Rural Health Information Hub

First Year of Life and Breastfeeding

In early childhood, it is important for families to follow a regular schedule of pediatric visits, recommended by the American Academy of Pediatrics. Consistently attending well-child checkups and appointments during a child's early months and years is critical. These appointments allow healthcare providers and family members to do screenings and assessments, track growth patterns, provide vaccinations, and ensure the child is reaching developmental milestones. When parents follow the wellness visit schedules, healthcare providers are in a good position to assess health and development from birth through early childhood. Healthcare providers should be trained to refer families to other resources when necessary. Nearly half of newborns and 40% of U.S. children are covered by Medicaid, which pays for early childhood well-child checks.

For families in rural communities, distance to healthcare services can be a barrier to attending well-child checkups. It can be particularly burdensome to families of children with special healthcare needs that need frequent trips to receive medical care. Telehealth has been successful in treating children, including addressing childhood obesity, though it should not replace in-person well-child visits with a pediatrician or other primary care provider.

Support for breastfeeding can also be provided during well-child visits. The World Health Organization (WHO) and the American Academy of Pediatrics (AAP) recommend a diet exclusively of breast milk to babies for the first 6 months of life, with the introduction of solids around 6 months of age. Breast milk provides all the nutrients a newborn needs. Some evidence supports breast milk as a protective factor against obesity. It has been shown to protect infants against other acute, as well as chronic conditions, such as ear infections, lower respiratory infections, eczema, childhood leukemia, and sudden infant death syndrome (SIDS).

Breastfeeding initiation and duration rates are historically lower in rural than urban areas, especially in Southern and Midwestern states. Many factors contribute to these disparities, including:

  • Maternal characteristics
    • Age
    • Education
    • Income
    • Socioeconomic status
  • Social influences
  • The healthcare system and other factors
    • Lack of breastfeeding programs and services
    • Lack of resources for providing support for mothers
    • Lack of access to healthcare resources
    • Travel distance to reach healthcare resources

In rural communities, breastfeeding support programs with volunteer peer counseling programs have been most successful. More information on breastfeeding programs and the importance for children's health can be found in Module 2. Additional information about the importance of access to healthcare for early childhood and challenges rural communities may face can be found in Module 4: Access to Healthcare.

Resources to Learn More

The AAP Parenting Website
Provides resources for parents at age-specific intervals for children through young adulthood, and includes information and tools for pregnant women.
Organization(s): American Academy of Pediatrics

Breastfeeding State Laws
Summarizes accumulated federal and state statutes from all states, the District of Columbia, and U.S. territories.
Organization(s): National Conference of State Legislatures

Promoting Maternal and Infant Health in the 4th Trimester
Highlights the 3-month transition period women experience after childbirth. Looks specifically at six health themes that directly impact maternal and infant health: mood and emotional well-being; infant care and feeding; sexuality, contraception, and birth spacing; sleep and fatigue; physical recovery from birth; and medications, substances, and exposures.
Author(s): Verbiest, S.B., Tully, K.P., & Stuebe, A.M.
Organization(s): Zero to Three
Date: 3/2017

Ten Steps to Successful Breastfeeding
Describes the Ten Steps to Successful Breastfeeding initiative, a group of policies and procedures promoting maternity and newborn services that support mothers in getting breastfeeding off to a good start.
Organization(s): World Health Organization