Breastfeeding Recommendations for Newborns

Core Recommendations for Exclusively Breastfed Infants

The American Academy of Pediatrics recommends exclusive breastfeeding for approximately 6 months after birth, followed by continued breastfeeding along with appropriate complementary foods introduced at about 6 months, as mutually desired by mother and child for 2 years or beyond 1, 2, 3
Exclusive breastfeeding (no other liquids or foods) should be maintained for approximately 6 months 1, 2, 3
Breastfed infants should receive vitamin D supplementation (400 IU daily) beginning in the first few days of life 1
Iron supplementation may be needed for preterm infants until they are consuming a completely mixed diet and their growth and hematologic status are normalized 1
No other supplements are routinely needed for healthy, exclusively breastfed infants 1

Complementary foods should be introduced at about 6 months, not before 4 months 1, 4, 5
Foods rich in protein, iron, and zinc (such as finely ground meats, chicken, or fish) are good first choices to complement breast milk 1, 5
Fruits and vegetables are also appropriate early complementary foods 5
Breast milk should remain the major component of the infant's diet as complementary foods are gradually introduced 1, 4

For infants at moderate or low risk of peanut allergy, peanut can be introduced at 6 months 1, 6, 5
For infants with severe eczema, egg allergy, or both, consider evaluation by specific peanut IgE measurement and/or skin prick testing before introducing peanut between 4-6 months 6
Foods containing egg need not be differentiated from other complementary foods 6

Pediatricians should directly communicate with families that breastfeeding is a medical and health priority 1
Incorporate breastfeeding observation into routine care 1
Avoid introducing complementary foods before 4-6 months, as this may reduce breastfeeding duration and displace valuable nutrients from breast milk 1
Avoid formula supplementation in the first 2 days of life unless medically indicated 1, 7

Exclusive breastfeeding should be protected and promoted not only as the healthier but also as the most sustainable feeding option 8
Commercial milk formula has significant environmental impacts compared to breastfeeding 8
Policies that protect breastfeeding, including paid maternity leave, insurance coverage for lactation support, and workplace accommodations for expressing milk are essential 4