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
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
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:
- Socioeconomic status
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.
Organization(s): National Conference of State Legislatures
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
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