Topics
Obstetrics
Four Urgent Actions for the Rights to Culturally Safe Breastfeeding for Aboriginal and Torres Strait Islander Mothers and Babies to Breastfeed in Neonatal Intensive Care Environments
Breast milk provides both short-term and long-term health benefits and is critical for infants admitted to neonatal intensive care units (NICUs). Presently, there is a large focus on increasing breastfeeding rates among Aboriginal and Torres Strait Islander women; however, culturally safe breastfeeding support is under-recognised and inadequately addressed in the NICU setting. This perspective highlights cultural and structural barriers and calls for urgent action to include the following four proposed strategies: strengthening the Aboriginal lactation workforce, embedding culturally inclusive education, partnering with community-controlled services, and developing a culturally specific NICU breastfeeding policy to improve outcomes.
Jessica Bennett, Jamie Bryant, Kade Booth, Michelle Kennedy
Australian Guidelines for Assessment and Diagnosis of Fetal Alcohol Spectrum Disorder: Overview of the Development Process and Revised Diagnostic Criteria
Introduction The Australian Guidelines for the Assessment and Diagnosis of Fetal Alcohol Spectrum Disorder were released in May 2025. These guidelines, updated from the 2016 Australian Guide, were developed through extensive stakeholder consultation, a comprehensive review of empirical evidence and the application of a novel Grading of Recommendations, Development and Evaluation (GRADE)-based approach for developing evidence-based diagnostic criteria. Recommendations The guidelines include 11 GRADE-based recommendations, forming the core of the diagnostic criteria, and 11 lived experience statements, supporting client-centred assessment approaches. The guidelines also feature 40 good practice statements and 18 implementation considerations, tools and tips as practical resources and supports for practitioners. Changes in Management as a Result of the Guidelines Key changes in the new guidelines include: A minimum prenatal alcohol exposure threshold for diagnosis to support more precise identification of fetal alcohol spectrum disorder (FASD); The assessment of neurodevelopmental impairments and functioning has been refined, including detailed advice for practitioners seeking to identify clinically significant impairments; Inclusion/exclusion of neurodevelopmental domains as part of the assessment; and Revisions to some of the content of the included neurodevelopmental domains. Changes have also been made with attention to the needs of First Nations Australians and people from other culturally and linguistically diverse backgrounds. The guidelines advocate for the use of shared decision-making approaches, promoting collaboration between practitioners, individuals attending for assessment and their support network. Importantly, the guidelines will enable an accessible, holistic and flexible assessment process, supporting timely and accurate assessment and diagnosis of FASD in Australia. The rigorous development process also provides practitioners with confidence in the guidelines, promoting increased uptake of assessment and diagnostic practices, and informing international diagnostic criteria and guidelines.
Natasha Reid · Nicole Hewlett, Nicole Hayes, Zachary Munn, Haydn Till, Delyse Hutchinson · James Stewart, Max Naglazas, Andrea Crawford, Raewyn C. Mutch, Carmela F. Pestell, Rowena Friend, Lisa K. Akison · Chelsea Vanderpeet, Prue Walker, Matthew Gullo, Doug Shelton, Elizabeth J. Elliott, Fiona Kay, Katrina Harris, Jayden Logan, Storm Anderson · Natalie R. Kippin, Seema Padencheri, Sophie Harrington, Diana Barnett, Kelly Skorka, Robyn Doney · Philippa Middleton
Maternal mortality trends in Australia
Maternal death is low and decreasing in Australia, but continuing surveillance is important
Michael D Humphrey
