Pediatrics. Consilium MedicumPediatrics. Consilium MedicumПедиатрия. Consilium Medicum2658-66302658-6622Consilium Medicum68739810.26442/26586630.2025.2.203341ArticlesСтатьиReview ArticleLactation dominant: How does a woman make her choice? A reviewДоминанта лактации: как женщина делает свой выбор?https://orcid.org/0000-0003-4200-4598ZakharovaIrina N.ЗахароваИрина Николаевна
Russian Federation

D. Sci. (Med.), Prof.

д-р мед. наук, проф., зав. каф. педиатрии им. акад. Г.Н. Сперанского, засл. врач России

zakharova-rmapo@yandex.ruhttps://orcid.org/0000-0002-2861-5619SugianNarine G.СугянНарине Григорьевна
Russian Federation

Cand. Sci. (Med.)

канд. мед. наук, доц. каф. педиатрии им. акад. Г.Н. Сперанского ФГБОУ ДПО РМАНПО, зам. глав. врача ГБУЗ МО ХКБ

zakharova-rmapo@yandex.ruhttps://orcid.org/0009-0005-2121-4010OrobinskayaYana V.ОробинскаяЯна Владимировна
Russian Federation

Assistant

ассистент каф. педиатрии им. акад. Г.Н. Сперанского ФГБОУ ДПО РМАНПО, врач-педиатр поликлиники «Мама и малыш» ГБУЗ МО ХКБ

zakharova-rmapo@yandex.ruRussian Medical Academy of Continuous Professional EducationФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава РоссииKhimki Clinical HospitalГБУЗ Московской области «Химкинская клиническая больница»1407202521141191307202513072025Copyright ©; 2025, Consilium MedicumCopyright ©; 2025, ООО "Консилиум Медикум"2025Consilium MedicumООО "Консилиум Медикум"https://creativecommons.org/licenses/by-nc-sa/4.0https://pediatria.orscience.ru/2658-6630/article/view/687398

Breast milk has numerous health benefits, but in high-income countries, breastfeeding rates remain below the recommended. Support and promotion of exclusive breastfeeding in the first months of life contributes to the reduction of morbidity and mortality and ensures the optimal development of the child. The timely start of feeding, skin-to-skin contact, professional support from healthcare personnel, and family motivation all play a crucial role. Educational programs and counseling are particularly important in the first days after birth, and an integrated approach that includes training, professional support, and enabling environments is a promising method to improve the rates of exclusive breastfeeding and any breastfeeding.

Грудное молоко обладает многочисленными полезными свойствами, однако в странах с высоким уровнем дохода показатели распространенности грудного вскармливания остаются ниже желаемых. Поддержка и продвижение исключительно грудного вскармливания в первые месяцы жизни способствует снижению заболеваемости, смертности и обеспечивает оптимальное развитие ребенка. Важную роль в этом процессе играют своевременное начало кормления, контакт «кожа-к-коже», профессиональная поддержка медицинского персонала и семейная мотивация. Образовательные программы и консультирование особенно важны в первые дни после рождения, а комплексный подход, включающий обучение, профессиональную поддержку и создание благоприятных условий, является перспективным методом улучшения показателей исключительно грудного вскармливания и любого грудного вскармливания.

breastfeedingpracticeskin-to-skin contactpediatricianmotivationtrainingsocial factorsгрудное вскармливаниепрактикаконтакт кожа-к-кожепедиатрмотивацияобучениесоциальные факторыHoddinott J, Alderman H, Behrman JR, et al. The economic rationale for investing in stunting reduction. Matern Child Nutr. 2013;9 Suppl. 2(Suppl 2.):69-82. DOI:10.1111/mcn.12080WHO, t. s. Implementation of the Baby-friendly Hospital Initiative. World Health Organization: Available at: https://yandex.ru/search/?text=2.+https%3A%2F%2Fwww.who.int%2Ftools%2Felena%2Fbbc%2Fimplementation-bfhi.&clid=2355923&win=545&lr=213. Accessed: 20.06.2025.Guideline: protecting, promoting and supporting breastfeeding in facilities providing maternity and newborn services. World Health Organization. Available at: http://www.who.int/nutrition/publications/guidelines/breastfeeding-facilities-maternitynewborn/en/ Accessed: 22.06.2025.Pérez-Escamilla R. Breastfeeding in the 21st century: How we can make it work. Soc Sci Med. 2020;244:112331. DOI:10.1016/j.socscimed.2019.05Prentice AM. Breastfeeding in the Modern World. Ann Nutr Metab. 2022;78 Suppl. 2:29-38. DOI:10.1159/000524354Bagci Bosi AT, Eriksen KG, Sobko T, et al. Breastfeeding practices and policies in WHO European Region Member States. Public Health Nutr. 2016;19(4):753-64. DOI:10.1017/S1368980015001767Грудное вскармливание детей первого года жизни. Росстат. Режим доступа: https://rosstat.gov.ru/search?q=грудное+вскармливание. Ссылка активна на 28.06.2025 [Breastfeeding of children in the first year of life. Rosstat. Available at: https://rosstat.gov.ru/search?q=грудное+вскармливание. Accessed: 28.06.2025 (in Russian)].Victora CG, Bahl R, Barros AJ, et al. Breastfeeding in the 21st century: epidemiology, mechanisms, and lifelong effect. Lancet. 2016;387(10017):475-90. DOI:10.1016/S0140-6736(15)01024-7Collaborative Group on Hormonal Factors in Breast Cancer. Breast cancer and breastfeeding: collaborative reanalysis of individual data from 47 epidemiological studies in 30 countries, including 50302 women with breast cancer and 96973 women without the disease. Lancet. 2002;360(9328):187-95. DOI:10.1016/S0140-6736(02)09454-0Kozhimannil KB, Jou J, Attanasio LB, et al. Medically complex pregnancies and early breastfeeding behaviors: a retrospective analysis. PLoS One. 2014;9(8):e104820. DOI:10.1371/journal.pone.0104820Snyder K, Hulse E, Dingman H, et al. Examining supports and barriers to breastfeeding through a socio-ecological lens: a qualitative study. Int Breastfeed J. 2021;16(1):52. DOI:10.1186/s13006-021-00401-4Saleh L. Women's Perceived Quality of Care and Self-Reported Empowerment With Centering Pregnancy Versus Individual Prenatal Care. Nurs Womens Health. 2019;23(3):234-44. DOI:10.1016/j.nwh.2019.03.008Jackson L, De Pascalis L, Harrold J, Fallon V. Guilt, shame, and postpartum infant feeding outcomes: A systematic review. Matern Child Nutr. 2021;17(3):e13141. DOI:10.1111/mcn.13141Lawton R, Ashley L, Dawson S, et al. Employing an extended Theory of Planned Behaviour to predict breastfeeding intention, initiation, and maintenance in White British and South-Asian mothers living in Bradford. Br J Health Psychol. 2012;17(4):854-71. DOI:10.1111/j.2044-8287.2012.02083.xKehinde J, O'Donnell C, Grealish A. The effectiveness of prenatal breastfeeding education on breastfeeding uptake postpartum: A systematic review. Midwifery. 2023;118:103579. DOI:10.1016/j.midw.2022.10357Santacruz-Salas E, Aranda-Reneo I, Segura-Fragoso A, et al. Mothers' Expectations and Factors Influencing Exclusive Breastfeeding during the First 6 Months. Int J Environ Res Public Health. 2019;17(1):77. DOI:10.3390/ijerph17010077Haroon S, Das JK, Salam RA, et al. Breastfeeding promotion interventions and breastfeeding practices: a systematic review. BMC Public Health. 2013;13 Suppl. 3(Suppl. 3):S20. DOI:10.1186/1471-2458-13-S3-S20Rollins NC, Bhandari N, Hajeebhoy N, et al. Why invest, and what it will take to improve breastfeeding practices? Lancet. 2016;387(10017):491-504. DOI:10.1016/S0140-6736(15)01044-2Marín Gabriel MA, Llana Martín I, López Escobar A, et al. Randomized controlled trial of early skin-to-skin contact: effects on the mother and the newborn. Acta Paediatr. 2010;99(11):1630-4. DOI:10.1111/j.1651-2227.2009.01597.xWidström AM, Brimdyr K, Svensson K, et al. Skin-to-skin contact the first hour after birth, underlying implications and clinical practice. Acta Paediatr. 2019;108(7):1192-204. DOI:10.1111/apa.14754Meyerink RO, Marquis GS. Breastfeeding initiation and duration among low-income women in Alabama: the importance of personal and familial experiences in making infant-feeding choices. J Hum Lact. 2002;18(1):38-45. DOI:10.1177/089033440201800106Falceto OG, Giugliani ER, Fernandes CL. Couples' relationships and breastfeeding: is there an association? J Hum Lact. 2004;20(1):46-55. DOI:10.1177/0890334403261028Rodgers RF, Fischer LE, Zimmerman E. Partner influences, breastfeeding, and body image and eating concerns: An expanded biopsychosocial model. Appetite. 2022;169:105833. DOI:10.1016/j.appet.2021.105833Zimmerman E, Rodgers RF, O'Flynn J, Bourdeau A. Weight-Related Concerns as Barriers to Exclusive Breastfeeding at 6 Months. J Hum Lact. 2019;35(2):284-91. DOI:10.1177/0890334418797312Hoddinott P, Britten J, Prescott GJ, et al. Effectiveness of policy to provide breastfeeding groups (BIG) for pregnant and breastfeeding mothers in primary care: cluster randomised controlled trial. BMJ. 2009;338:a3026. DOI:10.1136/bmj.a3026Ware J, Piovanetti Y. Pediatricians Are Perfectly Positioned to Help Mothers Reach Their Breastfeeding Goals. Pediatrics. 2020;145(4):e20200216. DOI:10.1542/peds.2020-0216Brand E, Kothari C, Stark MA. Factors related to breastfeeding discontinuation between hospital discharge and 2 weeks postpartum. J Perinat Educ. 2011;20(1):36-44. DOI:10.1891/1058-1243.20.1.36Pérez-Escamilla R, Buccini GS, Segura-Pérez S, Piwoz E. Perspective: Should Exclusive Breastfeeding Still Be Recommended for 6 Months? Adv Nutr. 2019;10(6):931-43. DOI:10.1093/advances/nmz039Scime NV, Metcalfe A, Nettel-Aguirre A, et al. Breastfeeding difficulties in the first 6 weeks postpartum among mothers with chronic conditions: a latent class analysis. BMC Pregnancy Childbirth. 2023;23(1):90. DOI:10.1186/s12884-023-05407-wMeek JY, Feldman-Winter L, Noble L. Optimal Duration of Breastfeeding. Pediatrics. 2020;146(5):e2020021063. DOI:10.1542/peds.2020-021063Kellams A, Harrel C, Omage S, et al. ABM Clinical Protocol #3: Supplementary Feedings in the Healthy Term Breastfed Neonate, Revised 2017. Breastfeed Med. 2017;12:188-98. DOI:10.1089/bfm.2017.29038.ajkFeldman-Winter L, Kellams A, Peter-Wohl S, et al. Evidence-Based Updates on the First Week of Exclusive Breastfeeding Among Infants ≥35 Weeks. Pediatrics. 2020;145(4):e20183696. DOI:10.1542/peds.2018-3696Shah MH, Roshan R, Parikh T, et al. LATCH Score at Discharge: A Predictor of Weight Gain and Exclusive Breastfeeding at 6 Weeks in Term Healthy Babies. J Pediatr Gastroenterol Nutr. 2021;72(2):e48-e52. DOI:10.1097/MPG.0000000000002927